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Traumatic spinal cord injury in Victoria, 2007–2016
Author(s) -
Beck Ben,
Cameron Peter A,
Braaf Sandra,
Nunn Andrew,
Fitzgerald Mark C,
Judson Rodney T,
Teague Warwick J,
Lennox Alyse,
Middleton James W,
Harrison James E,
Gabbe Belinda J
Publication year - 2019
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja2.50143
Subject(s) - medicine , incidence (geometry) , population , demography , poison control , retrospective cohort study , cohort , injury prevention , cohort study , tetraplegia , spinal cord injury , pediatrics , emergency medicine , surgery , spinal cord , psychiatry , environmental health , physics , sociology , optics
Objective To investigate trends in the incidence and causes of traumatic spinal cord injury ( TSCI ) in Victoria over a 10‐year period. Design, setting, participants Retrospective cohort study: analysis of Victorian State Trauma Registry ( VSTR ) data for people who sustained TSCI s during 2007–2016. Main outcomes and measures Temporal trends in population‐based incidence rates of TSCI (injury to the spinal cord with an Abbreviated Injury Scale [ AIS ] score of 4 or more). Results There were 706 cases of TSCI , most the result of transport events (269 cases, 38%) or low falls (197 cases, 28%). The overall crude incidence of TSCI was 1.26 cases per 100 000 population (95% CI , 1.17–1.36 per 100 000 population), and did not change over the study period (incidence rate ratio [ IRR ], 1.01; 95% CI , 0.99–1.04). However, the incidence of TSCI resulting from low falls increased by 9% per year (95% CI , 4–15%). The proportion of TSCI cases classified as incomplete tetraplegia increased from 41% in 2007 to 55% in 2016 ( P < 0.001). Overall in‐hospital mortality was 15% (104 deaths), and was highest among people aged 65 years or more (31%, 70 deaths). Conclusions Given the devastating consequences of TSCI , improved primary prevention strategies are needed, particularly as the incidence of TSCI did not decline over the study period. The epidemiologic profile of TSCI has shifted, with an increasing number of TSCI events in older adults. This change has implications for prevention, acute and post‐discharge care, and support.