Incidence, aetiology and injury characteristics of traumatic spinal cord injury in Stockholm, Sweden: A prospective, population-based update
Conran Joseph, Nina Andersson, Sapko Bjelak, Kajsa Giesecke, Claes Hultling, Lena Nilsson Wikmar, Julie Phillips , Åke Seiger, Vasilios Stenimahitis, Katarzyna Trok, Elisabet Åkesson, Kerstin Wahman
Neurobiology, Care Sciences and Society, Karolinska Institutet, 14183 Huddinge, Stockholm, Sweden. E-mail: firstname.lastname@example.org
Objectives: To update the incidence rate, aetiology and injury characteristics of acutely-injured adults with traumatic spinal cord injury in Stockholm, Sweden, using international standards of reporting.
Study design: Prospective, (regional) population-based observation.
Subjects: Forty-nine consecutively enrolled individuals.
Methods: A surveillance system of newly-injured adults with traumatic spinal cord injury was implemented for an 18-month period. The International Spinal Cord Injury Core Data Set was used to collect data on those who survived the first 7 days post-injury.
Results: After an 18-month period, 49 incident cases were registered, of whom 45 were included in this study. The crude incidence rate was 19.0 per million, consisting mainly of men (60%), and the mean age of the cohort was 55 years (median 58). Causes of injury were almost exclusively limited to falls and transport-related events, accounting for 58% and 40% of cases, respectively. The incidence has remained stable when compared with the previous study; however, significant differences exist for injury
aetiology (p = 0.004) and impairment level (p = 0.01) in that more fall- and transport-related spinal cord injury occurred, and a larger proportion of persons was left with resultant tetraplegia, in the current study, compared with more sport-related injuries and those left with paraplegia in the previous study.
Conclusion: The incidence rate appeared to remain stable in Stockholm, Sweden. However, significant changes in injury aetiology and impairment-level post injury were found, compared with the previous study. There remains a need for developing fall-related prevention strategies in rehabilitation settings as well as in population-based programmes.
It is important to frequently assess the number of injuries that occur over a given period. This information provides health care planners an opportunity to ensure that the system is able to cope if demands increase. We observed the number of spinal cord injuries over an 18-month period and found that 49 new cases were reported. Twenty-six (58%) of the total injuries were due to falls and 18 (40%) caused by transport accidents. We further found that the causes of injury differed when compared to a previous, however the number of injuries did not. This information could be used to adapt prevention strategies in Sweden.
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