Longitudinal incidence and concurrence rates for traumatic brain injury and spine injury – A twenty year analysis

BackgroundThe reported incidence of concurrent traumatic brain (TBI) and spine or spinal cord injuries (SCI) is poorly defined, with widely variable literature rates from 16 to 74%.ObjectivesTo define the incidence of concurrent TBI and SCI, and compare the incidence over a twenty-year time period.MethodsTo define the longitudinal incidence and concurrent rate of TBI and SCI via a retrospective review of the Nationwide Inpatient Sample (NIS) database over a twenty year period.ResultsOver the study period, the incidence of TBI declined from 143 patients/100k admissions to 95 patients/100k. However, there was a concurrent increase in SCI from 61 patients/100k admissions to 75 patients/100k admissions (P < 0.0001). Regional variations in SCI trends were noted, with specific regions demonstrating an increasing trend. Cervical fractures had the greatest increase by nearly a three-fold rise (1988: 4562–2008: 12,418). There was an increase in the incidence of TBI among SCI admission from 3.7% (1988) to 12.5% (2008) (OR = 1.067 per year; 95% CI = 1.065–1.069 per year; P < 0.0001). Concurrently, SCI patients had an increase in TBI (9.1% (1988)–15.9% (2008) (OR = 1.038 per year (95% CI 1.036–1.040; P < 0.001))).ConclusionA retrospective review of the NIS demonstrates a rising trend in the incidence of concurrent TBI and SCI. More investigative work is necessary to examine causative factors for this trend.