See All Evidence Sections
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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