Epidemiology Table 8: Falls

Falls

Author
Year
N

Geographic region

Inclusion/ exclusion criteria

Study population

Injury features

Cause: % (n of cases)

Hua et al.

2013

N=561

China

Retrospective review of individuals who were treated at The General Hospital of Chinese People’s Armed Police Forces

Males = 79.9%

Mean Age = 31.85 years

 

Fall Specific:

Incomplete: 47.7%

Cervical (45.5%)

Cervical-Thor (2.2%)

Thoracic (33.6%)

Thor-Lumbar (8.2%)

Lumbo-sacral (10.4%)

23.9%

Ibrahim et al. 2013

N=292 (traumatic and non)`

Kuala Lumpur,

Malaysia

2006-2009

Admitted to the Department of Rehabilitation Medicine, Hospital Kuala Lumpur

Males = 77%

Mean age = 39 years

Tetraplegia: 37% (108)

Paraplegia: 63% (180)

Traumatic:

Falls 28 %

Wang et al.

2013

N=761

 

Anhui Province, China

All patients admitted to two hospitals within Anhui Province, China between January 2007 and December 2010.

Males = 77.3%

Mean age = 45 years

Cervical (46.3%)

Thoracic (20.4%)

Lumbrosacral (33.3%)

Fall: 52.6%

Low Fall: 12.7%

Alshahri et al.

2012

N=307

Riyadh,

Saudi Arabia

2003 to 2008

Traumatic SCI, admitted to Riyadh Military Hospital in Saudi Arabia

Males = 88%

Mean age=29.5 years

Complete tetra = 21%

Incomplete tetra = 31%

Complete para = 29%

Incomplete para = 18%

Fall: 9.1%

(n=28)

Chhabra and Arora 2012

N=1138

India All patients admitted to an Indian Spinal Injuries Centre 2002 to 2010.

85.5% males

 

Mean age: 34.4 years

AIS A: 71.1%

AIS B: 14.7%

AIS C:8.2%

AIS D: 6.0%

Fall from height: 39.6%

Knutsdottir et al.

2012

N=207

Iceland

1975-2009

Patients admitted to Landspitali University Hospital

Males: 72%

Mean Age: 38 years

Cervical: 57%

Thoracic/Lumbar: 43%

Falls: 30.9%

Lenehan et al. 2012

N=930

British Columbia, Canada

1995-2004

Hospital admissions to level 1 trauma center were prospectively collected using a locally designed spine database

Males = 80%

 

Median: 35 years

Cervical: 45.1%

Thoracic: 24.5%

L/S: 20.9%

Unspecified: 9.5%

Fall: 28.5%

Middleton et al.

2012

N=324

New South Wales, Australia January 2004 to June 2008, Data from Ambulance Service of New South Wales

Males = 85%

Mean age = 42 years

Not Specified

High fall: 18.8%%

Low fall: 10.8%

Sabre et al. 2012

N=595

Estonia

1997-2007

SCI patients admitted to any Estonia hospitals

Male:Female = 5.5:1

Average age of injury = 39.0 years

C1-C4, AIS, A, B, C = 9.9%

C5-C8, AIS, A, B, C = 28.9%

T1-S5, AIS , A, B, C = 26.7%

All AIS D = 23.9%

Unknown = 10.6%

Falls: 41.0%

Wu et al.

2012

N=143

Tianjin, China Patients admitted to Tianjin Medical University General hospital with diagnosis of tSCI

Mean age 54.6 years

Male:Female = 5:1

ASIA A = 5.6%

ASIA B = 16.8%

ASIA C = 18.9%

ASIA D = 58.7%

Low fall = 45.5%

High fall = 4.2%

Devivo and Chen 2011

N=45,442

USA

1935-2008

Persons who were treated at either a SCI Model System or a Shriners Hospital SCI unit

Males= 79.2%

Mean age at injury= 32.5 years

19.8% C1-4

32.6% C 5-8

45.4% Paraplegic

2.2% Normal

Falls:

24.5%

(n=11,133)

Li et al.

2011

# of patients:

N=1079

data collected:

N=264

Beijing, China Patients with acute TSCI admitted to civilian or military hospitals during Jan 1- Dec 31 2002

200 male (76%)

 

Mean age: 41.7 years

Range: 6-80 years

Cervical (4.9%)

Thoracic (28%)

Thoracolumbar, lumbar and lumbosacral (66%)

Falls:

(41.3%)

n=109

McCammon and Ethans

2011

N=553

Manitoba,

Canada

1981-1985, 1998-2002, 2003-2007

Inclusion criteria: survival to hospital admission with TSCI, or outpatient referral to an SCI rehabilitation specialist.

Exclusion criteria: congenital causes of paralysis such as spina bifida or cerebral palsy as well as acquired paralysis from multiple sclerosis or Guillan-Barre syndrome.

75.8% male

 

Mean Age:

 

1981-1985: 29.0 years

1998-2002: 35.3 years

2003-2007: 39.8 years

1981-1985:

Cervical: 46.2%

Thoracic:33.0%

Lumbar: 20.9%

Sacral:0.0%

 

1998-2002:

Cervical:45.0%

Thoracic:33.3%

Lumbar: 21.6%

Sacral:0.0%

 

2003-2007:

Cervical:51.3%

Thoracic:34.9%

Lumbar:12.5%

Sacral:1.3%

Falls:

 

81-85: 14.5%

98-02: 16.1%

03-07: 16.4%

Ning et al.

2011

N=869

Tianjin, China

All patients with TSCI aged 15 or older admitted to tertiary hospitals in Tianjin from Jan 1, 2004- Dec 31, 2008

738 male (84.9%)

 

Mean age (sd)

46.0 (14.2)

Cervical (71.5%)

Thoracic (13.3%)

Lumbar (15.1%)

Sacral (0.1%)

Falls:

Low fall:

(37.6%)

n=327

High fall:

(19.3%)

n=168

Van Den Berg et al.

2011

N=540

Aragon, Spain

Hospitalized from January 1972 to December 2008 for traumatic SCI and

received medical care in Aragon following the acute stabilization period, regardless of place of injury and acute care.

79% male, mean age 39.6±17.7 yrs.

36.9% (n=199) cervical

37.4% (n=202) thoracic

19.3% (n=104) lumbar

4.3% (n=23) sacral

Falls

(24.6%)

Wu et al.

2011

N=41,586

Taiwan All SCI patients older than 20 years of age and admitted to medical services from 1998-2008 that were identified using the National Health Insurance Research Database of Taiwan.

62% male

(n=25857)

 

61.2% had traumatic SCI

(n=25,439)

Cervical: 51.8%

N=21,557

Thoracic: 12.3%

N=5,098

Lumbar: 22.9%

N=9,533

Other SCI: 13.0%

N=5,398

Falls:

(34.8%)

n=8,851

calculated using N traumatic SCI= 25,439)

Cosar et al.

2010

N TSCI=127

Turkey Patients with traumatic SCI who participated in an in-patient rehabilitation program at a tertiary research hospital from 1996-2008.

67.7% (n=86) male

mean age 37.81±13.65 years

36 (28.3%)-tetraplegic (C4-T1)

76 (59.8%)-paraplegic (T2–T12)

15 (11.8%) had conus–cauda equina (L1–S4) injury

Falls;

(33.9%)

n=43

Couris et al.

2010

N=936

Ontario, Canada The study included all patients aged 18 years or older living in Ontario during the fiscal years 2003–2004 (through 2006–2007) who experienced TSCI.

74.1% (n=694) male

 

mean age: 51.3±20.1 years

65.5% (n=610) cervical

21.3% (n=198) thoracic

10.0% (n=93) lumbar

3.2% (n=30) other

Falls:

(49.5%)

n=463

Hagen et al.

2010

N=336

Norway (2 counties: Hordaland and Sogn og Fjordane) Patients who suffered a TSCI from 1952-2001 and lived in Hordaland or Sogn og Fjordane

Male to female ratio was 4:7:1

 

% of women varied from 6.9-24.4%

Complete (41.4%)

Incomplete (58.6%)

 

Cervical (52.4%)

Thoracic (29.5%)

Lumbar/sacral (18.2%)

Falls:

(45.5%)

n=153

 

<1m: 11%

1-5m: 23.2%

>5m: 11.6%

NSCISC 2010

N=26852

USA

1973-2009

26 federally funded Model SCI Care Systems and National SCI Database

Male= 80.8%

(1973-2009)

Mean age at injury = 40.2 years (2005-2009)

2005-2009

Tetraplegia = 55.2%

 

Paraplegia = 44.4%

 

Complete Tetraplegia = 16.9%

Incomplete tetraplegia =   38.3%

Complete Paraplegia = 22.9%

Incomplete Paraplegia = 21.5%

Falls:

27.3%

(n=7331)

Pirouzmand 2010

N=12,192

Toronto, Canada

1986-2006

SCI and SI in Sunnybrook Trauma Registry Database

[SI

Male=66%

Median age=36 years]

 

SCI

Male= 76%

Median age=33 years

 

CSCI

Median age= 30 years

[Spinal Injury= 23.2%

-Cervical= 29%

– Thoracic= 21%

– Lumbosacral= 50%]

 

SCI= 5.4%

– Cervical=29%

– Thoracic=21%

– Lumbo-sacral = 50%

– Multiple Levels= 20%

 

CSCI=3%

Falls:

21.2%

Qureshi et al.

2010

N=521

Rawalpindi, Pakistan All patients who suffered a spinal injury from non-disaster causes and were admitted to the Spine Unit of a tertiary care hospital in Pakistan from 2001-2008.

402 male (77%)

 

Mean age (sd)

39.1 (16.17)

Level of injury:

Thoraco-lumbar spine (n=369, 71%), lower cervical spine (n=93, 18%), upper cervical spine (n=42, 8%) and sacrum (n=9, 2%).

Injuries at multiple levels in 8 (2%)

Fall from height:

(62%)

n=323

Chabok et al.

2009

N=245

Guilan,

Iran

Patients admitted to Poursina Hospital, with TSCI

71.8% male

Neurological status:

15 complete

29 incomplete

201 no neurological damage

 

cervical- n=17

thoracic- n=6

thoracolumbar- n=48

Lumbar= 12

Falls:

(43.3%)

N=106

Obalum et al. 2009

N=468

Lagos, Nigeria

1992-2006

Registrars at the emergency room and wards from the Lagos University Teaching Hospital (receives the majority of SCI patients in Lagos)

Male=70.1% 66.2% were ages 40 years and below. Peak age incidence = 21-30 years.

ASIA A n=230

ASIA B n=45

ASIA C n=36

ASIA D n=41

ASIA E n= 34

Death n=82

 

Lumbar n=278

Cervical n=142

Thoracic n=48

Falls:

9.4%

(n=44)

Ahoniemi et al. 2008

N=1647

Finland

1976-2005

Register survey;

Medical records from registers of Käpylä Rehabilitation Centre

83% male

Mean age of injury (M/F):

1976-1985: 34.7/35.8

1986-1995: 36.7/38.3

1996-2005: 42.4/40.4

50.6% tetraplegia

49.4% paraplegia

Falls:

41.2% (n=678)

Macciocchi et al.

2008

N= 298

South-eastern,

USA

2004-2005

All patients admitted for traumatic SCI between the ages 16-59. Excluded if unable to speak English.

Male=79% 

Mean age =28.7±10.1 years.74% of all eligible patients.

C1-4 ASIA A-C, n=9

C1-4 ASIA D, n=5

C5-8 ASIA A-C, n=30

C5-8 ASIA D, n=6

T1-8 ASIA A-C, n=26

T1-8 ASIA D, n=2

T9-12 ASIA A-C,n=15

T9-12ASIA D, n=3

L1-S3 ASIA A-C, n=5

Falls:

10%

(n=30)

National Spinal Cord Injury Statistical Center

2008

N=25,415

USA 26 federally funded Model SCI Care Systems and National SCI Database

77.8% male (2000-2008)

Average age = 39.5 years (2005-2008)

2000-2008

Incomplete tetraplegia: 34.1%

Complete paraplegia: 23.0%

Complete tetraplegia:18.3%

Incomplete paraplegia: 18.5%

Falls:

27.1% (n=6887)

Fassett et al.

2007

N=412

Philadelphia, Pennsyl-vania,

USA

1978-2005

Treated in Delaware Valley Regional Spinal Cord Injury Center at Thomas Jefferson University Hospital

≥70 years old. No further demographics given.

High quadriplegic  (C4 and above)=42%

Paraplegic=22%

 

ASIA  A ~ 45%

ASIA B ~ 13%

ASIA C ~ 15%

ASIA D ~ 24%

Falls:

74%

(n=305)

Shrestha et al.

2007

N=149

Eastern region,

Nepal

2001-2004

Admission to hospital in Dharan with cervical spinal injury.

Males=80%

Mean age=40 (6-88) years

Mortality=6 (4%)

Frankel levels:

A=54 (36%)

B=20 (13%)

C=22 (15%)

D=19 (13%)

E=34 (23%)

Falls:

60.4%

(n=90)

Pickett et al.

2006

N=151

London, Ontario,

Canada

1997-2006

Admissions to hospital in London, Ontario with SCI

Male=74.2%

Mean age = 42.2 ± 20.9 (9-96) years

Mortality=12 (8%)

Cervical=75%

Thoracic= 10%

Lumbar=9%

Junctional=6%

Complete=35% Incomplete=65%

Falls:

31.1%

(n=47)

Calancie et al.

2005

N=229

Dade County, Florida,

USA

Acute traumatic spine and/or spinal cord injury admitted to Jackson Memorial Hospital

Male = 74.6%

 

Average age at injury=40.0±17.5 years

15 were children

ASIA A = 32.8% (75)

ASIA B = 4.8% (11)

ASIA C = 24.0% (55)

ASIA D = 31.5% (72)

ASIA E = 7.0% (7.4)

Fractures:

Cervical = 62%

T1-T10 = 15% (35)

T11-L4 = 19% (44)

Non-fractures:

Cervical = 3% (7)

Complete = 32.8%

Falls:

19.7%

(n=45)

Dahlberg et al. 2005

N=152

Helsinki, Finland

January 1, 1999 cross-section date

Adult citizens (18 years or more) of Helsinki who had permanent sensory or motor deficits because of traumatic SCI (ASIA A–D). ASIA-E cases were excluded.

Males = 76%

Average age of injury=47.9 years

Data only for 121 subjects:

46% (n=56) tetraplegia

54% (n=65) paraplegia

57% (n=69) incomplete

43% (n=52) complete

Falls:

43%

(n=66)

Gur et al.

2005

N=539

South-eastern Anatolia, Turkey

1990-1999

4 hospitals that were major referral centers for trauma

Average age of injury=30.62 (1-70) years

77.2% (n=416) male

22.6% (n=120) civil servants

20.2% (n=109) housewives

15.0% (n=79) soldiers

29.3% (n=158) incomplete paraplegia

45.1% (n=243) complete paraplegia

13.7% (n=74) incomplete tetraplegia

13.9% (n=75) complete tetraplegia

25.4% (n=137) cervical

36.7% (n=198) thoracic

34.0% (n=183) lumbar

Falls:

31.9% (n=172)

Lakhey et al.

2005

N=233

Dharan, Nepal

May 1997- April 2001

Orthopaedic ward of BP Koirala Institute of Health Schiences

Male=72.5% <20years old=26 individuals (11.1%),

20-30yrs=59 (25.3%),

31-40yrs=49 (21.0%),

41-50yrs=37 (15.9%),

>50yrs=62 (26.6%)

cervical = 88 (37.8%)

dorsal = 70 (30.0%)

lumbar = 72 (30.9%)

none bony =  3 (1.3%)

 

complete = 46.8%

Falls:

77.6%

(n=181)

 

from trees: 40.3% (n=94)

1st/2nd floor: 27.9% (n=65)

Hill slope:

4.7%(n=11)

Ladder:

4.7% (n=11)

National Spinal Cord Injury Statistical Center 2005

N=23,683

USA

25 federally funded Model SCI Care Systems and National SCI Database

Male=79.6%

Average age of injury=37.6 years

62.9% Caucasian

22% African American

12.6% Hispanic

51.8% single

Incomplete tetraplegia (34.5%)

Complete tetraplegia (18.4%)

Incomplete paraplegia (17.5%)

Complete paraplegia (23.1%)

Falls:

22.9% (n=5423)

Umaru and Ahidjo

2005

N=36

Maiduguri,

Nigeria

1998-2002

Admissions to hospital in Maiduguri with SCI.

Exclusion Criteria:

Cases with inadequate information

Males=83%

Mean age =34.3±3 (13-55) years

Mortality=3 (8%)

Cervical=14 (39%)

Thoracic=10 (28%)

Thoracolumbar=10 (28%)

Lumbar=2 (6%)

Complete=20 (56%)

Incomplete=16 (44%)

Falls:

22.2%

(n=8)

Dryden et al.

2003

N=450

Alberta, Canada

1997-2000

Data from the Alberta Ministry of Health and Wellness, records from the Alberta Trauma Registry, and death certificates from the Office of the Medical Examiner

Male=71.6% Median age of injury=35.0 years

61.5% (n=277) cervical

17.3% (n=78) thoracic

17.1% (n=77) lumbar/sacral/cauda equina

4.0% (n=18) unspecified

Falls:

19.1%

(n=86)

Krassioukov et al.

2003

N=58

Toronto, Canada

1998-2000

Admissions to hospital in Toronto with traumatic SCI.

Exclusion Criteria:

Patients admitted with ASIA E.

Group 1

(n=30; Ages 17-59 years)

Males=87%

Ages 17-59 years:

Mean age=38.7 (17-56) years

ASIA A and B=30%

ASIA C and D=70%

Falls:
30.%
(n=9)

Group 2 (n=28)

Males=61%

Ages>60 years:

Mean age=73.3 (60-89) years

ASIA A and B=10.7%

ASIA C and D=89.3%

 

Falls:
64.3% (n=18)

Kuptinat-saikul

2003

N=83

Thailand

1997-2000

All SCI patients admitted to Spinal Unit, Siriraj Hospital, Nagkok.

Males=79.5%

Average age =32.3 ±11.7 years.

Falls:

Tetraplegic n=2

Paraplegic n=6

ASIA D=6

Falls:

16.9%

(n=14)

Pagliacci et al.

2003

N=684

Italy

1997-1999

Rehabilitation admissions to 32 institutions in Italy with traumatic SCI.

Males = 80% Mean age=38.5 (11-94) years.

ASIA Scores:

A=346 (50%)

B=72 (10%)

C=149 (22%)

D=94 (14%)

E=12 (2%)

Falls:

22.4% (n=153)

Pickett et al.

2003

N=2385

Ontario, Canada

1994-1999

SCI in Ontario Trauma Registry

Males=65%

<20 years =89 (9%)

20-39 years= 190 (18%)

40-59 years=245 (24%)

≥60 years=506 (49%)

No details

Falls:

43.2% (n=1030)

Singh et al. 2003

N=483

Haryana, India

2000-2001

Accident and emergency services and department of Orthopaedic Surgery and Rehabilitation of Pt. B.D. Sharma PGIMS, Rohtak.

Male=74.7%

Mean age at injury=35.4 years

 

164 tetraplegia

283 paraplegia

Falls:

44.5% (n=215)

Catz et al.

2002

N=250

Israel

1959-1992

Traumatic SCI, admitted to the Loewenstein Rehabilitation Center, the major referral center for rehabilitation medicine in Israel.

Males=75.6%

Mean age = 34.5 years (range 6-83 years).

High cervical 7.6%

low cervical 28.8%

thoracic 32.4%

lumbar 31.2%

Falls:

16.8%

(n=42)

O’Connor

2002

N=265

Australia

1998-1999

Australian Spinal Cord Injury Register (ASCIR) for persons 15 years and older. All adult SCI cases are reported to the ASCIR Transient neural deficits were excluded.

Male=76 %

No other demographics given

C4 n=47

C5 n=45

C6 n=22

L1 n=30

T12 n=17

Incomplete tetraplegia n=101

Incomplete paraplegia n=64

Complete tetraplegia n=51

Complete paraplegia n=48

Falls:

31%

(n=83)

Burke et al. 2001

N=161

Kentucky and Indiana counties, USA

1993-1998

University of Louisville Hospital SCI Trauma Registry and patient medical records

Male=75%

Mean age of injury=45.6 years

59.5% single

29.4% married

86.5% White

13.5% African American

43% complete

 

(all cases)

58% Frankel A

17% Frankel B

7% Frankel C

15% Frankel D

Falls:

23%

(n=37)

Demetriades et al.

2000

SCI=11

California,

USA

1993-1997

Los Angeles County and University

of Southern California Medical Center

Male=100% Average age of injury=43.5 years

Not given.

Falls:

27.3%

(n=3)

Karacan et al.

2000

N=581

Turkey

1992

Nation-wide survey of SCI admissions to medical institutions.

Exclusion Criteria:

Patients who died before hospitalization.

Mean age=35.5±15.1 years.

Males=415 (71%)

Females=166 (29%)

Cervical=31.7%

Thoracic=26.6%

Lumbar=25.1%

Tetraplegia=87 (32%)

Paraplegia=394 (68%)

Falls:

36.5% (n=212)

National Spinal Cord Injury Statistical Center

2000

N=19648

USA

24 federally funded Model SCI Care Systems and National SCI Database

Male=81.7% 55% within 16-30 years old, mean age at injury is 31.8 years

Tetraplegia = 51.7%

Paraplegia = 46.7 %

Complete Tetraplegia = 18.5%

Incomplete tetraplegia =   29.5%

Complete Paraplegia = 27.9%

Incomplete Paraplegia = 21.3%

Falls:

21.5% (n=4224)

van Asbeck et al.

2000

N=126

(specific data for 113)

Netherlands

1994

Patients with SCI in National Registration system. Further analysis occurred only for cases in which medical records were obtained

Exclusion Criteria:

Spinal contusions with no or temporary neurological symptoms.

Males=77%

<20 years=15 (13%)

21-30 years=28 (25%)

31-60 years=36 (32%)

>61=34 (30%)

Mortality=18 (16%)

Complete tetraplegia=

26 (23%)

Incomplete tetraplegia=

39 (34%)

Complete paraplegia=

29 (26%)

Incomplete paraplegia=

19 (17%)

Falls:

48.7%

(n=55)

Hoque et al.

1999

N=179

Bangladesh

1994-1995

Admissions to rehabilitation centre in Savar, Dhaka with SCI.

Males=88%

10-20 years=19%

20-30 years=42%

30-40 years=20%

40-50 years=15%

50-60 years=4%

Mortality=18 (7%)

Tetraplegia=72 (40%)

Paraplegia=107 (60%)

Falls from height

42.4% (n=76)

 

Falls while carrying load on head

20.7% (n=37)

Igun et al.

1999

N=68

Plateau State, Nigeria

1984-1997

Radiologically confirmed diagnosis of spinal cord injury.

Male=91.2% Mean age = 30 years.

Cervico-thoracic n=32

Cervico-thoracic n=36

Deaths n=18

Falls:

22.1%

(n=15)

Caldana and Lucca

1998

N=577

Veneto, Italy

1994-1995

New cases of traumatic spinal cord injury and non-traumatic spinal cord disease treated in regional hospitals (small hospitals excluded)

Male = 83.5%

Average age (male)

= 39.8 years old

 

Average age (female)

= 36 years old

Cervical=62

(21 were complete)

Thoracic=29

(25were complete)

Thoracolumbar

(T12-L1)=18(11)

Caudal=14(3)

Unidentified=1

Falls:

2.2%

(n=13)

Farmer et al. 1998

N=1817

USA

1979-1993

Regional Spinal Cord Injury Center of Delaware Valley (RSCICDV)

Male=78.7%

Mean age =37.6 years

72.2% White, 23.5% African American, 2.5% Hispanic

35.9% married

16% unemployed

62.4% cervical

26.8% thoracic

10.8% lumbosacral

40.9% complete

59.1% incomplete

25.1 % quadriplegia complete

36.7% quadriplegia incomplete 15.8% paraplegia complete

21.5% paraplegia incomplete

Falls:

26.9% (n=489)

Levy et al.

1998

N=136

Zimbabwe

1988-1994

Admissions to National Rehabilitation Centre with traumatic SCI.

Males=89%

Majority were between 20 and 49 years of age

Cervical=69 (51%)

Below Cervical=67 (49%)

Falls out of trees:

11%

(n=15)

Martins et al.

1998

N= 398

Portugal

1989-1992

2 hospitals that treat all SCI in the central region of Portugal. Including deaths due to SCI and paediatric cases. Cases without neurological lesion, rehospitalization and vertebral lesions were excluded.

Males = 77% Average age = 50.53±21.85 years.

Complete n=220

Incomplete n=176

Deaths = 223

Falls:

37.4% (n=149)

Aung and Masry

1997

N=219

Great Britain

1985-1988

New traumatic admissions to the Midlands Centre for SCI

Male=79%;

Average age of 35.5 years.

Female=21%;

Average age of 44.2 years.

Cervical n=116

Thoracic n=73

Lumbar n=30

Falls:

42.5%

(n=93)

Chen et al. 1997

SCI=1,586

Taiwan

1992-1996

113 hospitals (11 medical centers, 50 regional general hospitals, 52 local general hospitals)

Male=75.0% Average age of injury=46.1 years

49.9% cervical

13.3% thoracic

34.6% lumbar

6.6% (n=105) died after treatment

Falls:

44.1%, (n=699)

Maharaj 1996

N=75

Fiji

1985-1994

Medical records of spinal cord paralysis patients admitted to the Medical Rehabilitation Unit at Tamavua Hospital

Male=87%

Mean age=38.3 (6-76) years

10 (13%)

Fijian=35%

Indian=47%

40 (53%) tetraplegia

35 (47%) paraplegia

46 (61%) complete

29 (39%) incomplete

Falls:

38.7%

(n=29)

Karameh-metaglu et al. 1995

N=152

Istanbul, Turkey

1992

New patients with traumatic SCI, including pediatrics.

115 males. Mean age = 33 years. 72% of patients were under 40.

Tetraplegic n=50

Paraplegic n=102

Falls:

43%

(n=65)

Levi et al. 1995

N=353

Stockholm, Sweden

1991-1994

Survey of the regional Stockholm SCI population

Males=81%

Average age of injury=31 (3-77) years

41.6% (n=147) cervical

36.0% (n=127) thoracic

14.7% (n=52) lumbar

1.4% (n=5) sacral

39.4% (n=139) complete

59.5% (n=210) incomplete

Falls:

37.1%, (n=131)

Shingu et al.

1995

N=9752

Japan

1990-1992

Survey of nationwide institutions assumed to accept SCI patients.

Exclusion criteria:

Patients only receiving outpatient services in this period

Males=80.4%

Mean age=48.6±19.1 (0.92-96) years.

Frankel levels:

A=2518 (25.8%)

B=1208 (12.4%)

C=1984 (20.3%)

D=1761 (18.1%)

E=2242 (23.0%)

Unknown=39 (0.4%)

Cervical=7317 (75.0%)

Below cervical=2408 (24.7%)

Unknown=27 (0.3%)

Complete=61.1%

Falls:

41.8% (n=4076)

 

From height:

69% (n=6729)

On level ground:

31% (n=3023)

Silberstein and Rabinovich

1995

N=196

Novosibirsk,

Russia

1989-1993

All in patients with SCI admitted to the Department of SCI. Nerve root or plexus injury was excluded.

Males=93.4% Mean age =34.7 years.

Cervical spine

C1-2 n=15

C3-7 n=81

Thoracic T1-12 n=54

Lumbar L1-5 n=46

Falls:

26.6%

(n=52)

Hart and Williams

1994

N=616

South Africa

1988-1993

All records of SCI from the Natalspruit Spinal Rehabilitation Unit

Male=80%. Males between 15-40 made up the majority of patients

Complete n=404

Incomplete n=212

Cervical spine n=155

Upper thoracic n=135

Lower thoracic n=249

Lumbar spine n=74

Falls:

2.4%

(n=15)

Price et al.

1994

N=376

Oklahoma,

USA

1988-1990

SCI cases in Oklahoma statewide multilevel surveillance system

Exclusion Criteria:

Non Oklahoma residents; patients who died at scene; injuries to nerve roots or spinal plexus.

Males=80%

<15 years=12 (3%)

15-19 years=66 (18%)

20-29 years=110 (29%)

30-59 years=145 (39%)

≥60 years =43 (11%)

Mortality=30 (8%)

Complete tetraplegia=55 (15%),

Incomplete tetraplegia=157 (42%)

Complete paraplegia=59 (16%),

Incomplete paraplegia=105 (28%)

Falls:

19.9%

(n=75)

Shingu et al.

1994

N=3465

Japan

1990

Survey of nationwide institutions assumed to accept SCI patients;

Exclusion criteria:

Traumatic cervical syndrome cases and extradural nerve root; Patients only receiving outpatient services in this year or who obtained injury abroad

Male=81.2%

Mean age=44.1 years (sample)

 

Mean age=52.8 years (falls from height)

 

Mean age=61.5 years (falls on level ground)

Falls from height:

Cervical=667 (66%)

Below cervical=342 (34%)

Unknown=3

 

Falls on level ground:

Cervical=356 (88%)

Below cervical=48 (12%)

Unknown=3

Falls:

41.0% (n=1420)

 

From height: 71% (n=2460)

 

On level ground:

29% (n=1005)

Soopra-manien 1994

N=412

Bucharest, Romania

1992-1993

SCI patients admitted to Dr Gh. Marinescu Hospital

Male=77%

0-40 years

=41.3%

41-90 years

=58.7%

37.6%labourer

8.7% farmer

18.2% retired

158 cervical

81 thoracic

36 lumbar

47% incomplete

Frankel grade A n=134

Frankel grade B n=24

Frankel grade C n=25

Frankel grade D n=73

Frankel grade E n=150

Falls:

59%

(n=242)

Stavrev et al.

1994

N=980

Plovdiv Region,

Bulgaria

1983-1992

Treatment for SCI at 2 clinics in Plovdiv region

Males=72%

≤20 years=82 (8%)

21-40 years=387 (40%)

41-60 years=298 (30%)

61-70 years=137 (14%)

>70 years=76 (8%)

Mortality=72 (7%)

Cervical=206 (21%)

Thoracic (>T7) =275 (28%)

Lumbar=399, (41%)

Other=100 (10%)

Neurological deficit=409 (42%)

No neurological deficit=572 (58%)

Falls:

55.3% (n=542)

Thurman et al. 1994

N=223

Utah,

USA

1989-1991

Utah residents with SCI in Statewide reporting system of the Utah Department of Health, Bureau of Epidemiology.

Male=76% Median age=29 years

128 (57%) tetraplegia

95 (43%) paraplegia

41 (18%) fatal

21 (9%) died before hospital admission

110 (49%) Frankel A/B/C

46 (21%) Frankel D

25 (11%) full neurological function

Falls:

21.1%

(n=47)

Woodruff and Baron 1994

N=150

West Virginia,

USA

1985-1988

Data collected during the West Virginia Spinal Cord Injury Registry, includes only injured patients surviving until hospitalization

Male= 82%

Majority of individuals were between 15-24

48% tetraplegia

52% paraplegia

Falls:

21%

(n=31)

Acton et al.

1993

N=644

Arkansas, USA

1980-1989

Arkansas residents in Arkansas State Spinal Cord Commission registry.

Exclusion Criteria:

Lesions caused by degenerative disease; people who died at scene.

Males=80%

Mean age males=32.4 years

Mean age females=35.4 years

Tetraplegia=37

Paraplegia=45

Unknown=4

Falls:

13.4%

(n=86)

Dixon et al.

1993

N=164

New Zealand

1988

SCI cases in Health Services Statistics files.

Males=73.2%

Males aged 15-29 years=46%

C1-C4=49 (30%)

C5-C7=30 (18%)

T1-T6=19 (12%)

T7-T12-19 (12%)

Falls:

24%

(n=39)

Lan et al.

1993

N=99

Hualien county, Taiwan

1986-1990

Treatment of traumatic SCI in 4 hospitals in Hualien county.

Exclusion Criteria:

People who died before hospitalization; nontraumatic SCI; patients with transient paralysis; non residents of Hualien.

Males=80%

Mean age (males)=44 years

Mean age (females)=46 years

Mortality=10 (10%)

Complete tetraplegia =5

Incomplete tetraplegia = 5

Complete paraplegia =6

Incomplete paraplegia = 7

Falls:

23.3%  (n=23)

da Paz et al. 1992

N=1255

(SCI=108)

Brazil

1988

36 public hospitals from 7 Brazilian capitals (represents 6.2% of all hospitals and 9.2% of the total hospital bed capacity.

Males=80.6%

Mean age= 30.3 (range 6-56) years

5.6% high education

94 (87.0%) complete

61 (64.9%) paraplegia

33 (35.1%) quadriplegia

Falls:

14.8%  (n=16)

DeVivo et al.

1992

N=6563

USA

Admissions to Spinal Cord Injury Care Systems within 1 year of injury from:

1978-1980

Males=82.4%

Mean age =28.4 years

Frankel grade at discharge:

Complete=51.8%

Sensory=13.7%

Motor nonfunctional=7.2%

Motor functional=25.9%

Recovered=1.4%

Falls:
20% (n=1313)

1981-1983

Males=82.7%
Mean age =30.5 years

Frankel grade at discharge:
Complete=57.2%
Sensory=11.7%
Motor nonfunctional=7.8%
Motor functional=22.5%
Recovered=0.8%

Falls:
18.8% (n=1234)

1984-1986

Males=84.5%
Mean age
=31.2 years
 

Frankel grade at discharge:
Complete=48.6%
Sensory=16.2%
Motor nonfunctional=11.0%
Motor functional=23.5%
Recovered=0.6%

Falls:
22.2% (n=1457)

Dincer et al. 1992

N=1,694

Turkey

1974-1985

SCI patients admitted to Ankara Rehabilitation Centre

Average age of injury=26.8 (1-70) years

75.68% (n=1282) male

19.83% (n=336) agricultural workers

19.95% (n=338) housewives

19.48% (n=330) private industry workers

85.12% (n=1442) complete paraplegia

6.85% (n=116) incomplete paraplegia

4.84% (n=82) complete tetraplegia

3.19% (n=54) incomplete tetraplegia

Falls:

29.51% (n=500)

Garcia-Reneses et al.

1991

N=1010

Spain

1984-1985

Every traumatic and non traumatic SCI  patient in specialized Spanish hospitals

Male=72.4%. Mean age = 41.8 ± 1.2 years.

Sensory-motor incomplete SCI = 49%

Complete SCI= 38%

Falls:

27%

(n=273)

Goebert et al.

1991

N=59

Hawaii,

USA

1987-1989

Traumatic injury

Patient at the Rehabilitation Hospital of the Pacific

Male=84.7%

Mean age=20.2 years

0-5years=5.2%

16-30 years=44.8%

31-45 years=25.9%

46-60 years= 12.1%

61-90 years=12.1%

High Quad (C1-4)=16.2%

Low Quad (C5-8)=45.9%

High Thoracic (T1-6)=18.9%

Low Thoracic (T7-12)=10.8%

Lumbar (L1-5)=8.1%

Frankel Grades:

Complete (A)=50.8%

Motor functional (D)=35.6%

Falls:

27.6%

(n=16)

Biering-Sorensen et al.

1990

N=268

Kingdom of Denmark

(Denmark, Greenland, Faroe Islands)

January 1975- December 1984

Admission to national specialized rehabilitation hospitals

Male=76.9%

40% within 15-24 years old

Cervical = 136

Thoracic = 76

Lumbar = 56

Complete tetraplegia = 22%

Incomplete tetraplegia = 29%

Complete paraplegia = 26%

Incomplete paraplegia = 23%

Falls to level below:

23%

(n=61),

 

Falls to same level:

3%

(n=9)

Pedersen et al.

1989

N=27

Greenland

1965-1986

Admissions to rehabilitation hospital in Hornback with traumatic SCI; Patients injured in Greenland.

Males=74%

Mean age=33.5 (14-50) years.

Complete tetraplegia=2

Incomplete tetraplegia=4

Complete paraplegia=1

Incomplete paraplegia=2

Falls:

33.3%

(n=9)

Ring et al.

1986

N=202

New South Wales, Australia

1977-1978

Admissions to New South Wales hospitals with spinal injury; death certificates that involved spinal injury. 99% of cases had neurological involvement.

Males=81%

15-24 years=84 (42%)

25-44 years=58 (29%)

45-64 years=30 (15%)

≥65 years=15 (7%)

Mortality=69 (39%)

Glasgow Outcome Scale:

Severe disability=98(49%)

Moderate disability=19(9%)

Good recovery=13(6%)

Not recorded=3(1%)

Falls:

9.4%

(n=19)

Griffin et al.

1985a

N=154

Olmsted County, Minnesota, USA

1935-1981

Medical records-linkage system of

the Rochester Project at the Mayo Clinic, periodic multi-centre surveys

.

Male=72%

153 White, 1 Black

 

56.5% (n=87) cervical

31.8% (n=49) thoracic

9.1% (n=14) lumbar

2.6% (n=4) sacral

Falls:

13.0%

(n=20)

Gee and Sinha

1982

N=36

Papua New Guinea

1978-1981

Traumatic injury

Patients that stayed in Port Moresby, Lae and Manding hospitals

Male = 88%

 

Mean age = 26years

(range 16-41 years)

Cervical = 22%

Upper thoracic  = 11%

Thoraco-lumbar = 28%

Lumbar = 39%

Falls from trees:

31% (n=11)

 

Falls from roof :

9% (n=3)

 

 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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