Epidemiology of traumatic spinal cord injuries in Iceland from 1975 to 2009

Abstract

Study design: Retrospective population-based epidemiological study. Objectives: To assess the nationwide, population-based incidence, causes, age, gender, extent and prevalence of spinal cord injuries (SCIs) in Iceland from 1975 to 2009. Setting: Landspitali University Hospital in Iceland, the single referral center for SCIs in Iceland. Methods: A retrospective review of hospital records on all admissions due to SCIs. Analysis of incidence, causes, age, gender, extent of injury and prevalence. Results: A total of 207 patients with traumatic spinal cord injury (TSCI) were admitted: males 72%, females 28%. The percentage of females with TSCI increased to 37% in 2000–2004. Mean age at injury was 38 years. Average incidence per million population per year was 30 in 1975–1979, 12.5 in 1995–1999 and 33.5 in 2005–2009. Thirty-day mortality was 6.3%. Causes of injury were road traffic accidents (RTA) in 42.5% of the cases; the majority did not use seatbelts. Falls amounted to 30.9%, with an increase of low falls among the elderly causing incomplete cervical lesions. Sport/leisure activities were the cause in 18.8%, of which 54% occurred after 2000. The main single cause of TSCI in sport/leisure were horse-riding accidents, followed by winter sport accidents, especially among women. Other causes constituted 7.7%. The injury was complete in 39%; cervical lesions were 57% and thoracic/lumbar lesions were 43%. In December 2009, the crude prevalence rate was 526 per million population. Conclusions: The findings showed a significant increase of TSCI in 2005–2009, especially in sport/leisure accidents and incomplete cervical lesions due to falls among elderly. Prevention strategies need to focus on these risk groups and on seatbelt use.