Level I Trauma Centers Are Associated With Lower Adjusted In-Hospital Mortality After Operative Spine Trauma: Analysis of the 2023 United States National Trauma Data Bank.

Authors

• Mitchell K Ng
• Leonidas E Mastrokostas
• Paul G Mastrokostas
• Yulia Lee
• Gregorio Baek
• Jonathan Dalton
• Alec Giakas
• Adam Fano
• Sean Inzerillo
• Afshin E Razi
• Khaled Elmenawi
• Daniel R Fassett
• Thomas D Cha
• Mark F Kurd
• Zachary Wilt
• Jeffrey A Rihn
• Ian D Kaye
• Jose A Canseco
• Alan S Hilibrand
• Alexander R Vaccaro
• Gregory D Schroeder
• Christopher K Kepler
• Andrew P Alvarez

Publication/Presentation Date

1-16-2026

Abstract

Study DesignRetrospective cohort study.ObjectiveTo compare in-hospital mortality, complications, and resource utilization among patients undergoing fusion, decompression/discectomy, or instrumentation for spine trauma at Level I vs Level II trauma centers.MethodsThe National Trauma Data Bank was queried for adult patients with isolated spine trauma who underwent fusion, decompression/discectomy, or instrumentation at a Level I or Level II center. Multivariable logistic and linear regression models were used to adjust for patient demographics, injury severity, comorbidities, and hospital characteristics, comparing in-hospital mortality, complications, and length of stay (LOS).ResultsWe identified 10 295 patients (6588 at Level I; 3707 at Level II). Level I patients were younger, had more severe spinal injuries, and had a higher incidence of spinal cord injury, particularly involving the cervical spine. Unadjusted outcomes showed similar mortality, but longer hospital and ICU LOS at Level I centers. After risk adjustment, treatment at a Level I center was associated with a 34% lower adjusted odds of in-hospital mortality (OR 0.66; 95% CI 0.46-0.96;

First Page

21925682261417278

Last Page

21925682261417278

ISSN

2192-5682

Published In/Presented At

Ng, M. K., Mastrokostas, L. E., Mastrokostas, P. G., Lee, Y., Baek, G., Dalton, J., Giakas, A., Fano, A., Inzerillo, S., Razi, A. E., Elmenawi, K., Fassett, D. R., Cha, T. D., Kurd, M. F., Wilt, Z., Rihn, J. A., Kaye, I. D., Canseco, J. A., Hilibrand, A. S., Vaccaro, A. R., … Alvarez, A. P. (2026). Level I Trauma Centers Are Associated With Lower Adjusted In-Hospital Mortality After Operative Spine Trauma: Analysis of the 2023 United States National Trauma Data Bank. Global spine journal, 21925682261417278. Advance online publication. https://doi.org/10.1177/21925682261417278

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

41544380

Department(s)

Administration and Leadership

Document Type

Article