INCIDENCE, CHARACTERISTICS, AND OUTCOME OF SPINAL-CORD INJURY AT TRAUMA CENTERS IN NORTH-AMERICA

Acute spinal cord injury occurred in 2.6% of the 114 510 patients ente red into the Major Trauma Outcome Study from 1982 to 1989. The most co mmon causes of spinal cord injury were motor vehicle accidents (40%), falls (20%), and gunshot wounds (13.6%). Almost 80% of patients with s pinal 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% v s 6.9%). The TRISS method overpredicted the mortality rate among patie nts with multiple injuries (450 vs 379), but not among those with isol ated injury. A program for better national surveillance and prevention of spinal cord injury is warranted.