Michael J. DeVivo

Epidemiology of traumatic spinal cord injury: trends and future implications

Study design:Review supplemented by inception cohort.Objectives:To review trends in the incidence, prevalence, demographic characteristics, etiology, injury severity and selected treatment outcomes of traumatic spinal cord injury (SCI).Setting:International review and US model systems cohort.Methods:An extensive literature review was conducted to identify all relevant studies of descriptive epidemiology of traumatic SCI. This review was supplemented by analyses of trends in US SCI epidemiology that are reflected in the National Spinal Cord Injury Statistical Center and Shriners Hospital Spinal Cord Injury databases.Results:Incidence and prevalence of traumatic SCI in the United States are higher than in the rest of the world. Average age at injury is increasing in accordance with an aging general population at risk. The proportion of cervical injuries is increasing, whereas the proportion of neurologically complete injuries is decreasing. Injuries due to falls are increasing. Recent gains in general population life expectancy are not reflected in the SCI population. Treatment outcomes are changing as a result of increasing age and changes in US health care delivery.Conclusion:Within the prevalent population, the percentage of elderly persons will not increase meaningfully until the high mortality rates observed among older persons significantly improve. Those who reach older ages will typically have incomplete and/or lower level injuries, and will have relatively high degrees of independence and overall good health.

Causes and costs of spinal cord injury in the United States

A cross-sectional multicenter study was conducted to estimate the direct costs for each cause of spinal cord injury in the United States. Random samples of 227 new injuries and 508 persons 2 – 16 years postinjury were selected. Prospective data were collected during one year on all charges for emergency medical services, hospitalizations, attendant care, equipment, supplies, medications, environmental modifications, physician and outpatient services, nursing homes, household assistance, vocational rehabilitation, and miscellaneous items. In 1995 dollars, first year charges averaged

International Spinal Cord Injury Core Data Set.

233 947 for vehicle crashes,

Interference due to pain following spinal cord injury: important predictors and impact on quality of life

217 868 for violence,

Influence of early variables in traumatic brain injury on functional independence measure scores and rehabilitation length of stay and charges

295 643 for sports,

International spinal cord injury data sets

185 019 for falls and

Trends in New Injuries, Prevalent Cases, and Aging With Spinal Cord Injury

208 762 for other causes. Recurring annual charges for each cause averaged

Overview Of The National Spinal Cord Injury Statistical Center Database

33 439,

Suicide following spinal cord injury

17 275,

Standardization of data analysis and reporting of results from the International Spinal Cord Injury Core Data Set

27 488,