The Burden of Traumatic Spinal Cord Injury in the United States: Disability-Adjusted Life Years

Publication date: Available online 21 September 2018

Source: Archives of Physical Medicine and Rehabilitation

Author(s): O. Trent Hall, Ryan P. McGrath, Mark D. Peterson, Edmund H. Chadd, Michael J. DeVivo, Allen W. Heinemann, Claire Z. Kalpakjian

Abstract

Objective

To quantify the burden of traumatic spinal cord injury (SCI) as defined by non-fatal health loss and premature mortality among a large sample of participants over a 44-year period, and estimate the national burden of SCI in the United States (U.S.) for the year 2010.

Design

Longitudinal.

Setting

National SCI Model Systems and Shriners Hospitals.

Participants

Individuals were categorized by neurologic level of injury as cervical (N=28,178) or thoracic and below (N=23,048).

Main Outcome Measures

The burden of SCI was calculated in years lost due to premature mortality (YLL), years lived with disability (YLD) and disability-adjusted life years (DALY).

Results

For those with cervical level injuries, the overall YLLs and YLDs were 253,745 and 445,709, respectively, for an estimated total of 699,454 DALYs. For those with thoracic and below level injuries, the overall YLLs and YLDs were 153,885 and 213,160, respectively, for an estimated total of 367,045 DALYs. Proportionally-adjusted DALYs attributable to SCI in 2010 were 445,911.

Conclusions

SCIs accounted for over 1 million years of healthy life lost in a national sample over a 44-year span. We estimated that 445,911 DALYs resulted from SCIs in the U.S. in 2010 alone, placing the national burden of SCIs above other impactful conditions such as Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome. Future investigations may employ DALYs to monitor trends in SCI burden in response to innovations in SCI care and identify subgroups of persons with SCIs for whom tailored interventions might improve DALYs.

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