Mortality due to traumatic spinal cord injuries in Europe: a cross-sectional and pooled analysis of population-wide data from 22 countries

Abstract

BackgroundTraumatic spinal cord injuries (TSCI) pose a significant burden globally, while existing epidemiological data–especially on population mortality–are limited. The aim of this study was to calculate the age-standardized population mortality rates attributable to TSCI in 22 European countries, along with the pooled age-standardized mortality rate attributable to TSCI in Europe.MethodsA descriptive cross-sectional epidemiological study was conducted. Crude and age-standardized mortality rates attributable to TSCI for the year 2012 for 22 European countries were compared using data from death certificates provided by Eurostat. Pooled age-standardized mortality rates were calculated using the random effects model, and overall number of cases were estimated by extrapolating our findings to the populations of EU and Europe (48 countries), in 2012.ResultsA total of 1840 TSCI-related deaths were identified, of which 1084 (59%) were males. The pooled age-standardized TSCI-related mortality rate of 6.7 per million (95% CI: 5.2 to 8.2) overall, 9.4 (95% CI: 7.3 to 11.5) for males, and 4.5 (95% CI: 3.4 to 5.6) for females. Extrapolating our results, 3152 (95% CI: 2441 to 3915) deaths would occur in 2012 in the EU-28 and 4570 (95% CI: 3538 to 5675) deaths in the whole Europe. TSCI-related deaths contributed by 2% (95% CI: 1.8% to 2.2%) to the overall injury related mortality. 61% of fatal TSCI were located in the cervical spine area.ConclusionTo our knowledge, this is the largest study that reports TSCI-related population-based mortalities to date which brings valuable information that can inform further research or prevention strategies. Our study presents a comprehensive and large-scale overview of TSCI-related population mortality in Europe. With an estimated toll of nearly five thousand lives that could be potentially saved by prevention, our findings confirm TSCI as an important cause of injury related deaths in Europe. Further action towards harmonization of case ascertainment and towards prevention strategies targeted mainly on the elderly is warranted.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-017-0410-0) contains supplementary material, which is available to authorized users.

Change in the profile of traumatic spinal cord injury over 15 years in Spain

“…The mortality rate in our series was low (2.27%) and was related to older age, higher cervical levels of injury and poor functionality, as in other studies [ 11 , 25 ].…”

An Epidemiological Study of Traumatic Spinal Injuries in Iranian Patients from 2007 to 2017

“…A study by Ghaem et al showed that trauma-related mortality was higher in patients older than 55 years (17). Besides, Majdan et al argued that the TSCIrelated mortality rate was higher in patients older than 65 years (18), which is in agreement with our study. Interestingly, the prevalence of TSCI is significantly higher among young adults, and differences between age groups may be due to differences in methodology, socioeconomic status, culture, and area of living.…”

“…Moreover, the results showed that the mortality rate was significantly higher in patients with cervical spine and spinal cord injuries. Majdan et al reported that the most common cause of death in trauma patients was cervical injuries (66% in males vs. 55% in females), followed by lumbar injuries (19% in males vs. 26% in females) (18). A study by Majdan et al in Australia showed that the most common level of injury was cervical damage, which complied with our study.…”

Comprehensive analysis of the differential expression profile of microRNAs in rats with spinal cord injury treated by electroacupuncture

“…Spinal cord injury (Sci) is a serious neurological injury caused by traffic accidents, falls, or violence-associated injuries, resulting in heavy financial and psychosocial burdens on patients and society (1)(2)(3)(4). Sci can lead to impaired sensory and motor functions, autonomic nervous dysfunction and altered mental health (1).…”