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


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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    • "* Indicates estimates based on sub-national survey data. Country references: Greece (Divanoglou and Levi 2009); Iceland (Knutsdottir et al. 2012); Norway (Hagen et al. 2010); Spain (Perez et al. 2012); Sweden (Divanoglou and Levi 2009); France (Albert and Ravaud 2005); Austria (Jazayeri et al. 2014); Netherlands (Nijendijk et al. 2014); Finland (Ahoniemi et al. 2008); Ireland (O'Connor and Murray 2006); Denmark (Bjornshave Noe et al. 2015) 16 years and older, who started first rehabilitation in one of the four Swiss referral centers for SCI from January 1, 2005 to December 31, 2012 (Post et al. 2011). Only individuals that survived to be admitted to a rehabilitation center were thus included. "
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    ABSTRACT: Background: Traumatic spinal cord injury (TSCI) has a high personal and socio-economic impact. Effective public health prevention policies that aim to reduce this burden are reliant on contemporary information of the risk and underlying causes of TSCI. This study contextualizes Swiss annual incidence rates within the European context, and provides detailed estimates by age, gender and etiology towards informing targeted intervention strategies. Methods: TSCI cases that occurred in the years 2005 to 2012 were identified as part of the Swiss Spinal Cord Injury (SwiSCI) cohort study through a rehabilitation-based study of local medical files. Results: The crude annual incidence rate (IR) estimate of TSCI for the study period was 18.0 (95 % confidence interval 16.9-19.2) per one million population; standardized to the WHO world population IR was 21.7 (20.3-23.1) population. The injury rate of TSCI in Switzerland was intermediate in comparison to estimates for other European countries, which ranged from around 8.3 in Denmark to 33.6 per million in Greece. Males exhibited consistently higher IRs than females, with a highest IR ratio (IRR) of 3.9 (2.8-5.5) in young adults (aged 16 to 30). Sports and leisure and transport-related injuries were the predominant causes of TSCI in the youngest age group (aged 16 to 30); falls were the predominant cause among the oldest age group (76 years or over). With increasing age, a greater proportion of fall-related TSCIs were due to low-level falls, with more than 80 % of fall-related TSCIs due to low-level falls in the oldest age group. Conclusions: Evidence suggests sports/leisure- and transport-related injuries in young men and falls among the elderly as prime targets for prevention policies and programs.
    11/2015; 2. DOI:10.1186/s40621-015-0061-4
    • "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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