Cervical XXXX --a public catastrophe.

@entity1 @entity1688 @entity174 @entity146 @entity16 @entity1661 @entity51 @entity1566 @entity204 @entity130
Cervical spine @entity1566 continue to be a major cause of @entity204 and disability for @entity130 victims. Motor vehicle @entity130 results in 500 to 650 @entity1688 @entity1 per year. Most of the @entity1 are cared for at Level I @entity130 centers which may not have a dedicated rehabilitation facility. Long-term rehabilitation, nursing care, and financial support remain difficult areas in the overall management of these @entity130 . Seventy-one cervical spine @entity174 @entity1 were admitted to this medical center over a 2-year period. Twenty-two @entity1 had a @entity16 , 15 @entity1688 @entity1 , and seven with @entity51 . @entity130 was the etiology in 14 @entity130 ; gunshot wounds in five; falls in three. Twelve of these 22 @entity1 had associated @entity130 , including chest and @entity1661 . Prolonged stays in the intensive care unit were common (avg. = 13.5 days). Bronchoscopy (8/22 @entity1 ) and @entity146 pulmonary care were constantly needed. Six @entity1 died in the intensive care unit. The average hospital stay of the survivors was 45 days. Three of the 16 surviving @entity1 were ventilator dependent at the time of discharge. Ten @entity1 were discharged to a rehabilitation center, one to a nursing home, and five went home (one on a ventilator). The total hospital charges were  1,250,000. No financial resources were available for five of the 16 surviving @entity1 . Four @entity1 had resources which covered less than 50% of the total charges. Average hospital charges for survivors were  50,370. Maximum reimbursement using all outlier days under DRG 5 would be  12,385. The financial support of initial hospitalization, rehabilitation, and nursing care for these @entity1688 @entity1 is a serious national health care issue.
