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

Reznik, Jacqueline E. B App Sci (Physio); Biros, Erik PhD; Milanese, Steve PhD; Gordon, Susan PhD; Lamont, Anthony C. MD; Galea, Mary P. PhD

doi: 10.1097/HCM.0000000000000044

A study was undertaken to investigate the prevalence of neurogenic heterotopic ossification (NHO) in patients with traumatic brain injury (TBI) or traumatic spinal cord injury (TSCI) admitted to nonspecialized units. Methods consisted of a retrospective audit of patients, using the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) coding system, admitted to The Townsville Hospital with TBI/TSCI between July 1, 2006, and December 31, 2012. Fifty-eight patients with length of stay of 60 days or longer were admitted to The Townsville Hospital with TBI/TSCI over this period with mean age of 60 years (range, 31-87 years); 55 were TBI and 3 were TSCI patients. Three thousand one hundred fourteen TBI/TSCI patients with length of stay of less than 60 days and mean age of 43 years (range, 18-93 years) were also identified (2903 were TBI and 211 were TSCI patients). Overall, none had a diagnosis of NHO; 6 patients, identified by the ICD-10-AM codes, with a diagnosis of heterotopic ossification did not have an associated TBI/TSCI. Findings of 0% of NHO prevalence in TSCI/TBI patients admitted to the large tertiary referral hospital suggest that NHO may have been missed, possibly because of the TSCI/TBI ICD-10-AM codes, not being specifically designed for documentation of the TBI/TSCI complications. If NHO remains undiagnosed in nonspecialized units because of the method of coding, it may increase functional limitation in already compromised individuals.

Author Affiliations: James Cook University, Townsville (Ms Reznik, Drs Biros, Gordon, Lamont, and Galea); University of South Australia (Dr Milanese); The Townsville Hospital (Dr Lamont); and The University of Melbourne (Dr Galea), Australia.

The authors have no conflicts of interest.

Correspondence: Jacqueline E. Reznik, B App Sci (Physio), POB 165, James Cook University, Townsville, QLD 4811, Australia (

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