Falls Now Leading Cause of Spinal Cord Injuries

Spinal cord injuries tied to falls in older adults appeared to be on the rise in US

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Spinal cord injuries are often associated with dramatic accidents, but simple falls at home could be behind an increase in these injuries.

In a new study, researchers examined the rate of traumatic spinal cord injuries among adults in the US.

These researchers found that the rates and costs of these accidents have increased, and that falls were the leading cause of traumatic spinal cord injuries, especially among older adults.

"Use a walker or handrail to keep your balance."

According to the authors of this study, who were led by Shalini Selvarajah, MD, MPH, of the Center for Surgical Trials and Outcomes Research at the Johns Hopkins University School of Medicine in Baltimore, Maryland, the latest estimates on rates of spinal cord injuries were based on data gathered during the 1990s.

These injuries can occur after damage to any point along the spinal cord or surrounding areas, including tissues or bones, according to the US National Library of Medicine. Causes include car accidents, violence, falls and sports injuries, like diving into shallow water, and symptoms range from sensory changes to paralysis.

To update the data on traumatic spinal cord injuries, Dr. Selvarajah and colleagues utilized the Nationwide Emergency Department Sample, a database that gathers information from 980 emergency departments in 29 states across the US.

The researchers looked for visits to the emergency department for a traumatic spinal cord injury among adults during 2007 and 2009. Additional data on deaths, cause of injury, cost of visit and length of hospital stay were also examined.

In total, 43,137 such visits were identified. Dr. Selvarajah and colleagues then used this information to estimate the national rates of traumatic spinal cord injuries per one million people in the US.

During the three years of this study, the average rate of these injuries was estimated to be 56.4 per million US adults. The average age of traumatic spinal cord injury patients was 50.4 years old.

The rate of spinal cord injuries among older adults (those aged 65 or older) saw a significant increase from a rate of 79.4 per million in 2007 to 87.7 per million at the end of 2009. During this time, the rate remained fairly stable among younger adults between the ages of 18 and 64, dropping slightly from 52.3 per million in 2007 to 49.9 per million at the end of 2009.

Falls were found to be the leading cause of traumatic spinal cord injuries, and were responsible for an estimated 41.5 percent of all cases. Motor vehicle crashes were the next leading cause, responsible for 35.5 percent of cases. Adults aged 65 or older were more likely to experience a traumatic spinal cord injury from a fall than were their younger counterparts.

The researchers found that 5.7 percent of patients died, with older adults also having a higher risk of death during their hospital stay than their younger counterparts.

Dr. Selvarajah and colleagues found the average charge for emergency department visits related to a spinal cord injury increased by 20.1 percent during the study period, from $3,342 in 2007 to $4,024 in 2009.

In a news release from Johns Hopkins Medicine, Dr. Selvarajah stressed the importance of understanding these findings. “We have demonstrated how costly traumatic spinal cord injury is and how lethal and disabling it can be among older people,” said Dr. Selvarajah. “It’s an area that is ripe for prevention.”

The study authors noted that they did not have complete case histories on each patient to examine additional information like drug and alcohol use. Also, the study did not take into account patients who died at the scene of injury due to a traumatic spinal cord injury. Further research is needed to expand on this topic.

"Because a greater proportion of older adults are sustaining [traumatic spinal cord injuries] and having poorer outcomes, this points to a need for further research to better understand how and why these injuries take place so that prevention strategies based on key risk factors across various age groups in the adult population can be developed," the study authors concluded.

This study was published January 23 in the Journal of Neurotrauma. No conflicts of interest were reported.

Review Date: 
January 28, 2014
Last Updated:
January 29, 2014