Epidemiology of traumatic spinal cord injury in Catalonia, Spain: a 50 years' experience of a referral center

Abstract

Study design: Hospital-based retrospective epidemiological research.

Objectives: To describe the epidemiological and demographic characteristics of patients with traumatic spinal cord injury (TSCI) in Catalonia from 1972-2022.

Setting: Neurological university hospital in Catalonia.

Methods: All patients diagnosed with TSCI admitted to the hospital from 1972-2022 were retrospectively reviewed. Etiology categories, neurological level of injury, American Spinal Injury Association Impairment Scale (AIS), Functional Independence Measure (FIM), and crude incidence rates were analyzed.

Results: A total of 3092 individuals with TSCI met the criteria. The crude annual incidence rate was 0.94/100,000 inhabitants. Mean age rose significantly over the years, from 27.7 (SD = 10.9) during 1972-1981 to 41.8 (SD = 17.1) during 2012-2022. The proportion of females constantly increased during 1982-2022 (18.4-23.1%). Etiologies were traffic accidents (51.8%), falls (22.0%), sports (9.8%), work-related (9.1%), suicide attempts (4.6%) and violence (2.7%). The proportion of traffic accidents dropped from 62.4% during 1982-1991 to 37.5% during 2012-2022, whereas falls increased from 14.5% during 1982-1991 to 26.0% during 2012-2022. Suicide attempts was the only etiology constantly increasing during 1972-2022 from 1-8% and with highest proportion of females (55.9%). Thoracic injuries dropped from 57.9% (1972-1981) to 38.3% (2012-2022), while cervical injuries constantly increased up to 48.8% in 2012-2022 with AIS A cases dropping and AIS D increasing. During 2002-2022, the etiologies with highest proportion of poor motor FIM at admission were sports (68.9%) and falls (63.1%).

Conclusions: Our results suggest the need on prevention strategies specially addressing falls and female suicide attempts.