Introduction: Physical altercations can result in severe injuries, including spinal trauma. This study investigates the characteristics of these patients, focusing on disparities in tracheostomy requirements and discharge patterns.
Methods: We identified patients with spinal injuries resulting from physical altercations using the National Inpatient Sample database. Demographic and clinical characteristics were assessed in relation to the necessity for tracheostomy and non-routine discharge. Non-routine discharge was defined as any discharge other than returning home independently.
Results: A total of 804 patients with spinal injuries following a physical altercation were identified. Among these patients, 67.8% were male, and the average age was 48.3±15.3 years. The most common cause of injury was assault by bodily force (97.2%), followed by being pushed from a height (2.2%) and asphyxiation (0.6%). Of the 24 patients requiring a tracheostomy (3.0%), the majority were male (87.5%, p=0.036). Although there was no significant association between gender and non-routine discharge, a notable association was identified between tracheostomy and non-routine discharge (p=0.003). Non-routine discharges were experienced by 232 patients (30.8%), with 64.2% discharged to care facilities, 26.3% to home health care, and 9.5% to short-term hospitals. Hispanic patients exhibited a lower rate of non-routine discharges (6.4%) than routine discharges (16.1%), whereas other races were more commonly discharged non-routinely. Patients with non-routine discharges had longer lengths of stay than those with routine discharges (10.4±11.3 vs 5.3±10.1 days, p< 0.001). No evaluated factors were significantly associated with mortality.
Conclusion : Non-routine discharges are prevalent among patients with spinal injuries from physical altercations, especially among those requiring a tracheostomy. This trend is particularly pronounced in non-Hispanic patients. These results emphasize the patient morbidities and burdens on the healthcare system associated with physical altercations, underscoring the importance of initiatives aimed at reducing violence.
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