Abstract
Study design:
Observational prospective population-based incidence study.
Objectives:
The main objective of this study was to assess the incidence of traumatic spinal cord injuries (TSCIs) and incidence rates, in order to provide estimates by age, gender, characteristics and cause.
Setting:
This study was conducted at acute-care spinal cord injury (SCI) hospitals and SCI centers from 11 Italian regions, between 1 October 2013 and 30 September 2014.
Methods:
Data of all consecutive patients with acute TSCI who met the inclusion criteria were obtained through case reporting by clinicians. The data were collected into a web database. Incidence rates and incidence rate ratios were calculated and stratified by age, gender, cause, level and completeness.
Results:
From 50% of the entire population of Italy, 445 new cases of TSCI were included. The crude incidence rate of TSCI was 14.7 cases per million per year (95% CI: 13.4–16.4); the overall male to female ratio was 4:1 and the mean age was 54. Complete information was available in 85% of the sample and revealed tetraplegia in 58% and incomplete lesion in 67% of cases. The leading cause of TSCI was falls (40.9%) followed by road traffic accidents (33.5%). The leading cause was falls for patients over 55 and road traffic accidents for patients under 55.
Conclusion:
The changing trend of TSCI epidemiology concerns the increase in the average age of TSCI people and the increase of both cervical and incomplete lesions. The etiology shows the primacy of falls over road traffic accidents and suggests the need for a change in prevention policies.
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References
Caldana L, Lucca L . Epidemiological remarks on traumatic spinal cord injuries and non traumatic spinal cord diseases in Veneto 1994–1995. Eur Med Phys 1998; 34: 121–124.
Pagliacci MC, Celani MG, Spizzichino L, Zampolini M, Aito S, Citterio et al. Spinal cord lesion management in Italy: a 2-year survey. Spinal Cord 2003; 41: 620–628.
Pagliacci MC, Celani MG, Zampolini M, Spizzichino L, Franceschini M, Baratta S et al. An Italian survey of traumatic spinal cord injury. An Italian survey of traumatic spinal cord injury. The Gruppo Italiano Studio Epidemiologico Mielolesioni Study. Arch Phys Med Rehabil 2003; 84: 1266–1275.
DeVivo MJ . Epidemiology of traumatic spinal cord injury: trends and future implications. Spinal Cord 2012; 50: 365–372.
Selvarajah S, Hammond ER, Haider AH, Abularrage CJ, Becker D, Dhiman N et al. The burden of acute traumatic spinal cord injury among adults in the United States: an update. J Neurotrauma 2014; 31: 228–238.
Bjørnshave Noe B, Mikkelsen EM, Hansen RM, Thygesen M, Hagen EM . Incidence of traumatic spinal cord injury in Denmark, 1990–2012: a hospital-based study. Spinal Cord 2015; 53: 436–440.
Pérez K, Novoa AM, Santamariña-Rubio E, Narvaez Y, Arrufat V, Borrell C et al. Incidence trends of traumatic spinal cord injury and traumatic brain injury in Spain, 2000-2009. Accid Anal Prev 2012; 46: 37–44.
Nijendijk JHB, Post MWM, van Asbeck FWA . Epidemiology of traumatic spinal cord injuries in the Netherlands in 2010. Spinal Cord 2014; 52: 258–263.
Chamberlain JD, Deriaz O, Hund-Georgiadis M, Meier S, Scheel-Sailer A, Schubert M et al. Epidemiology and contemporary risk profile of traumatic spinal cord injury in Switzerland. Inj Epidemiol 2015; 2: 28.
Majdan M, Brazinova A, Mauritz W . Epidemiology of traumatic spinal cord injuries in Austria 2002-2012. Eur Spine J 2016; 25: 62–73.
National Spinal Cord Injury Statistical Center (NSCISC) [Internet].Birmingham (AL): University of Alabama; 2015. 2015 Annual Statistical Report. Complete Public Version. Available from https://www.nscisc.uab.edu/PublicDocuments/reports/pdf/2015%20NSCISC%20Annual%20Statistical%20Report%20Complete%20Public%20Version.pdf.
Shingu H, Ohama M, Ikata T, Katoh S, Akatsu T . A nationwide epidemiological survey of spinal cord injuries in Japan from January 1990 to December 1992. Paraplegia 1995; 33: 183–188.
Lee BB, Cripps RA, Fitzharris M, PC Wing PC . The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate. Spinal Cord 2014; 52: 110–116.
DeVivo M, Biering-Sørensen F, Charlifue S, Noonan V, Post M, Stripling T et al. International spinal cord injury core data set. Spinal Cord 2006; 44: 535–540.
Kirshblum SC, Burns SP, Biering-Sørensen F, Donovan W, Graves DE, Jha A et al. International standards for neurological classification of spinal cord injury (revised 2011). J Spinal Cord Med 2011; 34: 535–546.
Sabre L, Remmer S, Adams A, Vali M, Rekand T, Asser T et al. Impact of fatal cases on the epidemiology of traumatic spinal cord injury in Estonia. Eur J Neurol 2014; 22: 768–772.
Burns AS, Lee BS, Ditunno JF, Tessler A . Patient selection for clinical trials: the reliability of the early spinal cord injury examination. J Neurotrauma 2003; 20: 477–482.
Franceschini M, Cerrel-Bazo H, Lauretani F, Agosti M, Pagliacci MC . Age influences rehabilitative outcomes in Spinal Cord Injury patients. Aging Clin Exp Res 2011; 23: 202–208.
Acknowledgements
This study was financed within the framework of the 2012 CCM Program. CCM is the National Centre for Disease Prevention and Control whose task is to liaise with the Ministry of Health and the regional governments as far as surveillance and prevention are concerned and whose aim is to promptly respond to emergencies. http://www.ccm-network.it/progetto.jsp?id=node/1846&idP=740.
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Members of the italian sci study group steering committee
S Ferro1,2, M Bellentani1, M Franceschini6,7, A Cavina4, J Bonavita4, MC Pagliacci5, A Biggeri3, L Cecconi3, F De Iure9, G Gordini9, T Redaelli10, MV Actis11, G Del Popolo12, G Bertagnoni13, R Avesani14 and V Falabella15
9SCI Surgery Unit and Intensive Care Unit, Maggiore Hospital, Bologna, Italy; 10SCI Unit, Niguarda Hospital, Milan, Italy; 11SCI Unit, Città della Salute e della Scienza Hospital, Turin, Italy; 12SCI Unit, Careggi Hospital, Florence, Italy; 13SCI Unit, San Bortolo Hospital, Vicenza, Italy; 14Department of Neurorehabilitation, Don Calabria Hospital, Negrar, Verona, Italy and 15FAIP, Italian Federation of Paraplegics and Tetraplegics Associations, Rome, Italy.
Collaborating hospitals and regional health authorities
MV Actis11, M Stillittano11, S Petrozzino16, C Cisari17, M Salvini18, T Redaelli10, R Tosi10, CM Borghi19, A Bava19, C Pistarini20, G Molinero21, A Signorelli21, S Sandri22, F Simeoni23, M Brambilla24, MA Banchero25, A Olivero25, G Zanaboni25, R Avesani14, G Bertagnoni13, M Leucci13, L Lain13, M Saia26, A Zampa27, P Del Fabro27, M Saccavini28, A Fanzutto29, A Massone30, J Bonavita4, D Gaddoni4, S Olivi4, G Musumeci4, R Pederzini4, HC Bazo31, D Nicolotti31, M Nora32, R Brianti32, C Iaccarino32, A Volpi32, A Lombardi33, S Cavazza33, F Casoni33, F De Iure9, G Gordini9, R Piperno9, G Teodorani34, A Naldi34, G Vergoni34, E Maietti35, A Botti42, S Ferro1,2, G Pagoto2, G Del Popolo12, M Moresi12, M Postiglione12, C Bini12, M Tagliaferri36, MA Recchioni37, P Pelaia37, L Di Furia38, MC Pagliacci5, R Maschke5, L Caruso5, L Speziali5, M Zenzeri39, P Fiore40, R Marvulli40, R Nardulli41, C Lanzillotti42, M Ruccia43, MP Onesta44, T Di Gregorio44, F Franchina45, MG Furnari46, C Pilati47, MMerafina47, F Crescia47, D Fletzer48, G Scivoletto49 and N Di Lallo50
16Alessandria Hospital, Alessandria, Italy; 17Novara Hospital, Novara, Italy; 18Piedmont Region, Italy; 19Pini CTO Hospital, Milan, Italy; 20IRCCS Maugeri Foundation, Pavia, Italy; 21Bergamo Hospital, Bergamo, Italy; 22Legnano-Magenta Hospital, Legnano, Milan, Italy; 23Garbagnate Hospital, Garbagnate, Milan, Italy; 24Valtellina Hospital, Sondalo, Sondrio, Italy; 25Lombardy Region, Italy; 26Veneto Region, Italy; 27Gervasutta Hospital, Udine, Italy; 28Palmanova Hospital, Udine, Italy; 29Friuli Venezia Giulia Region, Italy; 30Santa Corona Hospital, Pietra Ligure, Savona, Italy; 31Villanova d’Arda Hospital, Piacenza, Italy; 32Parma Hospital, Parma, Italy; 33Baggiovara Hospital, Modena, Italy; 34Cesena Hospital, Cesena, Italy; 35Ferrara Hospital, Ferrara, Italy; 36Tuscany Region, Italy; 37Ospedali Riuniti, Ancona, Italy; 38Marche Region, Italy; 39Umbria Region, Italy; 40Bari Hospital, Bari, Italy; 41IRCCS Maugeri Foundation, Cassano Murge, Bari, Italy; 42IRCCS Maugeri Foundation, Ceglie Messapica, Brindisi, Italy; 43Puglia Region, Italy; 44Cannizzaro Hospital, Catania, Italy; 45Villa Sofia Hospital, Palermo, Italy; 46Sicily Region, Italy; 47Alesini CTO Hospital, Rome, Italy; 48Ostia Hospital, Rome, Italy; 49IRCCS S. Lucia Foundation, Rome, Italy and 50Lazio Region, Italy.
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Ferro, S., Cecconi, L., Bonavita, J. et al. Incidence of traumatic spinal cord injury in Italy during 2013–2014: a population-based study. Spinal Cord 55, 1103–1107 (2017). https://doi.org/10.1038/sc.2017.88
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DOI: https://doi.org/10.1038/sc.2017.88
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