Related Experiment Video
Updated: Apr 8, 2026
A Neonatal Mouse Spinal Cord Compression Injury Model
Published on: March 27, 2016
Pediatric spinal injury in the US: epidemiology and disparities
1Nemours Neuroscience Center, AI duPont Hospital for Children, Wilmington, Delaware; and Departments of Neurological Surgery and Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Insights
Racial disparities significantly impact pediatric spinal injuries in the US. Black children experience more severe injuries and higher mortality rates, highlighting the need to address socioeconomic factors in trauma care.
Area of Science:
- Trauma Surgery
- Pediatric Orthopedics
- Epidemiology
Background:
- Race and socioeconomic status are known to influence trauma care and outcomes in the US.
- Previous research indicates disparities in injury mechanisms, severity, management, and outcomes across different demographics.
- Understanding these disparities in pediatric spinal injury is crucial for equitable healthcare.
Purpose of the Study:
- To examine the large-scale relationships between race, economic status, and pediatric spinal injury in the US.
- To analyze injury patterns, severity, mortality, and treatment variations based on race and payor status.
- To identify specific risk factors and disparities in pediatric spinal trauma.
Main Methods:
- Utilized data from the Kids' Inpatient Database (KID) and National Trauma Data Bank (NTDB) for 2009 admissions.
- Included patients aged 0-21 years with spinal fracture, spinal cord injury (SCI), or SCI without radiographic abnormality.
- Employed multiple logistic regression to model mortality and spinal fusion rates, analyzing injury patterns by age, race, and payor.
Main Results:
- Estimated US incidence of pediatric spinal injury at 170 per million, with SCI at 24 per million.
- Black patients exhibited more severe injuries (higher Injury Severity Scale scores) and higher mortality rates (adjusted OR 1.571).
- Firearm-related spinal injuries were significantly higher in Black patients (23.9%) compared to white patients (1%). Spinal fusion rates varied by race and insurance status.
Conclusions:
- Pediatric spinal injury epidemiology in the US is intrinsically linked to race and economic status.
- Disparities in injury severity, mechanism (e.g., firearms), and treatment access (spinal fusion) are evident.
- Addressing socioeconomic factors and racial disparities is essential for understanding and mitigating pediatric spinal trauma outcomes.
Object:
In the US, race and economic status have pervasive associations with mechanisms of injury, severity of injury, management, and outcomes of trauma. The goal of the current study was to examine these relationships on a large scale in the setting of pediatric spinal injury.
Methods:
Admissions for spinal fracture without or with spinal cord injury (SCI), spinal dislocation, and SCI without radiographic abnormality were identified in the Kids' Inpatient Database (KID) and the National Trauma Data Bank (NTDB) registry for 2009. Patients ranged in age from birth up to 21 years. Data from the KID were used to estimate nationwide annual incidences. Data from the NTDB were used to describe patterns of injury in relation to age, race, and payor, with corroboration from the KID. Multiple logistic regression was used to model rates of mortality and spinal fusion.
Results:
In 2009, the estimated incidence of hospital admission for spinal injury in the US was 170 per 1 million in the population under 21 years of age. The incidence of SCI was 24 per 1 million. Incidences varied regionally. Adolescents predominated. Patterns of injury varied by age, race, and payor. Black patients were more severely injured than patients of other races as measured by Injury Severity Scale scores. Among black patients with spinal injury in the NTDB, 23.9% suffered firearm injuries; only 1% of white patients suffered firearm injuries. The overall mortality rate in the NTDB was 3.9%. In a multivariate analysis that included a large panel of clinical and nonclinical factors, black race retained significance as a predictor of mortality (p = 0.006; adjusted OR 1.571 [1.141-2.163]). Rates of spinal fusion were associated with race and payor in the NTDB data and with payor in the KID: patients with better insurance underwent spinal fusion at higher rates.
Conclusions:
The epidemiology of pediatric spinal injury in the US cannot be understood apart from considerations of race and economic status.
More Related Videos
Related Concept Videos
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion