E-Mail Contemporary Trends in the Epidemiology of Traumatic Spinal Cord Injury: Changes in Age and Etiology (original) (raw)
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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.
Global prevalence and incidence of traumatic spinal cord injury
Clinical Epidemiology, 2014
Background: Spinal cord injury (SCI) is a traumatic event that impacts a patient's physical, psychological, and social well-being and places substantial financial burden on health care systems. To determine the true impact of SCI, this systematic review aims to summarize literature reporting on either the incidence or prevalence of SCI. Methods: A systematic search was conducted using PubMed, MEDLINE, MEDLINE in process, EMBASE, Cochrane Controlled Trial Register, and Cochrane Database of Systematic Reviews to identify relevant literature published through June 2013. We sought studies that provided regional, provincial/state, or national data on the incidence of SCI or reported estimates of disease prevalence. The level of evidence of each study was rated using a scale that evaluated study design, methodology, sampling bias, and precision of estimates. Results: The initial search yielded 5,874 articles, 48 of which met the inclusion criteria. Forty-four studies estimated the incidence of SCI and nine reported the prevalence, with five discussing both. Of the incidence studies, 14 provided figures at a regional, ten at a state or provincial level and 21 at a national level. The prevalence of SCI was highest in the United States of America (906 per million) and lowest in the Rhone-Alpes region, France (250 per million) and Helsinki, Finland (280 per million). With respect to states and provinces in North America, the crude annual incidence of SCI was highest in Alaska (83 per million) and Mississippi (77 per million) and lowest in Alabama (29.4 per million), despite a large percentage of violence injuries (21.2%). Annual incidences were above 50 per million in the Hualien County in Taiwan (56.1 per million), the central Portugal region (58 per million), and Olmsted County in Minnesota (54.8 per million) and were lower than 20 per million in Taipei, Taiwan (14.6 per million), the Rhone-Alpes region in France (12.7 per million), Aragon, Spain (12.1 per million), Southeast Turkey (16.9 per million), and Stockholm, Sweden (19.5 per million). The highest national incidence was 49.1 per million in New Zealand, and the lowest incidences were in Fiji (10.0 per million) and Spain (8.0 per million). The majority of studies showed a high male-to-female ratio and an age of peak incidence of younger than 30 years old. Traffic accidents were typically the most common cause of SCI, followed by falls in the elderly population. Conclusion: This review demonstrates that the incidence, prevalence, and causation of SCI differs between developing and developed countries and suggests that management and preventative strategies need to be tailored to regional trends. The rising aging population in westernized countries also indicates that traumatic SCI secondary to falls may become an increasing public health challenge and that incidence among the elderly may rise with increasing life expectancy.
Epidemiology of traumatic spinal cord injury: a large population-based study
Spinal Cord
A retrospective population-based study. OBJECTIVES: Describe the incidence of traumatic spinal cord injury (TSCI) and mortality risks, based on the characteristics of the patient, anatomical level of the lesion, setting/cause of the injury, and type of healthcare support received within the regional trauma network (highly specialized trauma center or spoke hospital). SETTING: Between 2011 and 2020, 1303 patients with incident TSCI were identified in a population of 4.9 million inhabitants. METHODS: Hospital discharge records and mortality records were used to identify patients and outcomes. Cox regression models were fitted to estimate mortality risks across several subgroups. RESULTS: Over the past decade, age-sex-standardized TSCI incidence rates remained stable with 26.5 cases (95% CI, 25.0-27.9) per 1,000,000 inhabitants (mean age 59.2 years) and most cases were males (68.3%). Incidence was directly associated with age while the male to female ratio was inversely related. Most TSCIs were cervical lesions (52.1%), and the most common cause of injury were traffic crashes (29.9%) followed by occupational accidents (29.8%). Sex, cause of the trauma, or inpatient hospital management were not associated with an increased risk of death. Mortality rates were greater for cervical lesions, and increased with age, remaining stably high among older individuals even 12 months after the accident. One-month mortality risk was significantly higher at ≥75 years compared to <55 years (adjusted HR 9.14 (95% CI, 4.17-20.03)). CONCLUSION: Public health policies should aim at reducing preventable TSCIs, and special attention should be drawn to long-term management of elderly patients in the attempt to decrease mortality rates.
Traumatic spinal cord injury in the United States, 1993-2012
JAMA, 2015
Acute traumatic spinal cord injury results in disability and use of health care resources, yet data on contemporary national trends of traumatic spinal cord injury incidence and etiology are limited. To assess trends in acute traumatic spinal cord injury incidence, etiology, mortality, and associated surgical procedures in the United States from 1993 to 2012. Analysis of survey data from the US Nationwide Inpatient Sample databases for 1993-2012, including a total of 63,109 patients with acute traumatic spinal cord injury. Age- and sex-stratified incidence of acute traumatic spinal cord injury; trends in etiology and in-hospital mortality of acute traumatic spinal cord injury. In 1993, the estimated incidence of acute spinal cord injury was 53 cases (95% CI, 52-54 cases) per 1 million persons based on 2659 actual cases. In 2012, the estimated incidence was 54 cases (95% CI, 53-55 cases) per 1 million population based on 3393 cases (average annual percentage change, 0.2%; 95% CI, -0....
Introductory Chapter: Spinal Cord Injury
IntechOpen eBooks, 2023
syndrome usually affects children, while it is reported rarely in the adult population [31, 32]. The genesis of SCIWORA seems related to hyperextension forces, as cervical acceleration causing whiplash injuries in car accidents, or from a direct impact to the face, very similar to the diffuse axonal injury in the brain trauma [32, 33]. The treatment is usually conservative with early immobilization of the neck [34]. However, up to 16% of these patients suffer from relevant post-traumatic disorders. 6. Conclusion Spinal cord injury represents a scenario of multidisciplinary interest in which the injury-to-treatment time represents the most relevant factor in determining the functional outcome. Functional disorders after SCI represent socioeconomic burdens, in terms of direct and indirect health-related costs. Therefore, there is a growing interest in both ameliorating the treatment strategies in the acute management of SCI and standardizing rehabilitation and long-term care protocols for these patients.
Current synthetic overview on spinal cord injury epidemiological data
Romanian Journal of Medical Practice, 2015
Aim. To have updated information on the epidemiology of spinal cord injury (SCI) is required for developing an adequate and effective related health policy strategies and consequent contextual decisions making regarding this category of patients and also for planning and implementing SCI prevention education and measures. Accordingly, the rationale of this article is to provide a systematic overview of the literature regarding SCI epidemiology. Material and methods. We reviewed epidemiological published reports and searched on internet specifically databases, from different centres, worldwide, about SCI, collecting descriptive data for properly estimating the incidence, prevalence, and/ or causes of SCI. Results. The global annual incidence rate is considered to be 23 cases of Traumatic Spinal Cord Injury (TSCI) per million (179,312 new cases per annum – results provided by World Health Organisation’s (WHO) in 2007). Prevalence per million inhabitants varies quite largely among stat...
Epidemiology of Traumatic Spinal Cord Injury in Canada
Spine, 2006
35.2). The two leading causes of SCI were found to be motor vehicle crashes (41.4%; 95% CI: 35.4-47.4) and falls (34.9%; 95% CI: 26.7-43.1). Complete SCIs were found to be more common than incomplete injuries (complete SCI: 56.5%; 95% CI: 47.6-65.3; incomplete SCI: 43.0%; 95% CI: 34.1-52.0). Similarly, paraplegia was found to be more common than tetraplegia (paraplegia: 58.7%; 95% CI: 51.5-66.0; tetraplegia: 40.6%; 95% CI: 33.3-48.0). Conclusion: Through an understanding of the epidemiology of SCI in developing countries, appropriate preventative strategies and resource allocation may decrease the incidence and improve the care of these injuries.
People with Spinal Cord Injury in the United States
American Journal of Physical Medicine & Rehabilitation, 2017
The incidence of traumatic spinal cord injury (SCI) in the United States is estimated to be 40.1 cases per million, 1 indicating approximately 12,500 new SCI occur each year. 2 The prevalence of SCI is estimated to be 906 cases per million, or 276,000 individuals. 1,2 Males are more likely to experience an SCI than females at a ratio of 2.25:1 and are estimated to account for 80% of all traumatic SCI cases. Between 1993 and 2012, there was an estimated decrease in incidence of SCI from 144 to 87 cases per million in younger males aged 16 to 24 years. 3 Vehicular accidents are the leading cause of SCI in the United States, accounting for approximately 39.08% of all SCIs between 2005 and 2015. Unintentional falls (29.54%) ranked second, followed by acts of violence (14.41%; 13.01% from gunshot wounds) and sports/recreational activities (8.39%). 4 The average life expectancy for an individual with SCI has not changed since the 1980s and is significantly lower than an individual without SCI. 2 The leading cause of mortality in SCI individuals is disease of the respiratory system, such as pneumonia, accounting for 21.6% of all deaths. 5 Between 1997 and 2012, there was a significant increase in the incidence of acute traumatic SCIs as a result from unintentional falls. 3 Incidence and prevalence of SCI in individuals older than 60 years have increased, with prevalence increasing at a slower rate because of higher mortality rates in this age group.