Epidemiology of spinal cord paralysis in Fiji: 1985-1994

Abstract

This descriptive analytical ten year (1985 -1994) retrospective study assessed the pattern of spinal cord paralysis (SCP) in the Fiji Islands utilising medical rehabilitation hospital data. Fiji Islands is an archipelago of 300 islands in the south western Pacific with a multi-ethnic population of over three quarters of a million. Rehabilitation of all SCP is provided at the Medical Rehabilitation Unit (MRU). Data was collected from medical records of new SCP (n = 140) admitted to MRU and analysed with Epi Info 5 assessing associations between cause and other variables. The incidence of new SCP admitted to the MRU was 18.7/million/year. There were 75 (53.6%) traumatic and 65 (46.4%) non-traumatic SCPo The incidence varied according to gender and ethnicity with Fijian male being at the highest (41.85) risk. Amongst traumatic SCP, 38.7% were due to falls, 25.3% motor vehicle accidents, 20% sports, 8% shallow water dive and 4% each deep sea diving and others, whereas among non-traumatic SCP, 52.3% were due to unknown causes, 32.3% infections, 9.2% neoplasms and 6.2% others. The male/female ratio was 4: 1. The 16 -30 year age group accounted for 35% of SCPo 31 % had tetraplegia and 52.1 % had complete lesions. The subset of the sample who experienced traumatic SCP were more likely to be employed, aged between 16-30 years at the time of paralysis and to have complete tetraplegia. Those who experienced incomplete paraplegia were more likely to be unemployed, aged 46 -60 years and educated to primary level at the time of paralysis. There was a high proportion of complete spinal lesion when compared with other studies. The incidence of secondary complications such as pressure sores and UTI was also found to be high when compared with other studies. The results support the view that young Fijian males are most prone to sustaining traumatic spinal cord paralysis, and that there is a high incidence of secondary preventable complications. The need for preventative measures and adequate rehabilitation are emphasised.

The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate

“…79 Diving into water of unknown depths results in high proportions of tetraplegia in rivers and coastal regions. 40,77 There is a need for optimal retrieval services and acute SCI care within the first 72 h after TSCI and ideally direct transfer to specialised spinal treatment centres to reduce complications and optimise treatment and long-term outcomes. 81 Delayed admissions of over 1000 TSCI patients admitted to specialist centres in Italy and the United Kingdom resulted in more complications (pressure sores, heterotopic ossifications and urinary complications) and longer lengths of stay.…”

The Tetrafigap Survey on the long-term outcome of tetraplegic spinal cord injured persons, Part II: Demographic characteristics and initial cause of injury

“…21 Lin et al reported an even higher proportion of complete lesions 22 while most of the other series 3,6,7,12,15 show a majority of incomplete injuries. It is worth noting that the most recent studies 21,22 are the ones that found the largest number of complete injuries.…”

Rehabilitation of spinal cord injury in France: a nationwide multicentre study of incidence and regional disparities

“…4 Finally, in some countries, the context of accidentology is particularly severe, which explains high incidences. 18 Studies only focusing on patients in PMR units [24][25][26] are fewer. The incidence found in this survey is higher than in the former ones.…”

“…5 Inclusion of forms of ASIA E Soopramanien (1994) 5 1992-1993 Romania 18.5 R, postinjury acute care, 1 unit 28. 5 Inclusion of forms of ASIA E Karamehmetoglu et al (1995) 19 1992 Turkey (Istanbul) 21 R, postinjury acute care and PMR, multicentre Karamehmetoglu et al (1997) 20 1994 Turkey (rural areas) 16.9 R, postinjury acute care and PMR, multicentre Maharaj (1996) 26 1985 Temporal parameters: for reasons relating to the study period, with differences due to the trends in accidentology and care modalities over time.…”