Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey?

/pdf/incidence-prevalence-and-epidemiology-of-spinal-cord-injury-xo8iy8rerl.pdf

BACKGROUND: Spinal cord injury (SCI) is a traumatic event that impacts a patient's physical, psychological, and social well-being and places substantial financial burden on health care systems. To determine the true impact of SCI, this systematic review aims to summarize literature reporting on either the incidence or prevalence of SCI. METHODS: A systematic search was conducted using PubMed, MEDLINE, MEDLINE in process, EMBASE, Cochrane Controlled Trial Register, and Cochrane Database of Systematic Reviews to identify relevant literature published through June 2013. We sought studies that provided regional, provincial/state, or national data on the incidence of SCI or reported estimates of disease prevalence. The level of evidence of each study was rated using a scale that evaluated study design, methodology, sampling bias, and precision of estimates. RESULTS: The initial search yielded 5,874 articles, 48 of which met the inclusion criteria. Forty-four studies estimated the incidence of SCI and nine reported the prevalence, with five discussing both. Of the incidence studies, 14 provided figures at a regional, ten at a state or provincial level and 21 at a national level. The prevalence of SCI was highest in the United States of America (906 per million) and lowest in the Rhone-Alpes region, France (250 per million) and Helsinki, Finland (280 per million). With respect to states and provinces in North America, the crude annual incidence of SCI was highest in Alaska (83 per million) and Mississippi (77 per million) and lowest in Alabama (29.4 per million), despite a large percentage of violence injuries (21.2%). Annual incidences were above 50 per million in the Hualien County in Taiwan (56.1 per million), the central Portugal region (58 per million), and Olmsted County in Minnesota (54.8 per million) and were lower than 20 per million in Taipei, Taiwan (14.6 per million), the Rhone-Alpes region in France (12.7 per million), Aragon, Spain (12.1 per million), Southeast Turkey (16.9 per million), and Stockholm, Sweden (19.5 per million). The highest national incidence was 49.1 per million in New Zealand, and the lowest incidences were in Fiji (10.0 per million) and Spain (8.0 per million). The majority of studies showed a high male-to-female ratio and an age of peak incidence of younger than 30 years old. Traffic accidents were typically the most common cause of SCI, followed by falls in the elderly population. CONCLUSION: This review demonstrates that the incidence, prevalence, and causation of SCI differs between developing and developed countries and suggests that management and preventative strategies need to be tailored to regional trends. The rising aging population in westernized countries also indicates that traumatic SCI secondary to falls may become an increasing public health challenge and that incidence among the elderly may rise with increasing life expectancy. Language: en

https://www.dovepress.com/getfile.php?fileID=21721

Global prevalence and incidence of traumatic spinal cord injury

Study design:Literature reviewObjectives:Update the global maps for traumatic spinal cord injury (TSCI) and incorporate methods for extrapolating incidence dataSetting:An initiative of the International Spinal Cord Society (ISCoS) Prevention CommitteeMethods:A search of Medline/Embase was performed (1959-Jun/30/2011) Enhancement of data-quality 'zones' including individual data-ranking as well as integrating regression techniques to provide a platform for continued regional and global estimatesResults:A global-incident rate (2007) is estimated at 23 TSCI cases per million (179 312 cases per annum) Regional data are available from North America (40 per million), Western Europe (16 per million) and Australia (15 per million) Extrapolated regional data are available for Asia-Central (25 per million), Asia-South (21 per million), Caribbean (19 per million), Latin America, Andean (19 per million), Latin America, Central (24 per million), Latin America-Southern (25 per million), Sub-Saharan Africa-Central (29 per million), Sub-Saharan Africa-East (21 per million)Discussion:It is estimated that globally in 2007, there would have been between 133 and 226 thousand incident cases of TSCI from accidents and violence The proportion of TSCI from land transport is decreasing/stable in developed but increasing in developing countries due to trends in transport mode (transition to motorised transport), poor infrastructure and regulatory challenges TSCIs from low falls in the elderly are increasing in developed countries with ageing populations In some developing countries low falls, resulting in TSCI occur while carrying heavy loads on the head in young people In developing countries high-falls feature, commonly from trees, balconies, flat roofs and construction sites TSCI is also due to crush-injuries, diving and violenceConclusion:The online global maps now inform an extrapolative statistical model, which estimates incidence for areas with insufficient TSCI data The accuracy of this methodology will be improved through the use of prospective, standardised-data registriesSpinal Cord advance online publication, 26 February 2013; doi:101038/sc2012158 Language: en

/pdf/the-global-map-for-traumatic-spinal-cord-injury-epidemiology-3zcfjatazk.pdf

The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate

Background: Despite decades of research, there are no national estimates of the incidence or prevalence of spinal cord injury (SCI) in Canada. Our objective was to utilize the best available data to estimate the incidence and prevalence of traumatic SCI (TSCI) and non-traumatic SCI (NTSCI) in Canada for 2010. Methods: Initial incidence (number of TSCIs at injury scene) and discharge incidence (number discharged into the community) were calculated using published TSCI rates from Alberta and NTSCI rates from Australia. Prevalence was estimated by applying TSCI and NTSCI discharge incidence rates to historical Canadian population demographics using a cohort survival model and age-specific mortality rates for tetraplegia and paraplegia. Results: The estimated 2010 initial incidence of TSCI is 1,785 cases per year, and the discharge incidence is 1,389 (41 per million). The estimated discharge incidence for NTSCI is 2,286 cases (68 per million). The prevalence of SCI in Canada is estimated to be 85,556 persons (51% TSCI and 49% NTSCI). Conclusions: This study provides the first estimates of the incidence and prevalence of SCI in Canada. More population-based studies are needed, particularly for NTSCI, as an increasing number of Canadians are expected to be affected by SCI.

/pdf/incidence-and-prevalence-of-spinal-cord-injury-in-canada-a-106rrtjpud.pdf

Incidence and Prevalence of Spinal Cord Injury in Canada: A National Perspective

Study design: Literature review.Objectives:To map traumatic spinal cord injury (TSCI) globally and provide a framework for an ongoing repository of data for prevention. Setting: An initiative of the ISCoS Prevention Committee. Methods: The results obtained from the search of Medline/Embase using search phrases: TSCI incidence, aetiology, prevalence and survival were analysed. Stratification of data into green/yellow/red quality 'zones' allowed comparison between data. Results: Reported global prevalence of TSCI is insufficient (236-1009 per million). Incidence data was comparable only for regions in North America (39 per million), Western Europe (15 per million) and Australia (16 per million). The major cause of TSCI in these regions involves four-wheeled motor vehicles, in contrast to South-east Asia where two-wheeled (and non-standard) road transport predominates. Southern Asia and Oceania have falls from rooftops and trees as the primary cause. High-fall rates are also seen in developed regions with aged populations (Japan/Western Europe). Violence/self-harm (mainly firearm-related) was higher in North America (15%) than either Western Europe (6%) or Australia (2%). Sub-Saharan Africa has the highest reported violence-related TSCI in the world (38%). Rates are also high in north Africa/Middle East (24%) and Latin America (22%). Developed countries have significantly improved TSCI survival compared with developing countries, particularly for tetraplegia. Developing countries have the highest 1-year mortality rates and in some countries in sub-Saharan Africa the occurrence of a spinal injury is likely to be a fatal condition within a year. Conclusion: Missing prevalence and insufficient incidence data is a recurrent feature of this review. The piecemeal approach to epidemiological reporting of TSCI, particularly failing to include sound regional denominators has exhausted its utility. Minimum data collection standards are required.Spinal Cord advance online publication, 23 November 2010; doi:10.1038/sc.2010.146. Language: en

/pdf/a-global-map-for-traumatic-spinal-cord-injury-epidemiology-3zdjxpbeke.pdf

A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention

Information on the prevalence of spinal cord injury is becoming more important as the life expectancy of survivors is increasing, but few prevalence studies have been published. This paper summarises the internationally available findings on prevalence, including the methodologies and data sources used. Prevalence rates ranged from 11 to 112 per 100,000 population. Methodological difficulties in comparing findings over time, country, defined population and data source are discussed, and a more standardised methodology is recommended.

Prevalence of Spinal Cord Injury: An International Comparison

/pdf/aversion-to-xenotransplantation-27vgpclw5z.pdf

Aversion to xenotransplantation.

An investigation of an outbreak of Legionnaires' disease in 1992 in Fairfield, a municipality of Sydney, was carried out to determine the source of the outbreak. Cases of Legionnaires' disease with onset of symptoms between 11 and 20 April 1992 were included. Definite cases were individuals with a history consistent with Legionnaires' disease, confirmed by direct fluorescent antibody testing plus serology or culture. There were two control groups: patients admitted to the same hospital as the cases, matched for age and sex, and patients admitted to hospital with a presumptive diagnosis of Legionnaires' disease, in whom the diagnosis was subsequently excluded. There were 26 definite cases with onset of symptoms between 11 and 20 April 1992. Six (23 per cent) died. Twenty-two cases (85 per cent) reported visiting the Fairfield business district during the ten days prior to the onset of symptoms. They were 20 times more likely to have visited Fairfield than were matched controls. Matching of Legionella pneumophila serogroup 1 from environmental and clinical samples was achieved by cytogenetic fingerprinting. Fourteen cases were linked to a single environmental sample. The epidemiological findings were consistent with a point source of Legionella in the Fairfield business district. It is most likely that the exposure occurred on 10 April 1992.

/pdf/legionnaires-disease-outbreak-fairfield-1992-public-health-43s8kh18xn.pdf

Legionnaires' disease outbreak, Fairfield 1992: public health aspects.

Strong concerns about confidentiality of client shaving human immunodeficiency virus tests have made accurate determination of the true number of HIV infected people difficult.

/pdf/hiv-in-nsw-changing-patterns-in-major-risk-factors-549p7fs16i.pdf

HIV in NSW - changing patterns in major risk factors

Educating the public--Norman Swan's Plagued.

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