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. 2023 Jan;46(1):83-90.
doi: 10.1080/10790268.2021.1947680. Epub 2022 Jan 10.

Trends in traumatic spinal cord injuries in Estonia from 1997 to 2018

Affiliations

Trends in traumatic spinal cord injuries in Estonia from 1997 to 2018

Liis Sabre et al. J Spinal Cord Med. 2023 Jan.

Abstract

Objective: To analyze time trends in incidence, causes and risk factors for traumatic spinal cord injuries (TSCI) in Estonia between 1997-2007 and 2008-2018.

Design: Retrospective, population-based cohort study.

Setting: Specialized trauma centres in Estonia.

Participants: Medical records of patients with TSCI from 1997 to 2018.

Intervention: None.

Outcome measures: Demographical data, crude and age- and sex-adjusted incidence rates, causes of TSCI, level and extent of injury, associated injuries.

Results: A total of 940 new patients with TSCI were identified for the period of 1997-2018. The average annual incidence rate (standardized to the Estonian population by age and sex in 2011) decreased significantly from 37.8 (95% confidence interval (CI) 34.6-41.1) in the first period (1997-2008) to 28.2 per million population (95% CI 25.3-31.0) during the second period (2008-2018) (incidence rate ratio 0.74 (95% CI 0.65-0.85), P < 0.0001). The decrease in incidence was most significant among young men. The mean age at injury increased from 38.7 (±16.7) years to 46.6 (±19.9) years, P < 0.0001. Falls were the leading cause of injury during both periods followed by traffic accidents and sports injuries. Still, traffic accidents as a cause of TSCI decreased significantly (from 30.5% to 20.6%, P = 0.001) and falls increased (from 39.9% to 59.5%, P < 0.0001) during the second period. Alcohol consumption prior to injury also decreased significantly from 66.0% to 55.1% (P = 0.006).

Conclusion: Estonia has become closer to other European countries regarding TSCI during the last decade; TSCI incidence has significantly decreased, the mean age at injury and the percentage of falls have increased.

Keywords: Epidemiology; Traumatic spinal cord injury; Trends.

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Figures

Figure 1
Figure 1
Flow diagram of finding patients with traumatic spinal cord injury in Estonia from 1997 to 2018. TSCI, traumatic spinal cord injury.
Figure 2
Figure 2
Age-adjusted incidence rates of male and female, and total age- and sex-adjusted incidence rates of traumatic spinal cord injury per 1 000 000 inhabitants annually with 95% confidence intervals in Estonia from 1997 to 2018. CI, confidence interval.
Figure 3
Figure 3
Incidence of traumatic spinal cord injury in Estonia per 1,000,000 inhabitants by 5-year age-groups and sex.
Figure 4
Figure 4
Causes of traumatic spinal cord injury in Estonia from 1997 to 2018 among men and women by six age-groups.

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