Epidemiology of traumatic spinal cord injury: a large population-based study

Abstract

Study design 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.

The Time Sequence of Gene Expression Changes after Spinal Cord Injury

“…The distinguishing feature of boceprevir from other drugs is that it mainly acts in the chronic stage, as shown in Figure 8 and Table 1 . Currently, most treatment methods using animal models are effective only in the acute or subacute stages, but more than 80% of SCI patients can survive more than 12 months, and most SCI patients are in the chronic stage [ 82 ]. Therefore, drugs such as boceprevir might be a new hope for SCI patients.…”

Functional connectivity and amplitude of low-frequency fluctuations changes in people with complete subacute and chronic spinal cord injury

“…The sex ratio in our sample was unbalanced, with a larger proportion of men. However, this corresponds to the prevalence of SCI, where 68.3% are men 27 . Furthermore, the small sample in this study (especially that of the sSCI) is another limitation to generalization.…”

Biomaterial-Mediated Factor Delivery for Spinal Cord Injury Treatment

“…Globally, around 2.5 million people live with SCIs, and every year 180,000 novel cases are registered [ 4 , 5 ]. Obviously, SCI has a grave impact on the quality of life of the patients, and incurs heavy costs from both social and healthcare points of view [ 6 , 7 , 8 ]. From a pathophysiological perspective, the trauma starts with an acute phase (primary mechanical injury) as a consequence of compressive, stretching, or contusive trauma [ 9 , 10 , 11 , 12 , 13 ].…”