Traumatic spinal cord injury: A four-year study in Puerto Rico

Area of Science:

• Neurology
• Trauma Surgery
• Public Health

Background:

• Traumatic spinal cord injury (TSCI) poses a significant health burden globally.
• Understanding regional variations in TSCI incidence and characteristics is crucial for targeted interventions.
• Puerto Rico's unique geographical and demographic factors may influence TSCI occurrence.

Purpose of the Study:

• To assess the incidence and characteristics of traumatic spinal cord injury (TSCI) in Puerto Rico between 2019 and 2022.
• To identify trends in TSCI demographics, injury mechanisms, and outcomes.
• To evaluate the impact of the SARS-CoV-2 pandemic on TSCI patterns.

Main Methods:

• Retrospective analysis of patient data from Puerto Rico Trauma Hospital.
• Inclusion of encounters with specific ICD-10-CM codes related to spinal cord injuries.
• Data collection spanned from 2019 to 2022, covering patient demographics, injury details, and disposition.

Main Results:

• Annual TSCI incidence rates remained stable, with an increasing trend in older adults.
• Falls were the predominant mechanism of injury, particularly in older individuals.
• In-hospital mortality and length of stay were higher during 2020-2021, coinciding with the SARS-CoV-2 lockdown.
• A notable increase in discharges to inpatient rehabilitation was observed over the study period.

Conclusions:

• TSCI risk in Puerto Rico is substantially lower compared to the United States.
• The rising incidence of TSCI in older adults, driven by falls, necessitates focused prevention strategies.
• Pandemics like COVID-19 can alter TSCI demographics and outcomes, requiring adaptive trauma care approaches.
• Enhancing rehabilitation access through physiatry consults is recommended for improved patient outcomes.