The graying of spinal cord injury: National trends in traumatic spinal cord injury mortality in the United States, 1999-2024.

Authors

Adil Can Karaoğlu, Salim Katar

Published in

The journal of spinal cord medicine. Pages 1-11. Oct 23, 2026. Epub Oct 23, 2026.

Abstract

The epidemiology of traumatic spinal cord injury (SCI) is shifting toward older adults injured by low-energy falls, yet national US SCI-related mortality trends remain uncharacterized, partly because SCI lacks a surveillance registry. We characterized these trends, 1999-2024.
Retrospective, population-based ecological time-trend analysis.
US national multiple-cause-of-death data (CDC WONDER), 1999-2024.
US decedents with traumatic SCI among causes of death, identified by a validated eight-code ICD-10 definition.
Not applicable.
Age-adjusted mortality rate (AAMR; 2000 US standard); annual percent change (APC) by joinpoint regression; decomposition of the increase into population growth, aging, and age-specific risk.
Of 31,279 SCI-related deaths, annual deaths rose from 923 to 1,601. The AAMR was stable through 2016 (APC +0.11%, P = 0.81), then increased significantly (2016-2024 APC +2.28%; 95% CI, 1.06-6.40; P = 0.002). Mortality declined at ages 15-34 but rose 43-60% at 55-74 years. Of the increase, 44% reflected population growth, 20% aging, and 36% rising age-specific rates. Men (rate ratio 3.59) and non-Hispanic Black adults (rate ratio 1.75) had higher mortality, with increases concentrated in the Midwest and Northeast. Restricting to acute injury codes (excluding chronic sequelae) produced a lower absolute rate but the same +17% increase, indicating the trend was not a sequelae-coding artifact; falls accounted for 32% of acute SCI deaths, rising to 59% at ages ≥85 years.
US traumatic SCI mortality has risen since 2016, concentrated in older adults, reflecting demographic change and rising age-specific risk, amid persistent sex, racial, and regional disparities - the graying of SCI.

PMID:
42925110
Bibliographic data and abstract were imported from PubMed on 25 Oct 2026.

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