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A Preventable Public Burden

Alan H. Tyroch, MD; Jim W. Davis, MD; Krista L. Kaups, MD; Manuel Lorenzo, MD

Arch Surg. 1997;132(7):778-781.

Abstract
Background
Spinal cord injury (SCI) is a devastating occurrence with important consequences for the individual and society. Previous studies have documented the epidemiology and costs of SCI and the rehabilitation needs after SCI; however, data about the preventability of SCI are lacking.

Objective
To test the hypotheses that most SCIs are preventable and that much of the cost of SCI is borne by the public.

Design
Retrospective review of medical records and trauma registry data.

Setting
A 417-bed county hospital with a level I trauma center.

Methods
To evaluate the preventability of SCI, the records of trauma patients sustaining SCI from July 1, 1990, through June 30, 1995, were reviewed. The criteria for preventability of blunt injuries included the following: failure to use restraint devices; intoxication of drivers, motorcyclists, or pedestrians; and falls or diving accidents involving the use of drugs or alcohol. The criteria for preventability of penetrating injuries included the following: illegal possession of a firearm, accidental discharge of a weapon, and suicide attempts. Statistics were performed with the paired Student t test and X² with significance attributed to a P value less than .05.

Results
Spinal cord injury occurred in 150 patients; 71% of the injuries were the result of blunt trauma. Injury was potentially preventable in 74% of the blunt injuries and 66% of the penetrating injuries (P=.15). Patients with a penetrating SCI were younger (P<.001) and relied more on public funding than did those with a blunt SCI (65% vs 81%; P=.05).

Conclusions
Most SCIs are preventable with strict enforcement of existing statutes. Furthermore, the financial burden of these preventable injuries is largely borne by the public.

Arch Surg. 1997;132:778-781

Author Affiliations
From the Department of Surgery, University of California, San Francisco/Fresno University Medical Center, Fresno, Calif (Drs Tyroch and Kaups); the University of South Florida, Tampa, and the Division of Trauma, Tampa General Hospital, Tampa, Fla (Dr Davis); and the Department of Surgery, University of Puerto Rico, San Juan (Dr Lorenzo).

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