THE CHANGING NATURE OF ADMISSIONS TO A SPINAL-CORD INJURY CENTER - VIOLENCE ON THE RISE

The purpose of this study was to analyze changing etiologies for admis sion to a spinal cord injury center. This study was designed to retros pectively analyze the etiology of admissions to a spinal cord injury c enter during a 15-year period, specifically gunshot versus nongunshot wound injuries. Gunshot wounds are a well-recognized cause of spinal c ord injury. In some centers, up to 52% of admissions are due to this, and these trends are believed to be increasing. All patients with spin al cord injury admitted to our center between 1979 and 1993 were analy zed. Frequencies of specific etiologies were determined and then compa risons were made between gunshot wound and nongunshot wound groups, Fa ctors analyzed included age, male/female ratio, ethnic make-up, marita l status, employment status, level of injury, and neurologic status. O ne thousand eight hundred seventeen patients were included. Overall, g unshot wound spinal cord injuries compromised 16.9% of injuries. A cle ar trend of increasing numbers of admissions was seen between 1984 and 1993 because of this. Gunshot wounds and nongunshot wounds differed d ramatically in terms of age, ethnic make-up, marital status, employmen t status, and neurologic status. Cost attributed to treating gunshot w ound injuries at our center for 1993 was 5.4 million dollars. Gunshot wounds as a cause of spinal cord injury are increasing at an alarming rate. The demographics of the gunshot wounds and nongunshot wound spin e cord injuries differ significantly.