Epidemiology of spinal cord injury without radiographic abnormality in children: A nationwide perspective
| Autor: | Jeffrey B. Knox |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Pediatrics Epidemiology Spinal cord injury without radiographic abnormality Spinal cord injury Primary Payer Trauma 03 medical and health sciences 0302 clinical medicine Patient age Original Clinical Article medicine Orthopedics and Sports Medicine Pediatrics Perinatology and Child Health 030222 orthopedics business.industry medicine.disease Sciwora Healthcare utilization Pediatrics Perinatology and Child Health Orthopedic surgery Physical therapy Epidemiologic data business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Children's Orthopaedics |
| ISSN: | 1863-2548 1863-2521 |
| DOI: | 10.1007/s11832-016-0740-x |
| Popis: | Purpose To characterize the epidemiology and costs associated with spinal cord injury without radiographic abnormality (SCIWORA) based on patient age. Methods An analysis of data complied for 2012 in the Healthcare Utilization Project KID database (HCUP-KID), which represents a nationwide database of pediatric admissions, was performed. An initial search identified all children diagnosed with SCIWORA based on International Classification of Diseases, 9th edition (ICD-9) codes. Only data on patients aged Results A total of 297 patients were identified who met the inclusion criteria. There was a slight predominance of females among the youngest patients (53 %) with a significant dominance of males in the oldest group (72 %) ( p < 0.001). The most common race among the patients studied was white (50 %) followed by Hispanic (14 %), Black (12 %), Asian/Pacific Islander (4 %), and Native American (1 %). Overall, the most common cause of injury was sports injuries, which were responsible for 122/297 (41 %) injuries, followed by motor vehicle collisions (26 %). Mechanisms of injury were significantly varied based on age group, with motor vehicle collisions the most common cause in the youngest two age groups and sports injuries the most common in the oldest age group ( p < 0.05). The most common location injured was the cervical spine (46 %), with the upper cervical spine most commonly injured, particularly in the younger age groups. Additional injuries were found in 158/297 (53 %) of patients, and these were more common among younger patients. Head trauma was the most common associated injury in all age groups, but the highest rate was found the youngest age groups ( p < 0.0001). The average hospital stay for all patients was 13 days, with longer stays seen in younger age groups ( p < 0.05). In-hospital mortality was uncommon among these patients and occurred in only 6/297 (2 %) of patients. Hospital charges were highest in the younger age groups, with an average charge of $210,772 for those in the youngest age group, decreasing to $72,178 for those in group 3 ( p < 0.0005). The most common payer was public insurance/medicaid in the youngest age group and private insurance in groups 2 and 3 ( p < 0.0001). Conclusions SCIWORA is an uncommon but potentially devastating injury in children. As with many pediatric injuries, this injury is heterogeneous between children of differing ages. This analysis of a nationwide series of children with such injuries identified significant differences in injury location, causes of injury, associated injuries, and hospital charges associated with this diagnosis. |
| Databáze: | OpenAIRE |
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