Cost Analysis of Vertical Deceleration Injury in the Acute Setting

Vertical deceleration injury is a known but not well understood form of blunt injury in both the urban and rural environment. The purpose of this study was to investigate the financial cost of treatment for this specific mechanism of injury in the acute care setting, and to continue to expand a fall prevention program from our unit.

This is a prospective review of vertical deceleration injuries admitted over a 2-year period to a Level I trauma center. Patients were followed until discharge to either home or rehabilitation facilities.

Ninety-nine patients who sustained a vertical deceleration injury from a height of ≥ 6 ft were identified from our Trauma Registry database. The length of hospital stay, including rehabilitation, ranged from 1 to 78 days (mean, 13.1 days). The mean injury severity score (ISS) was 16.4 (range, 4-75). The average height of fall was 19.5 ft (range, 6-110 ft) with a mean impact velocity of 23 mph (range, 13-58). The cost of hospitalization was significantly correlated to the ISS score (correlation = 0.558, p < 0.001); and as expected, higher ISS scores yielded higher costs (χ(2) = 34.7, p < 0.001). We found that the best predictor variable for the cost of treatment for vertical deceleration injury is the ISS score with a regression equation of: Cost = $19,578 + ($6,609 × ISS). The average cost per fall incident was $91,435 (range $5,006-$948,957) for vertical deceleration injuries.

The cost of treatment of vertical deceleration injuries is very high. Hospital stays are prolonged and rehabilitation needs frequent. Overall, ISS is the best predictor of cost of treatment and length of hospital stay.