A new study published in Spine examines the reasons for treating cervical spinal cord injury late.
The researchers examined 2,636 patients for the study. They used the National Trauma Data Bank Research Data Set to gather information. There were 803 patients with complete spinal cord injury, 950 with incomplete spinal cord injury and 883 with central spinal cord injury.
Here are five key findings from the report:
1. The average time to surgery for each group was:
• Complete SCI: 51.1 hours
• Incomplete SCI: 55.3 hours
• Central SCI: 83.1 hours
2. Less than half — 44 percent — of the patients with SCI underwent surgery within the first 24 hours after surgery, including half of the patients with incomplete SCI.
3. The patients spent most of the time between injury and surgery waiting after admission instead of in the emergency department or in the field.
4. Factors associated with later surgery in all three groups were upper cervical SCI and greater Charlson Comorbidity Index.
5. There were also patient-driven risk factors, including pre-existing comorbidities, and surgeon factors like reimbursement that could impact surgical timing, according to the study discussion. There are studies showing patients with lower insurance status are more likely to be transferred to outside facilities and have worse clinical outcomes.