P314. Epidemiology of Lumbar Spine Fractures: 20-Year Assessment of Nationwide Emergency Department Visit Data

BACKGROUND CONTEXT Lumbar spine fractures are common injuries associated with substantial patient morbidity and socioeconomic burden. Despite this, few studies have aimed to characterize the trends in patient demographics of those suffering from lumbar fracture to guide injury prevention efforts. PURPOSE This study aims to epidemiologically analyze lumbar spinal fractures by injury mechanism and identify temporal trends in patient demographics. STUDY DESIGN/SETTING Retrospectively analyzed data. PATIENT SAMPLE The study cohort included patients who presented to the ED in the US for lumbar fracture and whose cases were recorded in the National Electronic Injury Surveillance System (NEISS). OUTCOME MEASURES Overall and variable-specific at-risk person-years incidences and yearly injury trends. METHODS Retrospective analysis of the United States National Electronic Injury Surveillance System (NEISS) database was performed between 2003 and 2022. The sample consisted of all patients presenting at participating institutions’ emergency departments (ED) with lumbar fracture. The mechanism of injury was extracted from the dataset. Descriptive statistics were performed, and US Census Bureau-derived estimates were utilized to calculate at-risk person-years for the entire population and variable-delimited subgroups (age, race, and sex). Linear regression analysis was used to assess yearly injury trends. Incidence rate ratios (IRR) were calculated to assess the relationship between demographic factors and incidence of injury. RESULTS A total of 15,196 unweighted injuries, representing 642,980 weighted injuries, were recorded between 2003 and 2022. There was a 20-year incidence rate of 10.14 cases per 100,000 persons-years with a 2-fold increase in fracture incidence between 2003 and 2022 (Figure 1). Compared to male patients, females were more prone to lumbar fracture (p=0.032). Injuries primarily stemmed from a fall (76.6%). Incidence of lumbar fracture increased most significantly in older patients with patients aged ≥80 years showing the greatest year over year increase in incidence from 2003 to 2022 (β1=8.771, R2=0.7439, p<0.001) while patients aged 60-69 showed the greatest percent increase from 2003 to 2022 with a 3.24-fold increase in incidence. Most (58.9%) of fractures occurred at home. Females were more often injured at home compared to male patients (p<0.001), who were more likely to sustain lumbar fractures during recreational or athletic activity (p<0.001). CONCLUSIONS This investigation over a 20-year study period showed a 2-fold increase in the incidence of lumbar vertebral fractures. All patients over the age of 40 showed at least a doubling in incidence rate, with patients aged ≥80 accounting for the greatest proportion of fractures, emphasizing the importance of bone health and fall prevention in the aging population. FDA Device/Drug Status This abstract does not discuss or include any applicable devices or drugs.