Epidemiology of Traumatic SCI
Violence
There were 63 papers reporting on SCI as a result of violence. 16 studies specifically cite gunshot wounds as a cause of SCI (Table 10). 42 studies used data arising from hospital admission/discharge records which included either single or multiple hospitals. A total of 12 studies were based on national data from specifically designed SCI databases. Most of the studies were conducted in North America (Canada N=6; United States N=19) and Europe (N = 16). Asia had 12 studies, Africa had 6 studies, 2 studies were from Oceania, 1 from South America, and 1 from Russia.
In the USA, the proportion of SCI due to violence was found to range from a low of 0.97% (Fasset el al. 2007) to a high of 18.9% (Macciocchi et al. 2008). In Canada, reported proportions were mostly below 5%, with the exception of a recent study reporting a frequency of 8.2% based on data from the largest Canadian trauma centre (Pirouzmand 2010). In Europe, rates range from 1% in Germany (Exner and Meicnecke 1997) to 11.1% in Greenland (Pederson et al. 1989). Variation in the proportions is likely due to differences in both reporting and study population.
The proportions of SCI due to gunshot wounds among all causes of SCI are as high as 36% in South Africa (Hart and Williams 1994) 26.9% in Brazil (da Paz et al. 1992), 21.3% in Turkey (Gur et al. 2005), and 25.8 % in Jordan (25.8%) (Otom et al.1997). High rates of SCI due to gunshot wounds tended to be found in countries with warfare or high rates of violent crimes. Other commonly reported causes of SCI due to violence were knife wounds (N=10 studies) and assault in general (N=6 studies).
| Author Year N of study population |
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 |
Stabbing Specific: Incomplete: 76.4% Cervical (23.5%) Cervical-Thor (0.0%) Thoracic (64.7%) Thor-Lumbar (11.8%) Lumbo-sacral (0.0%) |
Stabbing : 3.0% Gunshot: 1.1% Blunt-force trama: 0.4% |
| 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: Violenceinduced: 4% |
| 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%) |
Struck by object: 5.4% Other (Assault, Sports): 8.1% |
| 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% |
Violence – gunshot: 4.6% (n=14) |
| 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% |
Violence: 1.5% |
| 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% |
Assault: 1.4% Struck by Object: 4.9% |
| DeVivo et al. 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 |
Violence 11.7% (n=5,317) |
| 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%) |
Stabbing: (0.4%) n=1 Struck by object : (18.6%) n=49 |
| 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% |
Violence: 81-85: 4.5% 98-02: 2.1% 03-07: 3.2% |
| 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%) |
Assault: (1.4%) n=12 Struck by object (?): (6.3%) n=55 |
| 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 |
Violence 3.9% (n=21) |
| Cosar et al. 2010 N TSCI=127 |
Turkey | Patients with traumatic SCI who participated in an inpatient 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 |
ViolenceGunshot Wound; 7.9% (n=10) |
| NSCISC 2010 N=26,852 |
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% |
Violence: 15.0% (n=4,028) |
| 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% |
Violence: 8.2% (n=1000) |
| Qureshi et al. 2010 N=521 |
Rawalpindi, Pakistan |
All patients who suffered a spinal injury from nondisaster 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%) |
Gunshot wound: (2%) n=11 |
| 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) |
Males= 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 |
Gunshot Wounds: 7.3% (n=34) Assault: 1.78% (n=8) Violence: 2.1% (n=10) |
| Ahoniemi et al. 2008 N=1647 |
Finland | 1976-2005 Register survey; Medical records from registers of Käpylä Rehabilitation Centre |
Males= 83% 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 |
Violence: 2.7% (n = 44) |
| Macciocchi et al. 2008 N= 298 |
Southeastern, USA |
2004-2005 All patients admitted for traumatic SCI between the ages 16- 59. Excluded if unable to speak English. |
Males=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 |
Violence: 15% (n= 45) |
| National Spinal Cord Injury Statistical Center 2008 N=25,415 |
USA | 1973-2008 Residents of the US who have sustained traumatic SCI. Data from Model SCI Care Systems captures approx 13% of all new SCI cases in the U.S |
Males=77.8% (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% |
Violence 15.3% (n = 3888) |
| Fassett et al. 2007 N=412 |
Philadelphia, Pennsylvania, USA |
1978-2005 Treated in Delaware Valley Regional Spinal Cord Injury Center at Thomas Jefferson University Hospital |
≥70 years old | ASIA A ~ 45% ASIA B ~ 13% ASIA C ~ 15% ASIA D ~ 24% |
Gunshot wounds: ~1% (n=4) |
| 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%) |
Violence: 3.4% (n = 5) |
| Olasode et al. 2006 N=71 |
Ile-Ife, Nigeria |
All traumatic SCI within an 18 month period were included. Only patients with significant craniocerebral injuries were excluded. |
Males=66.7% Age range=12-80 years |
Tetraplegic n=39 Paraplegic n=13 Recovered with no residual disability n=14 died n=5 |
Violence: 4.2% (n=3) |
| Pickett et al 2006 N=151 |
London, Ontario, Canada |
1997-2006 Admissions to hospital in London, Ontario with SCI |
Men=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% |
Violence: 4.6 % (n = 7) |
| 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) Complete = 32.8% |
Gunshot wounds: 10.5% (n=24) |
| Dahlberg et al. 2005 N=152 |
Helsinki, Finland |
January 1, 1999 cross-section date 18 years or older; 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 |
Violence: 4% (n=6) |
| Gur et al. 2005 N=539 |
Southeastern Anatolia, Turkey |
1990-1999 4 hospitals that were major referral centers for trauma |
Males = 77.2% Average age of injury=30.62 (1-70) years Civil servants: 22.6% (n=120) Housewives: 20.2% (n=109) Soldiers: 15.0% (n=79) |
Incomplete paraplegia 29.3% (n=158) Complete paraplegia 45.1% (n=243) Incomplete tetraplegia 13.7% (n=74) Complete tetraplegia 13.9% (n=75) Cervical: 25.4% (n=137) Thoracic: 36.7% (n=198) Lumbar: 34.0% (n=183) |
Gunshot wounds: 21.3% (n=115) |
| National Spinal Cord Injury Statistical Center 2005 N=23,683 |
USA | 2000-2005 National Spinal Cord Injury Database from 25 Model SCI Care Systems |
Males=79.6% Average age of injury=37.6 years Caucasian62.9% African American 22% Hispanic12.6% |
Incomplete tetraplegia (34.5%) Complete tetraplegia (18.4%) Incomplete paraplegia (17.5%) Complete paraplegia (23.1%) |
Violence: 13.8% (n=3268) |
| 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%) |
Violence: 16.6% (n = 6) |
| 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 |
Violence: 2.4% (n=11) |
| Kuptniratsaikul, 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 |
Violence: Tetraplegic n=0 Paraplegic n=4 ASIA D=3 |
Violence: 8.4% (n = 7) |
| 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%) |
Violence: 1.9% (n=13) |
| Pickett et al. 2003 N=2385 |
Ontario, Canada |
1994-1999 SCI in Ontario Trauma Registry |
Males=73% <20 years =6 (11%) 20-39 years= 29 (56%) 40-59 years=13 (25%) ≥60 years=4 (8%) |
No details | Violence: 2.2% (n=52) |
| 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=28.8 years White 65% African American 35% |
48% thoracic 43% complete (all cases) 58% Frankel A 17% Frankel B 7% Frankel C 15% Frankel D |
Gunshot wounds: 13.0% (n=21) |
| Karacan et al. 2000 N=581 |
Turkey | 1992 Nation-wide survey of SCI admissions to medical institutions. Exclusion Criteria: Patients who died before hospitalization. |
Males=71% Mean age=35.5±15.1 years. |
Cervical=31.7% Thoracic=26.6% Lumbar=25.1% Tetraplegia=87 (32%) Paraplegia=394 (68%) |
Gunshot Wounds: 1.9% (n=11) Knife Wounds: 3.3% (n=19) Violence: 5.2% (n=30) |
| National Spinal Cord Injury Statistical Center 2000 N=19648 |
USA | 1973 -1990’s 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% |
Gunshot Wounds: 25.9% (n = 5089) |
| Igun et al. 1999 N=68 |
Plateau State, Nigeria |
1984-1997 Radiologically confirmed diagnosis of spinal cord injury. |
Males= 91.2% Mean age = 30 years. |
Cervico-thoracic n=32 Cervico-thoracic n=36 Deaths n=18 |
Violence: 2.9% (n=2) |
| Nobunaga et al. 1999 N=25,054 |
USA | 1973-1998 Admissions to a Model Spinal Cord Injury Care System within 365 days of injury. |
Males=81.5% Mean age=32.3±15.8 years. |
Complete tetraplegia=17.4% Incomplete tetraplegia=13.8% Complete paraplegia=42.2% Incomplete tetraplegia=26.4% |
Violence: 18.9% (n=4735) |
| Caldana and Lucca 1998 N=127 |
Veneto, Italy |
1994-1995 New cases of traumatic spinal cord injury and nontraumatic spinal cord disease treated in regional hospitals (small hospitals excluded) |
Male = 83.5%; average age of 39.8 years Female = 16.5%; average age of36 years |
Cervical=62 (21 were complete) Thoracic=29(25) Thoracolumbar (T12- L1)=18(11) Caudal=14(3) Unidentified=1 |
Gunshot wounds: 1% (n = 6) |
| Farmer et al. 1998 N=1817 |
USA | 1979-1993 Regional Spinal Cord Injury Center of Delaware Valley (RSCICDV) |
Male= 91.6% Mean age=26.3 years African 74.5% American, 12.6% Hispanic, 12.6% White 17.4% |
19.8% quadriplegia complete 9.4% quadriplegia incomplete 46.1 % paraplegia complete 24.7% paraplegia incomplete |
Gunshot wounds: 16.9% (n=307) |
| 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%) |
Violence: 15% (n=20) |
| Carroll 1997 N=902 |
Arkansas, USA |
1980-1989 database from Arkansas Spinal Cord Commission (ASCC) registry |
Males= 82% Mean age=32 years 75% white, 22% black |
Paraplegia 52% Tetraplegia 44% |
Violence: 15.3% (n = 138) |
| Chen et al. 1997 SCI=1,586 |
Taiwan | 1992-1996 113 hospitals (11 medical centers, 50 regional general hospitals, 52 local general hospitals) |
Males=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 |
Violence: 2.0% (n=31) |
| Exner and Meinecke 1997 N= 22,212 |
Germany | 1976-1996 All traumatic and nontraumatic SCI |
72% male | 62% paraplegic 38% tetraplegic |
Violence: 1% (n=239) |
| Author Year N of study population |
Geographic region |
Inclusion/ exclusion criteria |
Study population |
Injury features | Cause: %(n of cases) |
|---|---|---|---|---|---|
| Otom et al. 1997 N=151 |
Jordan | 1988-1993 Royal Jordanian Rehabilitation Centre (RJRC) King Hussein Medical Centre (KHMC) |
Males = 85.4% Average age of injury=33 years |
Cervical=31.8% (n=48) Thoraco-lumbar= 68.2% (n=103) Frankel A= 53.6% (n=81) Frankel B = 10% (n=15) Frankel C =22.5% (n=34) Frankel D= 13.9% (n=21) |
Gunshot wound: 25.8% (n=39) Knife Wounds: 2% (n=3) |
| Karamehmeta glu, 1995 N=152 |
Istanbul, Turkey |
1992 New patients with traumatic SCI, including pediatrics. |
Males=75.7% Mean age = 33 years. 72% of patients were under 40. |
Tetraplegic n=50 Paraplegic n=102 |
Gunshot Wounds: 5.3% (n=8) Knife Wounds: 1.3% (n=2) Violence: 7% (n=10) |
| 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 |
Cervical 41.6% (n=147) Thoracic 36.0% (n=127) Lumbar 14.7% (n=52) Sacral 1.4% (n=5) Complete 39.4% (n=139) Incomplete 59.5% (n=210) |
Assault: 3.1% (n=11) |
| 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 |
Violence: 1.6% (n=3) |
| Hart et al. 1994 N=616 |
South Africa | 1988-1993 All records of SCI from the Natalspruit Spinal Rehabilitation Unit |
Males=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 |
Gunshot Wounds: 36% (n=219) Knife Wounds: 20% (n=122) |
| 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% 15-19 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%) |
Violence: 12.8% (n = 48) |
| 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 62 (27%) fatal 110 (49%) Frankel A/B/C 46 (21%) Frankel D 25 (11%) returned to full neurological function |
Gunshot Wounds: 5.4% (n=12) |
| 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=20 Paraplegia=51 |
Violence: 11.1% (n = 71) |
| 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%) |
Violence: 2% (n=3) |
| 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%) |
Knife Wounds: Complete tetraplegia=1 Incomplete tetraplegia=1 Complete paraplegia=1 |
Knife Wounds: 3.0% (n=3) |
| 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 |
94 (87.0%) complete 61 (64.9%) paraplegia 33 (35.1%) quadriplegia |
Gunshot Wounds: 26.9% (n=29) |
| DeVivo et al. 1992 N=6563 |
USA | Admissions to Spinal Cord Injury Care Systems within 1 year of injury from: 1978-1980 n=17841981-1983 n=13911984-1986 n=1433 |
Males=82.4% Mean age=28.4 yearsMales=82.7% Mean age=30.5 yearsMales=84.5% Mean age=31.2 years |
Frankel grade at discharge: Complete=51.8% Sensory=13.7% Motor nonfunctional=7.2% Motor functional=25.9% Recovered=1.4%Frankel grade at discharge: Complete=57.2% Sensory=11.7% Motor nonfunctional=7.8% Motor functional=22.5% Recovered=0.8%Frankel grade at discharge: Complete=48.6% Sensory=16.2% Motor nonfunctional=11.0% Motor functional=23.5% Recovered=0.6% |
Violence: 12.8% (n = 228)Violence: 13.6% (n = 189Violence: 16.2% (n = 232) |
| Dincer et al. 1992 N=1,694 |
Turkey | 1974-1985 SCI patients admitted to Ankara Rehabilitation Centre |
Males = 75.7% Average age of injury=26.8 (1-70) years Agricultural workers= 19.8% (n=336) Housewives= 19.9% (n=338) Private industry workers = 19.5% (n=330) |
Complete paraplegia 85.1% (n=1442) Incomplete paraplegia 6.9% (n=116) Complete tetraplegia 4.8% (n=82) Incomplete tetraplegia 3.2% (n=54) |
Gunshot wounds: 22.0% (n=372) Knife Wounds: 2.01% (n=34) |
| 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 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% |
Assault: 3% (n=2) Knife Wounds: 2% (n = 1) |
| 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 16-30 years =44.8% 31-45 years =25.9% 46-60 years= 12.1% 61-90 years= 12.1% |
(C1-4) =16.2% (C5-8)=45.9% (T1-6) =18.9% (T7-12) =10.8% (L1-5)=8.1% Frankel Grades: Complete (A)=50.8% Motor functional (D)=35.6% |
Gunshot wounds: 10% (n=6) |
| BieringSorensen 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 |
Complete tetraplegia = 22% Incomplete tetraplegia = 29% Complete paraplegia = 26% Incomplete paraplegia = 23% |
Violence: 2% (n=5) |
| 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=1 Incomplete paraplegia=2 |
Violence: 11.1% (n=3) |
| Chen et al. 1985 N=560 |
Taipei, Taiwan |
1978-1981 All record from general hospitals in Taipei. Included all spinal cord lesion with or without vertebral injury. |
86% male. Mean age = 35.9 (range 20-49) years. |
Incomplete Paraplegia n=118 Complete paraplegia n=180 Incomplete Tetraplegia n=117 Complete Tetraplegia n=145 Death n=31 |
Violence: 2.7% (n=15) |
| Griffin and Opitz 1985 N=154 |
Olmsted County, Minnesota, USA |
1935-1981 Medical recordslinkage system of the Rochester Project at the Mayo Clinic, periodic multi-centre surveys |
Males= 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 |
Assault: 3.2% (n=5) |
| 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 = 26 years (range 16-41 years) |
Cervical = 22% Upper thoracic = 11% Thoraco-lumbar = 28% Lumbar = 39% |
Assault: 6% (n=2) |
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