Measures needed to combat growing incidence and burden of spinal cord injury

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The incidence and burden of spinal cord injury (SCI) has increased during the past 30 years and effective measures are needed to face the challenges brought about by a growing and aging population. This is the key takeaway from a recent study, the findings of which were published by Feng Li (Tongji Hospital, Wuhan, China) et al in the journal Spine.

The retrospective cohort study aimed to estimate the incidence, prevalence and years lived with disability (YLD) of SCI by location, sex, age, injury site and socio-demographic index (SDI) based on the data of the Global Burden of Disease Study (GBD) 2019. GBD 2019 estimates the burden of 369 diseases and injuries worldwide in 2019 and the temporal trends in the past 30 years.

A Bayesian meta-regression tool, DisMod-MR2.1, was used to produce the estimates. Estimated annual percentage change (EAPC) was calculated based on a linear regression mode of the age standardised rates (ASR) and the calendar year to represent the temporal trends of the ASRs. Spearman’s rank order correlation (rho) was used to determine the correlation between SDI and the incidence and burden of SCI.

The study found that, globally, there were 0.9 (95% uncertainty interval [UI], 0.7 to 1.2) million incident cases, 20.6 (95% UI, 18.9 to 23.6) million prevalent cases and 6.2 (95% UI, 4.5 to 8.2) million YLDs of total SCI in 2019.

The age-standardised prevalence rate (ASPR) increased (EAPC, 0.1; 95% CI, −0.01 to 0.2), while the age-standardised incidence rate (ASIR) (EAPC, −0.08; 95% UI, −0.24 to 0.09) and age-standardised year of life lost rate (ASYR) (EAPC, −0.08; 95% CI, −0.24 to 0.09) decreased.

In addition, males had higher ASIR and ASYR, and the rate of incidence, prevalence and YLD increased with age. Spinal injuries at neck level caused higher ASYR than injuries below neck level. The study also found that a positive correlation existed between SDI and ASIR (rho=0.1626, p<0.05), while a negative correlation was observed between SDI and EAPC of ASYR (rho=−0.2421, p<0.01).


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