title: Longitudinal incidence and concurrence rates for traumatic brain injury and spine injury - a twenty year analysis.
abstract: BACKGROUND
  The reported incidence of concurrent traumatic brain (TBI) and spine or spinal cord injuries (SCI) is poorly defined, with widely variable literature rates from 16 to 74%.
  
  
  OBJECTIVE
  To define the incidence of concurrent TBI and SCI, and compare the incidence over a twenty-year time period.
  
  
  METHODS
  To define the longitudinal incidence and concurrent rate of TBI and SCI via a retrospective review of the Nationwide Inpatient Sample (NIS) database over a twenty year period.
  
  
  RESULTS
  Over the study period, the incidence of TBI declined from 143 patients/100k admissions to 95 patients/100k. However, there was a concurrent increase in SCI from 61 patients/100k admissions to 75 patients/100k admissions (P<0.0001). Regional variations in SCI trends were noted, with specific regions demonstrating an increasing trend. Cervical fractures had the greatest increase by nearly a three-fold rise (1988: 4562-2008: 12,418). There was an increase in the incidence of TBI among SCI admission from 3.7% (1988) to 12.5% (2008) (OR=1.067 per year; 95% CI=1.065-1.069 per year; P<0.0001). Concurrently, SCI patients had an increase in TBI (9.1% (1988)-15.9% (2008) (OR=1.038 per year (95% CI 1.036-1.040; P<0.001))).
  
  
  CONCLUSIONS
  A retrospective review of the NIS demonstrates a rising trend in the incidence of concurrent TBI and SCI. More investigative work is necessary to examine causative factors for this trend.
authors: Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, USA.
authors: George M
authors: GM
authors: Ghobrial
authors: Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, USA.
authors: Peter S
authors: PS
authors: Amenta
authors: Rothman Institute, Philadelphia, USA.
authors: Mitchell
authors: M
authors: Maltenfort
authors: Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, USA.
authors: Kim A
authors: KA
authors: Williams
authors: Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, USA.
authors: James S
authors: JS
authors: Harrop
authors: Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, USA.
authors: Ashwini
authors: A
authors: Sharan
authors: Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, USA.
authors: Jack
authors: J
authors: Jallo
authors: Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, USA.
authors: Joshua
authors: J
authors: Heller
authors: Department of Neurosurgery, Stanford University, Stanford, USA.
authors: John
authors: J
authors: Ratliff
authors: Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, USA.
authors: Srinivas
authors: S
authors: Prasad
mesh_terms: D001930:Brain Injuries / Q000453:epidemiology*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors; D013124:Spinal Injuries / Q000453:epidemiology*
keywords: Longitudinal study; Nationwide inpatient sample; Neurotrauma; Spinal cord injury; Traumatic brain injury