INCIDENCE OF ACUTE-CARE COMPLICATIONS IN VERTEBRAL COLUMN FRACTURE PATIENTS WITH AND WITHOUT SPINAL-CORD INJURY

Study Design. This study retrospectively analyzed vertebral column fra ctures in trauma patients during a 2-year period. Data from a multicen ter trauma registry were used. Objectives, The purpose of this study w as to ascertain and describe the initial in-hospital morbidity and mor tality rates for patients with vertebral column fractures with and wit hout spinal cord injury. Summary of Background Data. Patients with ver tebral fractures and associated spinal cord injuries experience more m edical complications than those without spinal cord injuries. However, the precise incidence and relative risk of complications during acute care hospitalization for these two groups are not well documented. Me thods. Vertebral column fractures in 419 adolescent and adult trauma p atients hospitalized during a 2-year period were retrospectively analy zed using data from a multicenter trauma registry. Results. Of the 419 patients, 104 (24.8%) had an associated spinal cord injury. More than half of the spinal cord injury patients (52.9%) and 20.6% of those wi thout spinal cord injury had one or more complications during their ho spitalization. Complications resulted in an average of 33.1 extra hosp ital days, Which extrapolates nationally into 1.5 million additional d ays annually. The four complications differing most significantly in i ncidence between the spinal cord injury group and the non-spinal cord injury group were: urinary tract infections (24.0% vs. 8.6%), respirat ory (23.1% vs. 8.6%), cardiac (11.5% vs. 3.2%), and decubitus ulcer (7 .7% vs. 1.0%). Pneumonia, although not statistically different, was hi gh in both groups (13.5% vs. 7.3%). Conclusions. The incidence of the 25 types of medical complications reported here provides specific and relevant information to assist health professionals in treating patien ts during their acute care. We estimate that complications during init ial hospitalization add $1.5 billion annually to the cost of caring fo r patients with vertebral fractures in the United States.