Epidemiology of Traumatic SCI

Prevalence of SCI

Prevalence is the proportion of a group of individuals having a health condition at a given point in time. In our review, prevalence is expressed as the number of cases of traumatic SCI per million in a given year. Table 6 presents the prevalence of traumatic SCI by geographic area.

Author
Year
N

 Geographic
Area		 Inclusion and exclusion
criteria		 Methodology used to

determine prevalence

Prevalence

by million

inhabitants
Knutsdottir
2012
N=207		 Iceland 1975-2009
Patients admitted to
Landspitali University Hospital		 Discharge incidence (survival rate) 526 (2009)
Noonan et al.
2012
N=not given		 Canada Incidence rates from Dryden et al. 2003 Annual discharge incidence of tSCI multiplied by life expectancy by severity of injury. 1,298 (2010)
Correa et al.
2011
N=173		 Chile  Patients with traumatic SCI incurred in the workplace from 1986 to 2005 and were admitted to Hospital del Trabajador in Santiago, Santiago, Chile. The number of workers who present with TSCI including new cases and cases of previous years that survive TSCI, subtracting those who died during the year divided by the total labor force affiliated to ACHS per year. 112 cases/million
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 Not reported 36.5/100 000

Hordaland:

35.1/100,000 (95% CI: 29.8–41.1)

Sogn og Fjordane:

41.9/100,000 (95% CI: 30.6–56.1).
Dahlberg et
al.
2005
N=152		 Helsinki, Finland 1999
Adult citizens (18 years or more) of Helsinki who had permanent sensory or motor deficits because of traumatic SCI		 Number of SCI patients found (n=152)
/
Cross-sectional population of Helsinki (n=546,000)		 280.0
O’Connor
2005
N=2959		 Australia 1986-1997
Australian Spinal Cord Injury Register		 Prevalence = (disease incidence)(disease duration) 681.0
Levi et al.
1995
N=353		 Stockholm, Sweden Stockholm SCI population Survey of regional registers
/
1991 Stockholm Regional Analysis Census		 227.0
Razdan et al.
1994
N=616
SCI=15		 Rural Kashmir, India 1986
Complete rural population of 63,645		 House-to house screening and census, interview with neurologic team 236.0
Harvey et al.
1990
N=505		 USA 1988
Traumatic SCI population in both institutional and noninstitutional settings		 Traumatic SCI survey
/
1988 population census data US Bureau of the Census		 721.0
Griffin and
O’Fallon
1985N=154		 Minnesota, USA Medical records-linkage system of the Rochester Project at the Mayo Clinic Total prevalence rates are ageand sex-adjusted to 1970 U.S. white population 473.0 (1980)
DeVivo et al.
1980
N=not given		 USA National Model Spinal Cord Injury Data Base Life-expectancy tables of SCI patients 9-86 years at time of injury 906.0
Kalsbeek et
al. 1980
N=1,236
SCI=31		 USA 1974
National Head and Spinal Cord Injury Survey		 Hospital admissions
/
Midyear estimates of population size for the contiguous United States in 1974 based on data from the United States Bureau of the Census		 50

Discussion

There are 12 studies that provided estimates of prevalence of traumatic SCI varying from 50 to 1,298 cases per million worldwide. There are regional differences of traumatic SCI across the globe, but generally, the trend is towards increasing prevalence over the last decades.

In Canada, the estimated prevalence of SCI is 1,298 per million, the highest of any prevalence estimate to date. In different regions within the United States, the estimated prevalence varied from 50 to 906 individuals with traumatic SCI per million. In Sweden and Finland, the prevalence of traumatic SCI was estimated to be 227 and 280 individuals per million, respectively. Based on data from India, the prevalence of traumatic SCI was reported to be 236 cases per million (Razdan et al. 1994), while in Australia, O’Connor (2005) documented a prevalence of 681 individuals with traumatic SCI per million. In more recent studies, Correa et al. (2011) documented 112 cases per million in Chile, and Hagen et al. (2010) reported 35.1 to 41.9 cases per 100,000 in Norway. Knutsdottir et al. (2012) estimated the prevalence in Iceland to be 526 per million.

In one study reporting the prevalence of SCI at two or more time points from the United States, the results indicate an increasing prevalence of traumatic SCI. Griffin et al. (1985b) reported an increase in the prevalence of traumatic SCI in Olmsted County (Minnesota, USA) from 197 to 473 cases per million population between the 1950s and 1980s.

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