• Matthew J Hagan, Nathan J Pertsch, Owen P Leary, Rahul Sastry, Arjun Ganga, Kevin Xi, Bryan Zheng, Nikash S Kondamuri, Joaquin Q Camara-Quintana, Tianyi Niu, Patricia Zadnik Sullivan, Jose Fernandez Abinader, Albert E Telfeian, Ziya L Gokaslan, Adetokunbo A Oyelese, and Jared S Fridley.
• The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA.
• World Neurosurg. 2022 Oct 1; 166: e859e871e859-e871.

ObjectiveIdentifying patients at risk of increased health care resource utilization is a valuable opportunity to develop targeted preoperative and perioperative interventions. In the present investigation, we sought to examine patient sociodemographic factors that predict prolonged length of stay (LOS) after traumatic spine fracture.MethodsWe performed a cohort analysis using the National Trauma Data Bank tabulated during 2012-2016. Eligible patients were those who were diagnosed with cervical or thoracic spine fracture with spinal cord injury and who were treated surgically. We evaluated the effects of sociodemographic as well as psychosocial variables on LOS by negative binomial regression and adjusted for injury severity, injury mechanism, and hospital characteristics.ResultsWe identified 3856 eligible patients with a median LOS of 9 days (interquartile range, 6-15 days). Patients in older age categories, who were male (incidence rate ratio (IRR), 1.05; 95% confidence interval [CI], 1.01-1.09), black (IRR, 1.12; CI, 1.05-1.19) or Hispanic (IRR, 1.09; CI, 1.03-1.16), insured by Medicaid (IRR, 1.24; CI, 1.17-1.31), or had a diagnosis of alcohol use disorder (IRR, 1.12; CI, 1.06-1.18) were significantly more likely to have a longer LOS. In addition, patients with severe injury on Injury Severity Score (IRR, 1.32; CI, 1.14-1.53) and lower Glasgow Coma Scale (GCS) scores (GCS score 3-8, IRR, 1.44; CI, 1.35-1.55; GCS score 9-11, IRR, 1.40; CI, 1.25-1.58) on admission had a significantly lengthier LOS. Patients admitted to a hospital in the Southern United States (IRR, 1.09; CI, 1.05-1.14) had longer LOS.ConclusionsSocioeconomic factors such as race, insurance status, and alcohol use disorder were associated with a prolonged LOS after surgical management of traumatic spine fracture with spinal cord injury.Copyright © 2022 Elsevier Inc. All rights reserved.

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