Neural Regeneration Research ›› 2024, Vol. 19 ›› Issue (5): 1126-1132.

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Epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China: a hospital-based retrospective study

Hengxing Zhou1, 2, #, Yongfu Lou1, 3, #, Lingxiao Chen2, 4, #, Yi Kang3, Lu Liu5, Zhiwei Cai6, David B. Anderson7, 8, Wei Wang2, Chi Zhang2, Jinghua Wang9, Guangzhi Ning3, Yanzheng Gao10, Baorong He5, Wenyuan Ding11, Yisheng Wang12, Wei Mei13, Yueming Song14, Yue Zhou15, Maosheng Xia16, Huan Wang17, Jie Zhao18, Guoyong Yin19, Tao Zhang20, Feng Jing21, Rusen Zhu22, Bin Meng23, Li Duan24, Zhongmin Zhang25, Desheng Wu26, Zhengdong Cai27, Lin Huang28, Zhanhai Yin29, Kainan Li30, Shibao Lu31, Shiqing Feng1, 2, 3, *   

  1. 1Department of Orthopedics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, China; 2Department of Orthopedics, Shandong University Center for Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shandong, China; 3Department of Orthopedics, Tianjin Medical University General Hospital, International Science and Technology Cooperation Base of Spinal Cord Injury, Tianjin Key Laboratory of Spine and Spinal Cord, Tianjin, China; 4Faculty of Medicine and Health, The Back Pain Research Team, Sydney Musculoskeletal Health, The Kolling Institute, University of Sydney, Sydney, NSW, Australia; 5Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi Province, China; 6Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China; 7Faculty of Medicine and Health, School of Health Sciences, University of Sydney, NSW, Australia; 8Sydney Spine Institute, Burwood, Sydney, NSW, Australia; 9Laboratory of Epidemiology, Tianjin Neurological Institute, Department of Neurology, Tianjin Medical University General Hospital & Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China; 10Department of Orthopedics, Henan Provincial People’s Hospital, Zhengzhou, Henan Province, China; 11...
  • Online:2024-05-15 Published:2023-11-01
  • Contact: Shiqing Feng, MD, sqfeng@tmu.edu.cn.
  • Supported by:
    This study was supported by the National Key Research and Development Project, No. 2019YFA0112100 (to SF).

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Abstract: Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death. China has the largest population of patients with traumatic spinal cord injury. Previous studies of traumatic spinal cord injury in China have mostly been regional in scope; national-level studies have been rare. To the best of our knowledge, no national-level study of treatment status and economic burden has been performed. This retrospective study aimed to examine the epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China at the national level. We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China. Patient epidemiological and clinical features, treatment status, and total and daily costs were recorded. Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program. The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall (annual percentage change, –0.5% and 2.1%, respectively). A total of 10,053 (74.7%) patients underwent surgery. Only 2.8% of patients who underwent surgery did so within 24 hours of injury. A total of 2005 (14.9%) patients were treated with high-dose (≥ 500 mg) methylprednisolone sodium succinate/methylprednisolone (MPSS/MP); 615 (4.6%) received it within 8 hours. The total cost for acute traumatic spinal cord injury decreased over the study period (–4.7%), while daily cost did not significantly change (1.0% increase). Our findings indicate that public health initiatives should aim at improving hospitals’ ability to complete early surgery within 24 hours, which is associated with improved sensorimotor recovery, increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.  

Key words: China, clinical features, costs, epidemiology, methylprednisolone sodium succinate, methylprednisolone, retrospective study, traumatic spinal cord injury, treatment