Abstract
In the United States approximately 250,000 persons have a traumatic spinal cord injury (TSCI) and most will die from complications related to their injury. Interpretation of TSCI deaths by medical examiners is evolving as understanding of SCI pathophysiology increases. We queried our electronic database for deaths meeting inclusion criteria from 1989 to 2008 and identified 305 cases, of which 81% were males and 19% were females. A full autopsy was performed in 38.7% of cases and an external exam was performed in the remaining cases (61.3%). The manner of death distribution was accident (80%), homicide (7%), natural (7%), suicide (4%) or undetermined (2%). The most common mechanisms of spinal cord injury were motor vehicle accidents (42.6%), fall from a standing height (12.8%), fall from above a standing height (9.2%) and gunshot wounds (8.8%). The mechanism of spinal cord injury significantly impacted survival (p=0.0001) with decedents injured from motor vehicle accidents having a mean survival time of 14.4 years compared to 0.7 year from falling from a standing height. Analyzing patterns of deaths due to TSCI in a medical examiner office provides excellent epidemiological data for injury tracking and prevention as well as a context for medical examiners evaluating TSCI.
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