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July 1997

Spinal Cord Injury: A Preventable Public Burden

Author Affiliations

From the Department of Surgery, University of California, San Francisco/Fresno University Medical Center, Fresno, Calif (Drs Tyroch and Kaups); the University of South Florida, Tampa, and the Division of Trauma, Tampa General Hospital, Tampa, Fla (Dr Davis); and the Department of Surgery, University of Puerto Rico, San Juan (Dr Lorenzo).

Arch Surg. 1997;132(7):778-781. doi:10.1001/archsurg.1997.01430310092020

Background:  Spinal cord injury (SCI) is a devastating occurrence with important consequences for the individual and society. Previous studies have documented the epidemiology and costs of SCI and the rehabilitation needs after SCI; however, data about the preventability of SCI are lacking.

Objective:  To test the hypotheses that most SCIs are preventable and that much of the cost of SCI is borne by the public.

Design:  Retrospective review of medical records and trauma registry data.

Setting:  A 417-bed county hospital with a level I trauma center.

Methods:  To evaluate the preventability of SCI, the records of trauma patients sustaining SCI from July 1, 1990, through June 30, 1995, were reviewed. The criteria for preventability of blunt injuries included the following: failure to use restraint devices; intoxication of drivers, motorcyclists, or pedestrians; and falls or diving accidents involving the use of drugs or alcohol. The criteria for preventability of penetrating injuries included the following: illegal possession of a firearm, accidental discharge of a weapon, and suicide attempts. Statistics were performed with the paired Student t test and X2 with significance attributed to a P value less than .05.

Results:  Spinal cord injury occurred in 150 patients; 71% of the injuries were the result of blunt trauma. Injury was potentially preventable in 74% of the blunt injuries and 66% of the penetrating injuries (P=.15). Patients with a penetrating SCI were younger (P<.001) and relied more on public funding than did those with a blunt SCI (65% vs 81%; P=.05).

Conclusions:  Most SCIs are preventable with strict enforcement of existing statutes. Furthermore, the financial burden of these preventable injuries is largely borne by the public.Arch Surg. 1997;132:778-781