Abstract
Study design
Systematic review with meta-analysis.
Objectives
To explore temporal changes in incidence rates, demographic and injury characteristics of incident traumatic spinal cord injury (TSCI) in Nordic countries.
Methods
Peer-reviewed publications and periodic reports about epidemiology of TSCI in the Nordic countries (Denmark, Finland, Iceland, Norway, Sweden) are identified, reviewed and included in the meta-analysis. Data are stratified into 20-year intervals to allow for chronological comparisons. Pooled estimates are derived using random effects meta-analysis.
Results
Twenty-three data sources are included presenting a total of 5416 cases. The pooled incidence rate for 2001–2020 is 15.4 cases/million/year compared to 17.6 and 18.3 cases/million/year during the two previous 20-year intervals. The proportion of cases with TSCI in the 15–29 age-group decreases from 50% (1961–1980) to 20% (2001–2020), while it increases from 9% to 35% in 60+ age-group. Transportation-related injuries decrease from 44% (1961–1980) to 27% (2001–2020). Conversely, fall-related injuries increase from 32% (1961–1980) to 46% (2001–2020). The proportion of individuals with incomplete tetraplegia increases from 31% (1961–1980) to 43% (2001–2020), while complete paraplegia decreases from 25% to 16%.
Conclusion
The characteristics of TSCI in the Nordic countries have changed drastically over the last six decades, in line with clinical experiences, and limited research evidence from other countries. These changes indicate the need for adapting research focus, prevention strategies, design and provision of care, rehabilitation and community services towards older individuals, fall-related injuries, and incomplete injuries in Nordic countries and other settings internationally where such changes occur.
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Acknowledgements
We acknowledge all individuals who provided clarifications and additional information from published studies and SCI registries. We also acknowledge the participants of the Nordic Advanced Spinal Cord Injury Rehabilitation (NASCIR) Course for providing input in relation to the clinical implications of the findings of this systematic review. We thank Kenneth Chance-Larsen for valuable assistance with language editing and proofreading.
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AD conceived the idea, and designed the systematic review together with MM. MM with help from AD conducted the search and screened potentially eligible studies. MM with help from AD extracted the data and conducted the meta-analysis. AD and MM with assistance from WA, AH and ALP communicated with corresponding authors of identified sources to request clarifications and additional data. MM with help from AD developed all tables and figures. AD and MM conducted the assessment of bias. MM and AD wrote the manuscript with help from WA. AH and ALP contributed data from NordicSCIR and revised the manuscript. All authors have read and approved the submitted version of the manuscript.
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Moschovou, M., Antepohl, W., Halvorsen, A. et al. Temporal changes in demographic and injury characteristics of traumatic spinal cord injuries in Nordic countries - a systematic review with meta-analysis. Spinal Cord 60, 765–773 (2022). https://doi.org/10.1038/s41393-022-00772-3
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DOI: https://doi.org/10.1038/s41393-022-00772-3
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