Traumatic spinal cord injury mortality from 2006 to 2016 in China

Abstract

Purpose: To report on the national traumatic spinal cord injury (TSCI) mortality of China population, and assess sex-, age-, location-, and cause-specific mortality rates, respectively.Methods: A population-based longitudinal study based on mortality data from the Disease Surveillance Points system of China, 2006-2016. TSCI was defined according to the 10th International Classification of Disease. Negative binomial regression was used to test the significance of the change in overall and subgroup mortality rate.Results: Age-adjusted TSCI mortality rate increased by 64% from 2006 to 2016, ranging from 0.19 to 0.34 per 100,000 population. The crude mortality was 0.31 per 100,000 population in 2016. Males and rural residents had higher TSCI mortality rates than females and urban residents. The age-adjusted TSCI mortality rate increased 53% for males, 107% for females, 75% in an urban area, and 59% in a rural area. In comparison with insignificant change in the age group of 0-44 years, TSCI mortality increased 56% and 147% in age groups of 45-64 years and 65 years. Falls accounted for 45.4% of total mortality.Conclusions: TSCI mortality rates were higher in males and in rural residents than in females and in urban residents during the study time period. TSCI mortality increased quickly as age increased; adults aged 65 years and older had the highest mortality rate. Falls and motor vehicle crashes were the two most common causes of TSCI mortality. More prevention efforts are needed to reduce a number of deaths from TSCI injury considering a substantial increase in TSCI mortality.

Keywords: China; Disease surveillance points (DSP); Mortality; Spinal cord trauma.

Figure 1

Mortality rates from traumatic spinal injury by location (urban/rural), sex, age group, and external cause in China, 2006–2016. (A) Mortality rates from traumatic spinal injury by location (urban/rural), sex and age group (China, 2006–2016). Both the TSCI mortalities of rural and urban residents showed a rising tendency from 2006 to 2016, but the urban residents showed a trough period from 2009 to 2014, compared to a relatively stable trend of the rural residents. TSCI mortality for males showed a completely different pattern of change comparing to females. Males were at least taking two-fold risk of dying of TSCI over time in the study period. Both 0–44 years old subgroup and 45–64 years old subgroup showed nearly unchanged in study period. 75+ years old subgroup showed noticeable increases at 2006–2016. (B) Mortality rates from traumatic spinal injury by location, sex, and external cause (China, 2006–2016). Compared to in urban, the motor vehicle crashes contributed more, though the general trend of TSCI mortality keeps similar. Contrast to females, males with a noticeable higher mortality were suffering higher proportion lethal factor caused by motor vehicle crashes. MVC: Motor vehicle crash. (C) Mortality rates from traumatic spinal injury by age group and external cause (China, 2006–2016). In the three age groups, falls began to contribute more and more to total TSCI mortality as age increased, while motor vehicle crashes contribute less and less. MVC: Motor vehicle crash.