Abstract
Study Design:
Investigation of burden of traumatic spinal cord injury (SCI) using disease modeling.
Objectives:
The present paper is intended to estimate the SCI burden for the year 2008.
Setting:
Tehran, capital of Iran.
Methods:
Epidemiological data needed to calculate Disability-Adjusted Life-Years (DALYs) for SCI, was estimated according to prevalence, duration and relative risk of mortality using DISMOD software. For DALY calculation, the years of life lost because of premature mortality (YLL) was added to the number of years lost because of disability (YLD). To calculate DALYs for SCI, first year DALY calculated separately and for the next years, the DALY was assessed for six different clinical presentations of traumatic SCI including quadriplegia, quadriparesis, paraplegia, paraparesis, hemiplegia and hemiparesis.
Results:
In first year following SCI, the DALY was 3772 years, which has 0.5 DALY per 1000 people and YLL/DALY was 89.3%. Following the first year, the DALY was 435 for quadriplegia, 163 for quadriparesis, 868 for paraplegia, 164 for paraparesis, 26 for hemiplegia and 14 for hemiparesis. The total YLL for traumatic SCI was 4077 years and total YLD was 1364 years (total YLL/DALY was 74.9%) and total DALY was 5441 years, (M/F=2.0), which has 0.7 DALY per 1000 people in Tehran in 2008.
Conclusions:
This study showed a high burden for SCI. Identifying the risk factors of SCI, and performing cost-effective preventive interventions for reducing burden of SCI is recommended.
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References
Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL (eds). Global Burden of Disease and Risk Factors. A copublication of Oxford University Press and The World Bank: Oxford, 2006.
Polinder S, Meerding WJ, Mulder S, Petridou E, van Beeck E . Assessing the burden of injury in six European countries. Bull World Health Organ 2007; 85: 27–34.
Naghavi M, Abolhassani F, Pourmalek F, Moradi Lakeh M, Jafari N, Vaseghi S et al. The burden of disease and injury in Iran 2003. Popul Health Metr 2009; 7: 9.
Rahimi-Movaghar V . Efficacy of surgical decompression in the setting of complete thoracic spinal cord injury. J Spinal Cord Med 2005; 28: 1–6.
Saunders LL, Selassie AW, Hill EG, Nicholas JS, Varma AK, Lackland DT et al. Traumatic spinal cord injury mortality, 1981–1998. J Trauma 2009; 66: 184–190.
Allotey P, Reidpath D, Kouamé A, Cummins R . The DALY, context and the determinants of the severity of disease: an exploratory comparison of paraplegia in Australia and Cameroon. Soc Sci Med 2003; 57: 949–958.
Richmond TS, Lemaire J . Years of life lost because of gunshot injury to the brain and spinal cord. Am J Phys Med Rehabil 2008; 87: 609–615.
World Health Organization web site (http://www.who.int/healthinfo/global_burden_disease/tools_software/en/). Published in 2009. Available at 9 July 2009.
Jankovic S, Vlajinac H, Bjegovic V, Marinkovic J, Sipetic-Grujicic S, Markovic-Denic L et al. The burden of disease and injury in Serbia. Eur J Public Health 2007; 17: 80–85.
Coale A, Guo G . Revised regional model life tables at very low levels of mortality. Popul Index 1989; 55: 613–643.
Arnesen T, Kapiriri L . Can the value choices in DALYs influence global priority-setting? Health Policy 2004; 70: 137–149.
Rahimi-Movaghar V, Saadat S, Rasouli MR, Ganji S, Ghahramani M, Zarei MR et al. Prevalence of spinal cord injury in Tehran, Iran. J Spinal Cord Med 2009; 32: 428–431.
Taghipoor KD, Arejan RH, Rasouli MR, Saadat S, Moghadam M, Vaccaro AR et al. Factors associated with pressure ulcers in patients with complete or sensory only preserved spinal cord injury: is there any difference between traumatic and nontraumatic etiologies? A study of 5995 patients. J Neurosurg: Spine 2009; 11: 438–444.
Catz A, Thaleisnik M, Fishel B, Ronen J, Spasser R, Fredman B et al. Survival after spinal cord injury in Israel. Spinal cord 2002; 40: 595–598.
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.
Furlan JC, Kattail D, Fehlings M . The impact of co-morbidities on age-related differences in mortality after acute traumatic spinal cord injury. J Neurotrauma 2009 (e-pub ahead of print).
Krause JS, Carter RE . Risk of mortality after spinal cord injury: relationship with social support, education, and income. Spinal Cord 2009; 47: 592–596.
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.
Shavelle RM, DeVivo MJ, Paculdo DR, Vogel LC, Strauss DJ . Long-term survival after childhood spinal cord injury. J Spinal Cord Med 2007; 30: S48–S54.
Lidal IB, Snekkevik H, Aamodt G, Hjeltnes N, Biering-Sørensen F, Stanghelle JK . Mortality after spinal cord injury in Norway. J Rehabil Med 2007; 39: 145–151.
World Health Organization. Table: Threshold values for intervention cost-effectiveness by Region (http://www.who.int/choice/costs/CER_levels/en/print.html) Published at 2005. Available at 9 July 2009.
Acknowledgements
We extend our appreciation to Dr Farid Abolhassani for his helpful guidance in all stages of the study and for his help in answering our questions and resolving scientific problems. This study was supported by Grant number 0058–12.4.2008 of Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences. The first author received the funding.
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Rahimi-Movaghar, V., Moradi-Lakeh, M., Rasouli, M. et al. Burden of spinal cord injury in Tehran, Iran. Spinal Cord 48, 492–497 (2010). https://doi.org/10.1038/sc.2009.158
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DOI: https://doi.org/10.1038/sc.2009.158
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