A 50-year follow-up of the incidence of traumatic spinal cord injuries in Western Norway

Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Spinal Cord (Impact Factor: 1.8). 10/2009; 48(4):313-8. DOI: 10.1038/sc.2009.133
Source: PubMed

ABSTRACT Retrospective population-based epidemiological study.
To assess the prevalence and temporal trends in the incidence of traumatic spinal cord injuries (TSCI), and demographic and clinical characteristics of an unselected, geographically defined cohort in the period 1952-2001.
The patients were identified from hospital records. Crude rates and age-adjusted rates were calculated for each year. The multivariate relationship between cause of injury, age at injury, decade of injury and gender was examined using a Poisson regression model.
Of 336 patients, 199 patients were alive on 1 January 2002, giving a total prevalence of 36.5 per 100,000 inhabitants. The average annual incidence increased from 5.9 per million in the first decade to 21.2 per million in the last. Mean age at injury was 42.9 years and the male to female ratio 4.7:1. Fall was the most common cause of injury (45.5%), followed by motor vehicle accidents (MVA) (34.2%). The incidence of MVA-related injuries increased during the observation period, especially among men <30 years. The lesion level was cervical in 52.4%, thoracic in 29.5% and lumbar/sacral in 18.2%. The lesion was clinically incomplete in 58.6% and complete in 41.4%. The incidence of fall-related injuries and the proportion of incomplete cervical lesions increased during the observation period, especially among men >60 years.
The incidence of TSCI has increased during the past 50 years. Falls and MVA are potentially preventable causes. The increasing proportion of older patients with cervical lesions poses a challenge to the health system.

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Available from: Ellen Merete Hagen, Apr 15, 2014
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    • "On the other hand, interpersonal and road traffic injuries are associated with the youngest mean age at SCI. [6] As suggested by other authors, younger patients are more frequently involved in high energy traumas to the spinal cord, including gunshots and motor vehicle crashes and, consequently, have a tendency to develop more severe neurological impairment. [14] [19] [21] The limitations of our study must be acknowledged. First, it should be considered that our unit is part of a highly specialized university hospital in the most populous city of South America, so that a selection bias, with inclusion of more severe cases cannot be excluded. "
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    ABSTRACT: Epidemiological features of spinal cord injury (SCI) have been changing over the last decades. We evaluated the contemporary trends in the epidemiology of traumatic SCI patients from a rehabilitation center. In a cross-sectional study, a consecutive series of 348 patients with traumatic SCI were evaluated. Variables were collected through an epidemiological form, which included gender, age at injury, duration and cause of SCI. We investigated SCI epidemiological trends over time including the association between gender and age at injury with SCI features such as etiology, injury severity and level. The mean age at SCI has increased from 26.0 ± 11.8 in patients with SCI before 2003 to 37.9 ± 15.7 in those with SCI after 2009 (p < 0.001). Gunshot wounds were the main cause of injury in patients with SCI before 2003, dropping from 40.6 to 16.9% after 2009 and being surpassed by road traffic injuries (38.6%) and falls (31.4%) after 2009 (p < 0.001). Gender, SCI severity and level have not changed significantly over the time. There was a major increase in the average age of patients as well as changes in the etiology of SCI over the past fifteen years, including a significant decrease in gunshot wounds and an increase in the frequency of road traffic injuries and falls. These changes and accompanying risk factors must be taken into consideration when planning measures to prevent SCI. © 2015 S. Karger AG, Basel.
    Neuroepidemiology 03/2015; 44(2):85-90. DOI:10.1159/000371519 · 2.56 Impact Factor
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    • "A study in Norway reported that the annual incidence rate of SCI had grown from 6.2 per million in the period between 1952 and 1956 to 26.3 per million in the period between 1997 and 2001. The main reasons reported for the increase were car accidents and falls [2]. Other annual incidence rates of SCI that have been reported include 40.2 per million in Japan from 1990 to 1992, 18.0 per million in Jordan from 1988 to 1993, and 18.8 per million in Taiwan from 1992 to 1996 [3]. "
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    ABSTRACT: To evaluate the epidemiologic change of patients with spinal cord injury who were admitted to a Rehabilitation Hospital, Yonsei University College of Medicine, during 1987-1996 and 2004-2008. Medical records of 629 patients with spinal cord injury admitted to the Rehabilitation Hospital, Yonsei University College of Medicine, from 2004 to 2008 were collected and reviewed retrospectively. The male-to-female ratio decreased to 2.86:1, the mean age at injury increased, nontraumatic etiology increased, traffic accident remained to be the most common in traumatic spinal cord injury, and falling increased significantly. Tumor was the most common etiology in nontraumatic spinal cord injury, tetraplegia and incomplete injuries occurred more than paraplegia and complete injuries, indwelling catheter was the most common voiding method, and the duration of hospitalization decreased. Many trends changed in epidemiology of spinal cord injury.
    Annals of Rehabilitation Medicine 02/2013; 37(1):50-6. DOI:10.5535/arm.2013.37.1.50
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    • "In a population study from Western Norway, the incidence of acute traumatic SCI during the time period from 1997–2001 was estimated to be 1.4/100,000 [32]. This study also included SCI without concurrent CS-fx. "
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    ABSTRACT: The aim of this study was to estimate the incidence of traumatic cervical spine fractures (CS-fx) in a general population. The incidence of CS-fx in the general population is largely unknown. All CS-fx (C0/C1 to C7/Th1) patients diagnosed with cervical-CT in Southeast Norway (2.7 million inhabitants) during the time period from April 27, 2010-April 26, 2011 were prospectively registered in this observational cohort study. Over a one-year period, 319 patients with CS-fx at one or more levels were registered, constituting an estimated incidence of 11.8/100,000/year. The median age of the patients was 56 years (range 4–101 years), and 68% were males. The relative incidence of CS-fx increased significantly with age. The trauma mechanisms were falls in 60%, motorized vehicle accidents in 21%, bicycling in 8%, diving in 4% and others in 7% of patients. Neurological status was normal in 79%, 5% had a radiculopathy, 8% had an incomplete spinal cord injury (SCI), 2% had a complete SCI, and neurological function could not be determined in 6%. The mortality rates after 1 and 3 months were 7 and 9%, respectively. Among 319 patients, 26.6% were treated with open surgery, 68.7% were treated with external immobilization with a stiff collar and 4.7% were considered stable and not in need of any specific treatment. The estimated incidence of surgically treated CS-fx in our population was 3.1/100,000/year. This study estimates the incidence of traumatic CS-fx in a general Norwegian population to be 11.8/100,000/year. A male predominance was observed and the incidence increased with increasing age. Falls were the most common trauma mechanism, and SCI was observed in 10%. The 1- and 3-month mortality rates were 7 and 9%, respectively. The incidence of open surgery for the fixation of CS-fx in this population was 3.1/100,000/year. Level of evidence This is a prospective observational cohort study and level II-2 according to US Preventive Services Task Force.
    Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 12/2012; 20(1):85. DOI:10.1186/1757-7241-20-85 · 2.03 Impact Factor
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