National Hospitalization Burden Associated with Spinal Cord Injuries in the United States

Objectives: The objective of this study was to determine the national hospitalization burden of spinal cord injuries (SCIs) among adults in the United States. Factors predicting hospitalization outcomes including length of stay (LOS), total charges and discharge disposition of death were identified.

Setting: The study was conducted in the United States.

Methods: The 2009 Health Care Utilization Project Nationwide Inpatient Sample (HCUP-NIS) data were used in this study. Hospitalization outcomes among individuals with SCI were compared with a control group of individuals without SCI. Predictors of LOS, total charges and discharge disposition of death for SCI-related hospitalizations were determined using regression techniques.

Results: In 2009, there were a total of 11,848 hospitalizations because of SCI in the United States. Hospitalizations because of SCIs had 2.5 times higher LOS (12.37 (± 0.51) versus 4.93 (± 0.09), P<0.0001) and 4 times higher average charges ($142,366 (±$7430.51) versus $35,011 (±$1048.88), P<0.0001) as compared with those for the control group. The total national charge attributable to SCI-related hospitalizations was approximately $1.69 billion in 2009. Percentage of hospitalizations with discharge disposition of death was significantly higher among individuals with SCI as compared with those without SCI (5.77 versus 2.27%, P<0.0001). Different patient and hospital characteristics predicted LOS, total charges and discharge disposition of death for SCI-related hospitalizations.

Conclusions: There is considerable inpatient burden associated with SCI in the United States. Inpatient LOS, charges and percentage of hospitalizations with discharge disposition of death were higher among individuals with SCI as compared with those without SCI.