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. 2016 Apr;54(4):270-6.
doi: 10.1038/sc.2015.167. Epub 2015 Oct 13.

Changing demographics of spinal cord injury over a 20-year period: a longitudinal population-based study in Scotland

E J McCaughey  1   2   3   4 , M Purcell  3   4 , A N McLean  3   4 , M H Fraser  3   4 , A Bewick  3 , R J Borotkanics  1   5 , D B Allan  3   4
Affiliations

Changing demographics of spinal cord injury over a 20-year period: a longitudinal population-based study in Scotland

E J McCaughey et al. Spinal Cord. 2016 Apr.

Abstract

Study design: A retrospective cohort study.

Objectives: To review demographic trends in traumatic spinal cord injury (TSCI) and non-traumatic spinal cord injury (NTSCI).

Setting: The Queen Elizabeth National Spinal Injuries Unit (QENSIU), sole provider of treatment for TSCI in Scotland; a devolved region of the UK National Health Service.

Methods: A retrospective review of the QENSIU database was performed between 1994 and 2013. This database includes demographic and clinical data from all new TSCI patients in Scotland, as well as patients with severe NTSCI.

Results: Over this 20-year period there were 1638 new cases of TSCI in Scotland; 75.2% occurring in males. TSCI incidence increased non-significantly (13.3 per million population to 17.0), while there were significant increases in mean age at time of TSCI (44.1-52.6 years), the proportion of TSCIs caused by falls (41-60%), the proportion of TSCIs resulting in an American Spinal Injury Association Impairment Scale score of C and D on admission (19.7-28.6% and 34.5-39.5%, respectively) and the proportion of cervical TSCIs (58.4-66.3%). The increase in cervical TSCI was specifically due to an increase in C1-C4 lesions (21.7-31.2%). NTSCI patients (n=292) were 5 years older at injury, more likely to be female (68.1% male) and had a range of diagnoses.

Conclusion: This study supports the suggestion that demographic profiles in SCI are subject to change. In this population, of particular concern is the increasing number of older patients and those with high level tetraplegia, due to their increased care needs. Prevention programmes, treatment pathways and service provision need to be adjusted for optimum impact, improved outcome and long-term care for their target population.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Incidence rate of traumatic spinal cord injury in Scotland between 1994 and 2013. All patients are shown in black, patients between the ages of 16 and 50 are shown in dark grey and patients between 51 and 85 years of age are shown in light grey. Results are presented as mean annual incidence rate over a 5-year period.
Figure 2
Figure 2
Incidence rate of new traumatic spinal cord injuries in Scotland per 10-year age group. Results are presented as mean annual incidence rate over a 5-year period.
Figure 3
Figure 3
Aetiology of traumatic spinal cord injury in Scotland between 1994 and 2013. Black bar represents patients over the age of 65. Results are presented as mean percentage of new injuries per year over a 5-year period.
Figure 4
Figure 4
Percentage of new traumatic spinal cord injuries resulting in a cervical injury in Scotland between 1994 and 2013. All cervical injuries are shown in black, C1–C4 injuries are shown in dark grey, while C5–C8 injuries are shown in light grey. Results are presented as mean percentage of new injuries per year over a 5-year period.
Figure 5
Figure 5
American Spinal Injury Association Impairment Scale score at admission for patients with new traumatic spinal cord injuries in Scotland between 1999 and 2013. AIS A are shown in black, AIS B are shown in dark grey with a dashed line, AIS C are shown in grey with a solid line and AIS D are shown in light grey with a dashed line. Results are presented as mean percentage of new injuries per year over a 5-year period.
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