Changing trends in traumatic spinal cord injury in an aging society: Epidemiology of 1152 cases over 15 years from a single center in Japan

PLOS ONE, 2024 · DOI: https://doi.org/10.1371/journal.pone.0298836 · Published: May 16, 2024

Simple Explanation

This study examines the trends in traumatic spinal cord injuries (TSCI) in Japan, focusing on how an aging population affects the types and causes of these injuries. It looks at data from over 1152 patients treated at a major spinal injury center over 15 years. The research reveals that the average age of people experiencing TSCI is increasing, with more elderly individuals sustaining these injuries. The leading causes of injury are also changing, shifting from high-impact incidents like traffic accidents to falls on level surfaces and downstairs, especially among older adults. Understanding these trends is essential for planning healthcare resources and creating prevention strategies tailored to an aging population, both in Japan and worldwide.

Study Duration

15 Years

Participants

1152 patients with traumatic spinal cord injury

Evidence Level

Not specified

Key Findings

1
There was a statistically significant increasing trend in age at injury. Since 2014, the average age of injury has increased to exceed 60 years.
2
Incomplete tetraplegia was the most common cause or etiology category of TSCI, accounting for 48.4% of cases.
3
As the number of injuries among the elderly has increased, the injury mechanisms have shifted from high-fall trauma and traffic accidents to falls on level surfaces and downstairs.

Research Summary

This study analyzed data from 1152 patients with traumatic spinal cord injuries (TSCI) in Japan over a 15-year period (2005-2021). The study found a significant increase in the average age of TSCI patients, with the majority of injuries now occurring in individuals over 60 years old. The primary cause of TSCI has shifted from high-impact trauma, such as traffic accidents and high falls, to falls on level surfaces and downstairs, particularly among the elderly. Incomplete tetraplegia is the most common type of SCI observed. The study also found a correlation between alcohol consumption and increased damage in the upper cervical cord in patients with cervical SCI. These findings highlight the importance of developing targeted prevention and treatment strategies for TSCI in aging populations worldwide.

Practical Implications

Healthcare Resource Allocation

The increasing age of TSCI patients and the shift in injury mechanisms necessitates a reallocation of healthcare resources to address the specific needs of elderly individuals with SCI, including rehabilitation and long-term care.

Prevention Strategies

Targeted prevention strategies should be developed to reduce the risk of falls among the elderly, such as home modifications, balance training programs, and public awareness campaigns.

Public Health Policy

Public health policies should address the issue of alcohol consumption and its association with TSCI, particularly in the elderly, through education, regulation, and treatment programs.

Study Limitations

1
Incomplete data for 2005 and 2011 due to database registration and hospital renovations.
2
AIS grade could change significantly within four weeks of an injury.
3
Exclusion of pediatric trauma cases under 14 years of age may have resulted in an increase in the average age at the time of injury.

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