Incidence rates and populations at risk for spinal cord injury: A regional study (original) (raw)
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Risk factors and mechanisms of occurrence in motor vehicle-related spinal cord injuries: Utah
Accident Analysis & Prevention, 1995
The purpose of this paper is to describe the incidence, risk factors, and crash factors of motorvehicle-related spinal cord injuries in Utah. The Utah Department of Health established a statewide registry of spinal cord injuries (SCIs) occurring in 1989-1991, analyzing data from hospital medical records and police reports. Forty-nine percent of all SCIs involved motor vehicles, including injuries arising from motor vehicle collisions with bicyclists and pedestrians. Adolescent and young adult males were at highest risk of injury. Among occupants of automobiles and trucks with SCI, 70% were involved in a vehicle rollover, while 39% were ejected from the vehicle. Only 25% reported using seatbelts. SCIs were much more likely to be associated with rollover compared with other types of motor vehicle-occupant injuries. These findings suggest areas in which SC1 prevention programs and research should be focused.
Accident Analysis & Prevention, 2006
Road crashes involving occupants of light passenger vehicles are the leading cause of traumatic spinal cord injury (SCI). Confirming the results of an earlier study, this study showed that: in single vehicle car crashes in the country, the odds of SCI were nearly five times higher (4.7) for occupants of non-sedan type light passenger vehicles compared with sedans; in single vehicle rollover crashes in the country, the odds of SCI were nearly three times higher (2.8) in non-sedans compared with sedans; the odds of SCI were nearly five times higher (4.8) for sports utility vehicles (SUVs) compared with sedans. When the data from the earlier study was included in order to increase statistical power, it was found that when compared to sedans that did not roll, occupants of all types of light passenger vehicles had a statistically significant substantially higher likelihood of SCI when involved in rollover (sedans 7.5 times, SUVs 5.9 times and others 8.4 times). In addition, SUVs had a higher likelihood of SCI even when not involved in rollover (5.4 times). Vehicle designers and regulators need to give more attention to the prevention of vehicle rollover and the means to improve occupant protection in the event of rollover. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and characteristics for low occurrence of SCI identified.
Patterns of spinal cord injury in automobiles versus motorcycles and bicycles
Spinal Cord Series and Cases, 2020
Study design Retrospective case series. Objectives To examine the patterns and relative rates of occurrence of spinal cord injury (SCI) in automobiles compared to motorcycles and bicycles. Setting Los Angeles County, California. Methods A retrospective chart review of SCI consults at Rancho Los Amigos National Rehabilitation Center in Los Angeles County, California between 2003 and 2013 were selected and screened for a mechanism of injury involving a vehicular accident. Chart review was performed to determine neurological levels and extent of impairment, which were graded according to the International Standards for Neurological Classification of Spinal Cord Injury. Results We identified 398 cases of SCI from 2003 to 2013 that fit the inclusion criteria. Overall, the relative percentages of ASIA impairment scale (AIS) A/B/C/D did not differ statistically across automobiles, motorcycles, or bicycles. When stratified by spinal region, motorcycles had a higher percentage of thoracic SCIs compared to automobiles. Automobiles resulted in more cervical SCIs with few injuries in the lumbar region. Bicycle patterns followed automobiles, not motorcycles. Thoracic SCIs were more likely graded motor complete than cervical or lumbar injuries, regardless of the mechanism. Conclusions Automobile, motorcycle, and bicycle related SCIs occur primarily in the cervicothoracic region. SCIs due to motorcycle accidents have a higher predilection for the thoracic region, and there is a statistically higher percentage of motor complete injuries. A higher percentage of cervical SCIs occur as a result of automobile and bicycle accidents. Extrapolations from motor vehicle usage data suggest that the relative rate of occurrence of SCI for motorcycles is higher than for automobiles.
Traumatic Spinal Cord Injuries Due to Motor Vehicle Accidents
2018
Background and Aim: Spine trauma is an important health problem. Traumatic Spinal Cord Injury (SCI) due to Motor Vehicle Accident (MVA) might have a different epidemiologic pattern in Guilan province of Iran owing to its geographical characteristics. Therefore, the present study was conducted to the study epidemiology of SCI injuries due to road accidents in a trauma referral center in Guilan. Methods and Materials/Patients: In this cross-sectional study, we used data SCI registry of Poursina Hospital. All the patients with spine trauma, due to MVA, hospitalized in the trauma center of Poursina Hospital, Rasht, Guilan, Iran between March 2015 and March 2018 were studied. Results: A total of 127 patients with spine trauma due to MVA were reviewed. The Mean±SD age of patients was 38.27±16.22 years. We observed that 93.7%, 1.6%, and 4.7% of the patients had initial Glasgow Comma Scale (GCS ≥13, 9 ≤GCS ≤12, and GCS<9, respectively). SCIs were found several anatomical regions including cervical (n=54, 42.5%), lumbar (n=39, 30.7%), thoracic (n=23, 18.1%), thoracic and lumbar (n=7, 5.5%), thoracic and cervical (n=3, 2.4%), and lumbar and cervical (n=1, 0.8%) regions. Evaluated by Glasgow Outcome Scale (GOS), good recovery, moderate disability, severe disability, vegetative state, and death were found in 114(91.2%), 4 (3.1%), 4(3.1%), 1(0.8%), 2(1.6%) of the patients, respectively. Two patients were discharged by their personal contest. Conclusion: Spine trauma due to MVA is mostly seen in the young. SCI due to such trauma is mostly found in the cervical region. Good recovery was seen in most of the subjects.
Spinal injury resulting from car accident:Focus to prevention
Asian Journal of Neurosurgery, 2015
approximately 40% of spinal injuries due to RTAs. [5] Kashan, with 500,000 population located in the central part of Iran is at the junction of the north-south main highways of the country, which allows evaluation and comparison of RTAs in city streets and roads out of the city. Shahid Beheshti Hospital of Kashan University of Medical Sciences (KAUMS) as the main trauma center in the region receives more than 8000 cases of trauma every year. In spite of studies comparing RTAs with other spinal injury mechanisms such as fall, [5] or evaluating spinal cord injury (SCI) in RTAs, [6] there is no specific study about car related spinal injuries; and all of the previous studies had a general epidemiological attitude toward this subject in Iran. [7-9]
Accident Analysis & Prevention, 2020
Background: Cervical spine injury is a common result of traffic crashes, and such injuries range in severity from minor (i.e. sprain/strain) to moderate (intervertebral disk derangement) to serious and greater (fractures, dislocations, and spinal cord injuries). There are currently no reliable estimates of the number of crash-related spine injuries occurring in the US annually, although several publications have used national crash injury samples as a basis for estimating the frequency of both cervical and lumbar spinal disk injuries occurring in lower speed rear impact crashes. Purpose: To develop a reliable estimate of the number of various types of cervical spine injuries occurring in the US by comparing data from national crash injury to national hospital ED and inpatient samples. Study Design: Comparative cross-sectional Methods: Cervical spine injury data were accessed, analyzed, and compared from 3 national databases; the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS), Nationwide Emergency Department Sample (NEDS), and the Nationwide Inpatient Sample (NIS). Results: It is estimated that there are approximately 869,000 traffic crash-related cervical spine injuries seen in hospitals in the US annually, including around 841,000 sprain/strain (whiplash) injuries, 2800 spinal disk injuries, 23,500 fractures, 2800 spinal cord injuries, and 1500 dislocations. Because of a highly restrictive inclusion criteria for both crash and injury types, as well as a very small sample size, the NASS-CDS underestimated all types of crash-related cervical spine injuries seen in US hospital emergency departments by 84 %. The injury type with the largest degree of underestimation in the NASS-CDS was cervical disk injuries, which were estimated at an 88 % lower frequency than in the NEDS. National insurance claim data, which include cases of cervical disk injury diagnosed both in and outside of the ED, indicate that the NEDS likely undercounts cervical disk injuries by 92 %, and thus the NASS-CDS correspondingly undercounts such injuries by 99 % or more. Conclusions: Because of a limited sample size and restrictive criteria for both crash and injury inclusion, the NASS-CDS cannot be used to estimate the number of crash-related spinal injuries of any type or severity in the US. The most inappropriate use of the database is for estimating the number of spinal injuries resulting from low speed rear impact collisions, as the NASS-CDS samples fewer than 1 in 100,000 of the cervical spine injuries of any type occurring in low speed rear impact collisions.
Characterization of traffic accidents that presented spinal cord injury as an outcome
Journal of Nursing Ufpe on Line Jnuol Doi 10 5205 01012007, 2013
Objective: to characterize the traffic accident which had an outcome of victims with spinal cord injury, the locations of greater TA occurrence and whether there is a relationship between the nature of the traffic accident and the type of spinal cord injury. Method: the study was an observational descriptive sample of 32 individuals in João Pessoa, Brazil-PB who suffered some kind of spinal cord injury caused by a traffic accident. For analysis of the association nature of the accident and the level of spinal cord injury the correspondence analysis was used. The study was approved by the Ethics in Research, CAAE 0070.0.126.000-07. Results: the majority of victims were male (62.5%) and the level of the injury was complete paraplegia (50%) followed by complete paraplegia (37.5%). The vehicle most involved in these AT was mopeds (43%). Conclusion: the study showed a significant involvement of mopeds, signaling that this is a vulnerable group for this type of the injury. Descriptors: External Causes; Traffic Accidents; Spinal Injury. RESUMO Objetivo: caracterizar o acidente de trânsito que apresentou como desfecho vítimas com trauma raquimedular, os locais de maior ocorrência de AT e se existe relação entre a natureza do acidente de trânsito e o tipo de lesão medular. Método: o estudo observacional descritivo, com amostra de 32 indivíduos residentes em João Pessoa/PB que sofreram algum tipo de trauma raquimedular decorrente de acidente de trânsito. Para análise da associação natureza do acidente e o nível da lesão medular utilizou-se da análise de correspondência. O estudo foi aprovado pelo Comitê de Ética em Pesquisa, CAAE 0070.0.126.000-07. Resultados: a maioria das vítimas era do sexo masculino (62,5%), e o nível da lesão foi paraplegia incompleta (50%) seguido da paraplegia completa (37,5%). O veículo mais envolvido nesses AT foram os ciclomotores (43%). Conclusão: o estudo apresentou expressivo envolvimento dos ciclomotores, sinalizando ser este um grupo vulnerável para a ocorrência do agravo. Descritores: Causas Externas; Acidentes de Trânsito; Traumatismos da Coluna Vertebral. RESUMEN Objetivo: caracterizar los accidentes de tráfico (AT) como el resultado mostró que el trauma espinal. Método: el estudio fue observacional descriptivo de la muestra de 32 individuos que viven en João Pessoa-PB que han sufrido algún tipo de trauma espinal como consecuencia de accidentes de tráfico. Para analizar la asociación entre el tipo de accidente y el grado de lesión de la médula espinal se utilizó el análisis de correspondencias. Resultados: la mayoría de las víctimas eran de sexo masculino (62,5%), y el nivel de la lesión fue paraplejía completa (50%) seguido por paraplejía completa (37,5%). El vehículo involucrado en estos AT eran más ciclomotores (43%) que mostraron una fuerte asociación con lesiones en el pecho. Inexperiencia del conductor y el exceso de velocidad fueron factores contribuyentes mencionados por la mayoría de los encuestados (59%). Conclusiones: el estudio mostró una participación importante de los ciclomotores, lo que indica que se trata de un grupo vulnerable para la aparición de esta enfermedad. Dicha información permite que las políticas públicas se crean, prevención, vigilancia y educación de este grupo. Descriptores: Causas Externas; Accidentes de Tránsito; Traumatismos Vertebrales.
Surveillance of spinal cord injuries in Utah, USA
Paraplegia, 1994
From 1989 through 1991, we conducted surveillance of spinal cord injury (SCI) among residents of Utah. We found an annual incidence rate of 4.3 per 100,000, with the highest rates occurring among males 15-24 years of age. Motor vehicles were the leading cause of injury, followed by falls, and sports and recreation. We also examined the accuracy and completeness of reporting in this surveillance system. We found the predictive value positive of SCI diagnoses reported in hospital discharge data to be only 61%. When we considered only patients who received acute hospital care in-state, we found that the sensitivity of hospital discharge data 89%. These findings indicate serious problems in the reporting of spinal cord injury diagnoses in hospital discharge data and the need to verify case reports based on these data. There is also a need to study this problem in other jurisdictions to determine if overreporting is widespread.
Accident Analysis & Prevention, 2006
This study reports on trends in spinal cord injury based on the Australian Spinal Cord Injury Register (ASCIR), which provided full coverage in those aged 15 years and over. The underlying annual rate of change from 1986 to 1997 was calculated for age-specific, crude and agestandardised incidence rates. An appropriate model for this type of data was the Poisson regression model, with a Poisson error distribution, a log link function and the natural log of population treated as an 'offset'. It was found that there was no change in the age-standardised rate of spinal cord injury. However, an assessment of specific rates by age, sex, cause and neurological group revealed some contrasting trends, notably declining rates in young males, transport-related injury and complete tetraplegia, and increasing rates in elderly males, fall-related injury and incomplete tetraplegia and complete paraplegia. These changes are considered to reflect the impact of a raft of public health measures directed at transport-related injury but a paucity of prevention programs directed at fall-related spinal cord injury. More research is required to determine the causes of the increasing rate of elderly male fall-related spinal cord injury. There is also more that can be done to prevent transport-related spinal cord injury. Sport utility vehicles pose an increased concern. In order to reinvigorate the debate about the need for a vehicle rollover resistance rating in Australia, the spinal cord injury risk of different models of SUV should be measured. This has already been implemented in the United States, providing the public with information to assist purchasing based on safety considerations.
An Epidemiological Overview of Spinal Trauma in the Kingdom of Saudi Arabia
Spine Surgery and Related Research
The World Report on Road Traffic Injury Prevention indicates that by 2020, road traffic injuries will be a major killer, accounting for half a million deaths and 15 million disability-adjusted life years. The Kingdom of Saudi Arabia (KSA) has one of the highest rates of spinal cord injuries in the world, with 62 people injured per 1 million, and the injuries are mostly due to traffic accidents. Materials and Methods: All polytrauma patients associated with spinal injuries admitted to Prince Mohammed bin Abdul Aziz Hospital (PMAH), Riyadh, from January 2017 to June 2018, were included in this study. Patients with old spinal injuries, any previous spinal surgery, spine infection, or concomitant diagnosed malignancies or osteoporotic collapse with or without falls were excluded. All patients underwent whole-spine computed tomography scan and, in selective cases, magnetic resonance imaging of the spine. Results: Of the 230 patients, 90.0% were male, and 60% were in the second and third decades. Motor vehicle accidents were responsible for 83% of the cases, of which 50% of the victims were the drivers, and 80% were passengers with no seatbelt on. Nearly 50% of the spinal injuries were associated with injuries in the other body parts. Cervical spine injury accounted for 44% of the cases, followed by the lumbar spine injury. Twenty five percent of the patients presented with fixed neurologic deficit in the form of quadriplegia or paraplegia (ASIA-A). The mortality rate was 1.3%. Conclusion: This study revealed that motor vehicle accidents are a major cause of spinal injuries in the KSA. One-fourth of the spinal Injuries are associated with complete spinal cord injuries. Therefore, in order to prevent lifelong disability in the young population, a nationwide program should be initiated to prevent road traffic accidents.