Sex-related discrepancies in the epidemiology, injury characteristics and outcomes after acute spine trauma: A retrospective cohort study

Abstract

Context/Objective: The potential effects of sex on injury severity and outcomes after acute spine trauma (AST) have been reported in pre-clinical and clinical studies, even though the data are conflicting. This study compared females and males regarding the epidemiology, injury characteristics, and clinical outcomes of AST.

Design: Retrospective cohort study.

Setting: Acute spine care quaternary center.

Participants: All consecutive cases of AST admitted from January/1996 to December/2007 were included.

Interventions: None.

Outcome Measures: The potential effects of sex on the epidemiology, injury characteristics, and clinical outcomes of AST were studied.

Results: There were 504 individuals with AST (161 females, 343 males; mean age of 49.44 ± 0.92 years). Sex was not associated with age or pre-existing co-morbidities as assessed using the Charlson Co-morbidity Index, however, females had a greater number of International Classifications of Diseases (ICD) codes at admission and higher Cumulative Illness Rating Scale (CIRS) than males. Over the 12-year period, the male-to-female ratio has not significantly changed. Although there were significant sex-related discrepancies regarding injury etiology, level and severity of AST, males and females had similar lengths of stay in the acute spine center, in-hospital survival post-AST, and need for mechanical ventilation and tracheostomy.

Conclusion: This study suggests that females with AST present with a greater number of pre-existing co-morbidities, a higher frequency of thoraco-lumbar trauma, less severe neurological impairment and a greater proportion of MVA-related injuries. However, females and males have a similar length of stay in the acute spine center, and comparable in-hospital survival, need for mechanical ventilation, and tracheostomy after AST.

Keywords:

• Spinal cord injury
• Acute spine trauma
• Neurotrauma
• Age
• Sex

ORCID

Julio C. Furlan http://orcid.org/0000-0002-2038-0018

B. Catharine Craven http://orcid.org/0000-0001-8234-6803

Michael G. Fehlings http://orcid.org/0000-0002-5722-6364

Notes

* This paper is directly related to the theme of the 8th National Spinal Cord Injury Conference – Sex and Gender, and Health of Women.

Additional information

Funding

Dr. Furlan receives salary support from the Wings for Life Spinal Cord Research Foundation. Dr. Craven acknowledges support from the Toronto Rehab Foundation as the Toronto Rehabilitation Institute Chair in Spinal Cord Injury Rehabilitation. Dr. Fehlings acknowledges support from the Halbert Chair in Neural Repair and Regeneration.