Traumatic spinal injuries in a rural tourist area: Epidemiology, seasonal trends and implications for healthcare resource allocation.

Abstract

Several epidemiological studies have evaluated trends and epidemiology of Traumatic Spinal Injury (TSI) but often they don't take into account the geographical variability of nations. Having identified a lack of literature on the epidemiology of rural and touristic areas we conducted this retrospective study in our hospital near Como Lake to understand how best to manage TSI patients. This retrospective epidemiological study included all patients with TSI admitted to Emergency Department (ED) of Gravedona ed Uniti Hospital between April 2018 and March 2024. We focused on vertebral fractures. Demographics, trauma mechanisms, regions of the spine involved, patient comorbidities, polytrauma or Traumatic Brain Injury (TBI), any surgical treatment were analysed. We then focused on differences between warm and cold seasons. 140 patients were included, but only 132 were considered due to missing data. Average age was 60.0 years. TSI involved cervical spine in 23.5% of the cases, thoracic in 27.3%, lumbosacral in 37.1%, and multiple sites in 12.1%. 54.5% of the patients were treated with conservative therapies while 45.5% underwent surgery (78.3% spinal arthrodesis and 21.7% vertebroplasty). Mechanisms of trauma were as follows: accidental falls 56.8%, vehicular accidents 21.2%, sports 20.4% and violence 1.5%. There was a statistically significant increase in TSIs during warm months compared to cold ones (78 vs 54, p-value 0.04) due to a marked increase in sports injuries (22 vs 5, p-value 0.001). Rural areas with high levels of summer tourism and sporting activity could benefit from deployment of resources and teams at specific times.