Spinal Cord Injury Incidence Stable Over Past Two Decades

The incidence rate of acute traumatic spinal cord injury remained stable in the United States between 1993 and 2012, suggested findings published in the Journal of the American Medical Association.

Researchers from Vanderbilt University School of Medicine analyzed survey data from the US Nationwide Inpatient Sample databases between 1993 and 2012 in order to assess trends in spinal cord injury incidence, etiology, mortality, and associated surgical procedures during the time period. A total of 63,109 eligible patients with acute spinal cord injury were identified.

There was a slight increase in actual number of acute traumatic spinal cord injuries during the observation period. In 1993, 2,659 cases were identified, while there were 3,393 in 2012. However, the researchers concluded the incidence rate was relatively stable, finding that the estimated rate for acute traumatic spinal cord injury was 53 cases per 1 million persons in 1993 and 54 cases per 1 million persons in 2012.

Specifically for younger males, incidence rates declined — males aged 16 to 24 years saw 144 cases per 1 million in 1993 (for a total of 2,405 cases) to 87 cases per 1 million in 2012 (a total of 1,770 cases); males aged 25 to 44 years, there were 96 cases per 1 million (3,959 cases) in 1993 and 71 cases per 1 million (2,930 cases) in 2012.

For males aged 65 to 74 years, acute traumatic spinal cord injury rates increased: in 1993, there were 84 cases per 1 million (695 cases) and in 2012, there were 131 cases per 1 million (1,465 cases). The researchers continued, though, that elderly female populations additionally saw an increase in incidence of spinal cord injury.

“We don’t really know the exact reasons for why there is an increased incidence of falls that cause spinal cord injury,” explained lead author Nitin B. Jain, MD, MSPH in a press release, and continued by adding that “older adults are likely much more active now, putting them at a higher risk. We also find that the portion of patients who have surgical procedures is also increasing over time.”

Additionally, the researchers noted that the percentage of spinal cord injury associated with falls increased significantly for patients aged 65 years or older. Between 1997 and 2000, 28% of spinal cord injuries were related to falls, while that number increased to 66% between 2010 and 2012.

“This is a major public health issue and it likely represents a more active 65 to 84 year old US population currently compared with the 1990s, which increases the risk of falls in this age group,” the authors concluded. “This issue may be further compounded in the future because of the aging population in the United States.”

Lastly, the researchers determined that overall in hospital mortality increased from 6.6% between the years 1993 and 1996 to 20% in the 2010 to 2012 period among patients aged 85 years or older. Overall mortality decreased significantly, the investigators said, between the 1993 and 1996 period (24.4%) and the 2010 to 2012 period (20.1%) for persons aged 85 years or older.