A nationwide register-based study of the socio-economic consequences of traumatic and non-traumatic spinal cord injury

Research Objectives: To investigate the socioeconomic consequences of traumatic (tSCI) and non-traumatic (ntSCI) spinal cord injury (SCI) in relation to health care costs, risk of job loss, and divorce.

Design: A nationwide population-based register study

Setting: General community, Denmark.

Participants: All survivors of SCI (tSCI: n=838; ntSCI: n=913) admitted for specialized SCI rehabilitation during the years 2008-2018 were included. Furthermore, a cohort of relatives to survivors of SCI (n=3,084) was identified using national registers. Using propensity score matching (including age, gender, marital status, region, labor market affiliation, and months of education) control groups for SCI survivors (n=8,139) and their relatives (n=15,921) were identified. Data were retrieved up to two years before the injury year and up to four years after the injury year.

Interventions: Not applicable

Main Outcome Measures: Utilization of health care costs (including hospital services, use of general practitioner and practicing specialists, and prescribed medication), risk of job loss, and risk of divorce.

Results: Survivors of tSCI and ntSCI had significantly increased health care costs up to two years before the injury and the following four years after injury (all p-values < 0.0001). Survivors of SCI had nine times higher risk of losing their job compared to their controls during the three years after the injury year (OR=9.26; 95% CI: 7.70 to 11.15), and risk of divorce was also higher (OR=1.58; 95% CI: 1.09 to 2.29) the three following years, but only significant for the ntSCI group. No significant differences on health care cost and job loss between the group of relatives of SCI survivors and their controls were found.

Conclusions: In conclusion, the SCI group had significantly higher utilization of health care costs, both pre-morbidly and post-injury. The SCI group also had an increased risk of job loss, which emphasizes how the socioeconomic consequences of SCI are pervasive and long-lasting.

Author(s) Disclosures: No conflicts of interest for all authors