Acute traumatic spinal cord injury, 1993-2000A population-based assessment of methylprednisolone administration and hospitalization

BACKGROUND: Administration of methylprednisolone sodium succinate (MPSS) after acute traumatic spinal cord injury (TSCI) is controversial. This study compared differences in acute care charge, hospital stay, and related variables as a function of MPSS receipt. METHODS: Determinants of MPSS administration were examined after acute TSCI for South Carolina patients during the period 1993 to 2000 in a multivariate logistic regression model. RESULTS: Administration of MPSS was documented for 48.7% of 1,227 randomly selected patients with TSCI. Patients admitted via trauma centers and emergency departments were more likely to receive MPSS (trama center level 1 odds ratio [OR], 4.06; 95% CI confidence interval [CI], 2.11-7.83; emergency department OR, 1.64; 95% CI, 1.20-2.23). Hospital charge and length of stay were significantly higher for MPSS recipients. CONCLUSIONS: The study findings indicate MPSS use is associated with higher acute care charges and longer hospital stays. These findings suggest the need for outcome studies to assess the long-term benefits of MPSS administration.