Risk factors for complications in traumatic spinal cord injury: A retrospective analysis of a cohort of patients identified from administrative data

STUDY DESIGN: Retrospective data analysis of a population-based observational cohort. Setting: TSCI in British Columbia, Canada Participants: 3,433 TSCI patients included in the study. METHODS: Hospital records linked with administrative databases were utilized to measure in-hospital mortality, adverse event rate, and LOS between 2001 and 2021. Adverse events included all documented complications during hospital admission. Multivariable logistic regression and Cox proportional hazard models were used to identify factors associated with mortality, adverse events, and LOS. RESULTS: All cause in-hospital mortality was 6.4%. The average age of patients was 53.2 years (SD 19.7), 75.4% were males and 70% incurred a cervical spinal cord injury. Multivariable analysis demonstrated that patients 35 years old, multiple medical comorbidities, cervical injury, neurologically complete, high injury severity score (25), concomitant brain injury, lower socioeconomic status, and no surgical management were at higher risk for death. Factors associated with adverse events were similar with the exception of non-operative patients who had lower adverse events. Cox modeling for LOS demonstrated similar findings to mortality analysis. CONCLUSIONS: This study found that spinal cord injury patients were more likely to have adverse outcomes with older age, cervical injury, multiple comorbidities, complete neurological injury, or higher severity initial traumatic injuries. This study identified risks associated with complications in TSCI, future research should address ways to improve outcomes in these targeted groups.