Abstract
Study design:
Retrospective population-based cohort study.
Objectives:
To provide national data on epidemiology of traumatic spinal cord injury (TSCI) among the population of Estonia from 1997 to 2007.
Setting:
All Estonian hospitals.
Methods:
Medical records of patients with TSCI from all regional, central, general and rehabilitation hospitals in Estonia were retrospectively reviewed. Epidemiological characteristics, etiology, neurological level and severity of injury, concomitant injuries were analyzed.
Results:
A total of 595 patients with TSCI from 1 January 1997 to 31 December 2007 were identified. The male to female ratio was 5.5:1. The mean age at injury was 39.0 years. The crude incidence rate was 39.7 (95% confidence interval: 36.6–43.0) per million population. The most frequent cause of TSCI was falls (41%), followed by traffic accidents (29%). Alcohol consumption preceded 43% of injuries. The lesion level was cervical in 59.4%, thoracic in 18.3% and lumbar/sacral in 22.3%.
Conclusion:
Compared to recent studies from Europe, where the incidence of TSCI is between 15 and 30 per million population, the incidence of TSCI in Estonia is among the highest. The rates are significantly higher in men compared with women and especially among the youngest men. The leading cause of TSCI is falls. A significant proportion of injuries are related to alcohol consumption before trauma in Estonia.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Wyndaele M, Wyndaele JJ . Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Spinal Cord 2006; 44: 523–529.
Chiu WT, Lin HC, Lam C, Chu SF, Chiang YH, Tsai SH . Review paper: epidemiology of traumatic spinal cord injury: comparisons between developed and developing countries. Asia Pac J Public Health 2010; 22: 9–18.
Lai T, Köhler K, Rooväli L . Injuries in Estonia. Ministry of Social Affairs of Estonia, Health Information and Analysis Department: Tallinn. 2009 p 15 Available at: http://www.sm.ee/fileadmin/meedia/Dokumendid/V2ljaanded/Toimetised/2009/series_20095eng.pdf.
Maynard FM, Bracken MB, Creasey G, Ditunno JF, Donovan WH, Ducker TB et al. International standards for neurological and functional classification of spinal cord injury. Spinal Cord 1997; 35: 266–274.
DeVivo MJ, Biering-Sorensen F, Charlifue S, Noonan V, Post M, Stripling T et al. International Spinal Cord Injury Core Data Set. Spinal Cord 2006; 44: 535–540.
DeVivo MJ, Biering-Sorensen F, New P, Chen Y . Standardization of data analysis and reporting of results from the International Spinal Cord Injury Core Data Set. Spinal Cord 2011; 49: 596–599.
van Asbeck FW, Post MW, Pangalila RF . An epidemiological description of spinal cord injuries in The Netherlands in 1994. Spinal Cord 2000; 38: 420–424.
Hagen EM, Eide GE, Rekand T, Gilhus NE, Gronning MA . 50-year follow-up of the incidence of traumatic spinal cord injuries in Western Norway. Spinal Cord 2010; 48: 313–318.
Cripps RA, Lee BB, Wing P, Weerts E, Mackay J, Brown D . A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention. Spinal Cord 2011; 49: 493–501.
Berg MV, Castellote JM, Mahillo-Fernandez I, de Pedro-Cuesta J . Incidence of traumatic spinal cord injury in Aragón, Spain (1972–2008). J Neurotrauma 2011; 28: 469–477.
Ahoniemi E, Alaranta H, Hokkinen EM, Valtonen K, Kautiainen H . Incidence of traumatic spinal cord injuries in Finland over a 30-year period. Spinal Cord 2008; 46: 781–784.
Martins F, Freitas F, Martins L, Dartigues JF, Barat M . Spinal cord injuries—epidemiology in Portugal's central region. Spinal Cord 1998; 36: 574–578.
Ackery A, Tator C, Krassioukov A . A global perspective on spinal cord injury epidemiology. J Neurotrauma 2004; 21: 1355–1370.
Golias I, Karlaftis MG . An international comparative study of self-reported driver behavior. Transp Res Part F Traffic Psychol Behav 2002; 4: 243–256.
Dryden DM, Saunders LD, Rowe BH, May LA, Yiannakoulias N, Svenson LW et al. The epidemiology of traumatic spinal cord injury in Alberta, Canada. Can J Neurol Sci 2003; 30: 113–121.
European Union.. Europe in figures: Eurostat yearbook 2010. Office for Official Publications of the European Union: Luxembourg. 2010 pp 149–203.
Pomerleau J, McKee M, Robertson A, Vaasc S, Kadziauskiene K, Abaravicius A et al. Physical inactivity in the Baltic countries. Prev Med. 2000; 31: 665–672.
Furlan JC, Bracken MB, Fehlings MG . Is age a key determinant of mortality and neurological outcome after acute traumatic spinal cord injury? Neurobiol Aging 2010; 31: 434–446.
de Groot LC, Verheijden MW, de Henauw S, Schroll M, van Staveren WA . SENECA Investigators. Lifestyle, nutritional status, health, and mortality in elderly people across Europe: a review of the longitudinal results of the SENECA study. J Gerontol A Biol Sci Med Sci 2004; 59: 1277–1284.
Lai T, Habicht J . Decline in alcohol consumption in Estonia: combined effects of strengthened alcohol policy and economic downturn. Alcohol Alcohol 2011; 46: 200–203.
Acknowledgements
The study was supported by the Estonian Science Foundation grant no. 7868 and the targeted financing no. SF0180064s07. We thank the medical staff of all Estonian hospitals for their kind help in the study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Sabre, L., Pedai, G., Rekand, T. et al. High incidence of traumatic spinal cord injury in Estonia. Spinal Cord 50, 755–759 (2012). https://doi.org/10.1038/sc.2012.54
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2012.54
Keywords
This article is cited by
-
Spinal cord injury: molecular mechanisms and therapeutic interventions
Signal Transduction and Targeted Therapy (2023)
-
A systematic review and meta-analysis of the global epidemiology of pediatric traumatic spinal cord injuries
European Journal of Pediatrics (2023)
-
Reliability and minimal detectable change of the Trunk Assessment Scale for Spinal Cord Injury (TASS) and the trunk control test for individuals with spinal cord injury
Spinal Cord Series and Cases (2022)
-
Current status of traumatic spinal cord injury caused by traffic accident in Northern China
Scientific Reports (2022)
-
Epidemiology of traumatic spinal cord injury in Finland
Spinal Cord (2021)


