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Systematic Review

Table 1: Systematic Review of Epidemiology

Authors; Country

Date included in the review

Number of articles

Level of Evidence

Type of Study

Score

Method

Databases

 

Conclusions
Van den Berg et al. 2010

 

Reviewed articles published from January 1997 to December 2008

 

N=13

 

Level of evidence:

N/A

 

Type of study:

Epidemiological (retrospective n=11; prospective n=2)

 

AMSTAR: 5

Method: Review of original articles that estimated the incidence rate of SCI worldwide.

 

Database: PubMed and EMBASE

1.    In Western Europe, crude incidence ranged from 12.1 (Netherlands) to 57.8 (Coimbra, Portugal) per million.

2.    In North America, studies revealed annual rates between 25.2 and 52.5 per million.

3.    Incidence rates of 18.8, 12.7, and 16.9 per million were reported in Taiwan, southeast Turkey and Australia, respectively.

4.    Three age groups were found to have a higher incidence of SCI: 15-29, 40-49, and ≥50 years of age.

5.    Higher incidence of SCI in males with ratios ranging from 2:1 in Turkey to 6.7:1 in Ireland for traumatic injuries and a lower ratio of 1.3:1 for non-traumatic SCI in Australia.

6.    The largest cause of SCI was motor vehicle collisions.

 

 

Ning et al. 2012

 

Review of published articles from January 1980 to December 2011

 

N=39

 

Level of Evidence:

N/A

 

Type of study: Epidemiological (retrospective n=35; prospective n=4)

 

AMSTAR: 4

Methods: Review of original articles that estimated either incidence and/or prevalence of traumatic SCI in Asia

 

Databases: PubMed, EBSCO, MEDLINE, EMBASE, and Google Scholar

 

1.    Among studies conducted in East, Southeast, and West Asia, incidence rates ranged from 12.06 per million (Anatolia, Turkey) to 61.6 per million (Taiwan).

2.    Injury ratios between men and women ranged from 0.99:1(Taipei, Taiwan) to 13.5:1 in India.

3.    Most common causes of injury were motor vehicle collisions (59.5%) and falls (37.8%).

Cripps et al. 2011

 

Reviewed published articles prior to 2011

 

N= 73

 

Level of Evidence:

N/A

 

Type of study:

Epidemiological primarily

 

AMSTAR: 3

Methods: Reviewed published articles which estimated the incidence and prevalence rates of SCI worldwide.

 

Replicated search of Wyndaele 2006 without date and language restriction using search phrases (exploded).

 

Databases: MEDLINE and EMBASE

 

1.    Incidence rate was 39, 15, and 16 per million in North America, Western Europe, and Australia, respectively.

2.    Prevalence rates in South and Southeast Asia were available for India and Vietnam with 236 and 464 per million, respectively.

3.    Prevalence rates in Australasia were estimated for Australia and were 370 (1987), 681 (1997), and 540 (1998).

4.    Prevalence rates in Western European countries of Finland, Iceland, and Norway were 280 (1999), 316 (1973-1989), and 365 (2002) per million respectively.

5.    Prevalence in Canada was estimated at 1173 per million (2001-2002).

6.    Prevalence reported for the US (1935- 2006) ranged between 473 and 1009 per million

7.    Common causes of SCI reported worldwide were road traffic accidents, falls, and violence.

8.    Violence/self-harm was higher in North America (15%) than either Western Europe (6%) or Australia (2%).

9.    Sub-saharan Africa has the highest reported violence-related TSCI in the world (38%), followed by north Africa/Middle East (24%), and Latin America (22%).

Furlan et al. 2013

 

Review of articles published from 1950 (MEDLINE) or 1980 (the other databases) to December 1, 2012

 

N=73

 

Level of evidence:

N/A

 

Type of study: Epidemiological

 

 

AMSTAR: 2

Method: Review of original articles that estimated either incidence and/or prevalence of traumatic SCI among adults worldwide

 

Database: MEDLINE, EMBASE, CINAHL, PSYCHINFO, and Cochrane databases.

 

 

 

1.    In the Americas, the incidence rate of traumatic SCI varied from 20.7 to 83.0 people per million inhabitants a year (most recent studies).

2.    In Europe, the estimated incidence rate varied from 8.0 in Spain to 130.6 individuals with traumatic SCI per million inhabitants per year in Bulgaria.

3.    Among countries and cities located in Asia , the lowest incidence rate was 14.6 in Taipei, Taiwan (1978-1981) and the highest (1998-2008) with 246.0 people per million per year in all of Taiwan

4.    In Oceania, the estimated incidence rate varied from 10.0 (Fiji) to 77.0 (New Zealand)  per million per year

5.    The prevalence worldwide varied from 50 to 1, 298 cases per million.

Ackery et al. 2004

 

Reviewed published articles between 1993 and November 2003

 

N= 41

 

 

Level of Evidence:

N/A

 

 

Type of study:

Epidemiological primarily

 

AMSTAR: 1

Methods: Reviewed published articles on the epidemiology of SCI worldwide.

 

 

Database: PubMed

 

 

1.    In Western Canada, Portugal, Italy, Japan, the Russian Federation, and Australia, incidence rates were 52.5, 57.8, 18-20, 39.4, 29.7, and 14.5 respectively.

2.    Mean age ranged from between 15-24 to 55.4 years of age

3.    The ratio male/female ranged from 2.5:1 to 8.1:1

Hagen et al. 2012

 

Reviewed articles published prior to April 1, 2011

 

N=147

 

Level of evidence:

N/A

 

Type of study:

Epidemiological

 

AMSTAR: 0

Method: Reviewed published articles which estimated the incidence and prevalence rates of SCI worldwide.

 

Database: PubMed

1.    Annual incidence rates (1947- 2008) ranged from 2.3 (Canada and Western Europe) to 83 (Alaska) per million worldwide.

2.    Prevalence rates ranged from 236 (India) to 1800 (US) per million.

3.    Average age at the time of injury worldwide varied from 26.8 years (Turkey) to 55.5 years (USA).

4.    Overall, SCI occurred more often in men in countries other than Iran and Taiwan where the frequencies of SCI was equal among both genders.

5.    Common causes of SCI in decreasing order included traffic accidents, falls, violence, and sports accidents.

Chiu et al. 2010

 

Reviewed published articles from 1989 to 2009

 

N=18

 

Level of Evidence:

N/A

 

Type of study:

Epidemiological

 

AMSTAR: 0

 

Methods: Reviewed published articles reporting on traumatic SCI epidemiological data

 

 

Databases: PubMed and MEDLINE

 

1.    Among developed countries incidence rates decreased from 52.2 to 13.1 (1976- 2005)

2.    Among developing countries, the incidence rates ranged from 12.7 to 29.7 per million.

3.    Average age in developed countries ranged from 30.7 to 48.5 years and between 40 and 50 years in the majority of studies conducted in developing countries.

4.    First and second most common causes in developed countries were traffic accidents and falls respectively. However falls was the main cause of SCI in developing countries.

 

Wyndaele M & Wyndaele J-J. 2006

 

Reviewed published articles from 1995 to present

 

N=19

 

Level of evidence:

N/A

 

Type of study:

Epidemiological

 

AMSTAR: 0

 

Method: Reviewed published articles which estimated the incidence and prevalence rates of SCI worldwide.

 

Database: PubMed.

1.    Prevalence rates in Australia (1997), Finland (1999), USA (2001), and USA (2005) were estimated to be 681, 280, 700, and 755 per million respectively.

2.    In Europe (Turkey, Russia, Portugal, The Netherlands, and France) incidence rates ranged from 10.4 to 29.7 per million.

3.    In North America (Alaska, Mississippi, Kentucky, Indiana, Ontario, and Alberta), incidence rates ranged from 27.1 to 83 per million.

4.    In Asia (Jordan, Japan, Taiwan, and Fiji Islands), incidence rates ranged from 18.0 to 40.2 per million.

5.    In Australia, the crude SCI incidence (1997) was 16.8 per million per year.

6.    On average the incidence of SCI worldwide (1977 to 2005) ranged from 29.5 to 34.4 with a higher average reported for the period of 1975-1995.

7.    The average age at injury was 28.7 yrs from 1973 to 1979, which has risen to 37.6 yrs in 2000.

8.    The sex distribution (M/F) of SCI in recent studies is 3.8/1, where it used to be 4.8/1.