Prevalence of Neurogenic Heterotopic Ossification in Traumatic Head- and Spinal-Injured Patients Admitted to a Tertiary Referral Hospital in Australia

Abstract

Objective: To investigate the prevalence of neurogenic heterotopic ossification (NHO) in patients with traumatic brain injury (TBI) or traumatic spinal cord injury (TSCI) admitted to non-specialised units. Subjects and Method: Retrospective audit of patients, using the ICD-10-AM coding system, admitted to The Townsville Hospital (TTH) with TBI/TSCI between 1 July 2006 and 31 December 2012. Results: 58 patients with length of stay (LOS) ≥60 days were admitted to TTH with TBI/TSCI over this period; mean age 60 years (range 31-87 years); (55 were TBI and 3 TSCI patients). 3114 TBI/TSCI patients with LOS <60 days and mean age of 43 years (range 18-93years) were also identified (2903 were TBI and 211 TSCI patients). Overall, none were diagnosed with NHO; six patients, identified by the ICD-AM-10 codes, diagnosed with heterotopic ossification (HO) did not have an associated TBI/TSCI. Conclusion: Findings of zero percent of NHO prevalence in TSCI/TBI patients admitted to the large tertiary referral hospital suggest that NHO may have been missed, possibly due to the TSCI/TBI ICD-10-AM codes, not being specifically designed for documentation of the TBI/TSCI complications. If NHO remains undiagnosed in non-specialised units due to the method of coding, it may increase functional limitation in already compromised individuals.