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Abstract
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Study Design. Retrospective database analysisObjective. To examine the incidence of hospitalization, treatment, and cost of caring for patients with axis(C2) fracturesSummary of Background Data. The incidence of C2 fractures in the elderly appears to be increasing, however, a comprehensive analysis of the incidence, treatment, and cost of treating C2 fractures has not been previously reported.
METHODS. The Nationwide Inpatient Sample(NIS) from years 2000-2010 was utilized to identify patients with C2 fracture without neurologic injury(ICD-9 code 805.02). Examined variables included age, ICD-9 injury severity score(ICISS), comorbidities, mortality, hospital length of stay(LOS), treatments, and total inpatient hospitalization charge. Charges were adjusted for inflation to 2010 US dollars as well as for cost-to-charge ratios.
RESULTS. In total, 31,129 C2 fracture patients were identified. From 2000 to 2010 the incidence of C2 fracture hospitalization increased in all age groups(p<0.0001). The most rapid increase was in patients >84years of age, who experienced a 3-fold increase from 3.18 to 9.77 hospitalizations/10,000 individuals/year(p<0.0001). From 2000 to 2010, the rate of halo vest placement decreased from 25.2% to 10.4%(p<0.0001), while the rate of surgical intervention increased from 13.1% to 16.5%(p = 0.029). For nonoperative patients, the mean hospitalization charge per patient increased from $39,346 in 2000 to $63,222 in 2010, and for surgically treated patients increased from $70,784 in 2000 to $133,064 in 2010(p<0.0001). Over the decade, the estimated charges for annual inpatient care for C2 fracture patients in the U.S. increased 4.7-fold from $334,138,919 to $1,577,254,958(p<0.0001).
CONCLUSION. The incidence of C2 fracture hospitalizations increased dramatically from 2000 to 2010, with the most rapid increase in the elderly represented by a greater than 3-fold increase for patients >84. The inpatient charges for treating C2 fractures have risen faster than the increased incidence, with a 4.7-fold increase in hospital charges resulting in estimated annual charges of >$1.5 billion in 2010.
Language: en |