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May 1993

Incidence, Characteristics, and Outcome of Spinal Cord Injury at Trauma Centers in North America

Author Affiliations

From the Departments of Surgery (Drs Burney and Maio) and Physical Medicine and Rehabilitation (Dr Maynard), and the Model Spinal Cord Injury Care System (Dr Maynard and Ms Karunas), The University of Michigan Medical Center, Ann Arbor.

Arch Surg. 1993;128(5):596-599. doi:10.1001/archsurg.1993.01420170132021

• Acute spinal cord injury occurred in 2.6% of the 114 510 patients entered into the Major Trauma Outcome Study from 1982 to 1989. The most common causes of spinal cord injury were motor vehicle accidents (40%), falls (20%), and gunshot wounds (13.6%). Almost 80% of patients with spinal cord injury had multiple injuries. Cervical cord injury was seen in 65% of patients with isolated spinal cord injury, but in only 52% of patients with multiple injuries. The hospital mortality rate was 17%, with patients with multiple injuries having a significantly higher mortality rate than patients with isolated spinal cord injury (19.8% vs 6.9%). The TRISS method overpredicted the mortality rate among patients with multiple injuries (450 vs 379), but not among those with isolated injury. A program for better national surveillance and prevention of spinal cord injury is warranted.

(Arch Surg. 1992;128:596-599)