Epidemiology and contemporary risk profile of traumatic spinal cord injury in Switzerland

Injury Epidemiology, 2015 · DOI: 10.1186/s40621-015-0061-4 · Published: October 22, 2015

Simple Explanation

Traumatic spinal cord injuries (TSCIs) are a rare condition with long-term physical, psychological, social and financial implications. They can result in lasting neurologic impairments of all organ systems and body functions below the neurologic lesion level, thereby causing the loss of function, decreased mobility, increased morbidity and reduced life expectancy and quality-of-life. This study aims to establish prevention priorities in Switzerland by estimating reliable, contemporary incidence rates of TSCI according to key demographic characteristics. The Swiss Spinal Cord Injury (SwiSCI) Cohort Study is used to estimate the burden of TSCI and identify areas for prevention purposes. Data was gathered from medical files from all four specialized rehabilitation centers for SCI in Switzerland from 2005 to 2012. The study reports on all diagnoses of acquired traumatic SCI that were recorded among persons aged 16 years and older, who started first rehabilitation.

Study Duration

2005 to 2012

Participants

932 cases of traumatic SCI, of which 239 were female, and 693 were male

Evidence Level

Not specified

Key Findings

1
The crude annual incidence rate estimate of TSCI for the study period was 18.0 per one million population; standardized to the WHO world population IR was 21.7 population.
2
Males exhibited consistently higher IRs than females, with a highest IR ratio in young adults (aged 16 to 30).
3
Sports and leisure and transport-related injuries were the predominant causes of TSCI in the youngest age group (aged 16 to 30); falls were the predominant cause among the oldest age group (76 years or over).

Research Summary

This study found that injury rates for Switzerland varied according to both age and sex with the highest annual IRs observed among men, and the greatest proportion of TSCIs occurring in individuals between 16 and 30 years. The most common cause of TSCI was falls, for which incidence steadily increased with increasing age. In comparison with other European countries, the overall annual IR of TSCI in Switzerland is intermediate. The injury rates reported within this study are the first nationwide estimates for Switzerland that utilize rehabilitation-based data and provide detailed information for prevention and comparison purposes.

Practical Implications

Targeted Prevention Policies

Evidence suggests sports/leisure- and transport-related injuries in young men and falls among the elderly as prime targets for prevention policies and programs.

Haddon Matrix Application

The Haddon Matrix can be used to conceptualize strategies for prevention and response at both the individual- and population-level, focusing on causal factors and phases of the injury event.

Fall Prevention Strategies

Prevention efforts could focus on strength, balance, and resistance training for the host/person, the addition of handrails or level seats could modify the vehicle, and home hazard assessment and modification could address the physical environment.

Study Limitations

1
The study included only those cases admitted to a specialized rehabilitation center, potentially missing those who died onsite or received rehabilitation elsewhere.
2
There is a large amount of missing information for work-related injuries and intent of injury, so these statistics should be interpreted with caution.
3
Socioeconomic status or other factors that might impact risk and could impact intervention programs could not be evaluated.

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