Injury hospitalizations among individuals with paraplegia: Nationwide Inpatient Sample 2001-2004

Purpose: To describe patient and hospital characteristics of injury hospitalizations among individuals with paraplegia, and examine factors associated with length of stay (LOS) and total hospital charges in this population. Methods: The Nationwide Inpatient Sample for years 2001-2004 was used to identify records with a primary injury diagnosis and paraplegia comorbidity. National estimates for hospitalizations due to injury in individuals with paraplegia were calculated by patient and hospital characteristics. Multivariable linear regression was used to identify patient and hospital level factors associated with LOS and total hospital charges. Results: A total of 2,293 records were identified, representing an estimated 11,164 injury hospitalizations nationwide for individuals with paraplegia over four years. The majority of patients were male (67.5%), aged 41-50 years (24.9%), and White (70.7%). Other coexisting comorbid conditions were present in 67% of patients. The mean charges (per discharge) and LOS were $37,138 and 7 days, respectively, with a total estimated annual cost of $97,953,341. Falls, poisoning, and motor vehicles were the most common cause of injury. Falls and motor vehicles injuries were also associated with significantly greater hospital charges than other causes of injury. Almost half (49.1%) of the injuries were due to fracture of a lower limb or hip, and approximately 12% of injuries were due to poisoning by medications and drugs. Conclusion: The results capture the magnitude of injury hospitalizations in individuals with paraplegia, and support primary injury prevention initiatives in this special population. The presence of other coexisting comorbidities are important to consider in this population with mobility and sensory limitations. Interventions designed to target the prevention of injuries due to falls, poisonings, and motor vehicles are needed to help reduce further disability in an already vulnerable population and help reduce the consequential burden of length of stay and cost.