1] Epworth-Monash Rehabilitation Medicine Unit, Southern Medical School, Monash University, Melbourne, Victoria, Australia [2] Spinal Rehabilitation Unit, Rehabilitation Services, Caulfield Hospital, Alfred Health, Caulfield, Victoria, Australia.
School of Medicine (Prevention, Promotion and Primary Health Care Cluster), Flinders University, Adelaide, South Australia.
Spinal Cord. 2014 Feb;52(2):97-109. doi: 10.1038/sc.2012.165. Epub 2013 Jan 15.
Literature review.
Globally map non-traumatic spinal cord injury (NTSCI) incidence, prevalence, survival, level of injury and aetiology. Propose a research framework for NTSCI prevention and launch a repository of NTSCI data.
Initiative of the International Spinal Cord Society Prevention Committee.
Literature search of Medline and Embase (1959-June 2011). Relevant articles in any language regarding adults with NTSCI were included. Stratification of information about incidence and prevalence into green/yellow/orange/red data quality 'zones' and comparisons between World Health Organisation (WHO) regions and countries.
Three hundred and seventy-seven abstracts reviewed--45 of these from 24 countries in 12 of the 21 WHO global regions had relevant information. Only one publication had survival data. Prevalence data for NTSCI existed for only two countries, India (prevalence of 2,310/million population, Kashmir region) and Canada (prevalence of 1,120/million population). The incidence rates for WHO regions were: Asia Pacific, high income 20/million population/year; Australasia (26/million population/year); Western Europe median of 6/million population/year; North America, high income median 76/million population/year (based on poor-quality studies); and Oceania 9/million population/year. Developed countries tended to have a higher proportion of cases with degenerative conditions and tumours. Developing countries, in comparison, tended to have a higher proportion of infections, particularly tuberculosis and HIV, although a number also reported tumours as a major cause.
Insufficient survival, prevalence and incidence data are a predominant finding of this review. The piecemeal approach to epidemiological reporting of NTSCI, particularly failing to include sound regional population denominators, has exhausted its utility. Minimum data collection standards are required.
文献回顾。
绘制全球非外伤性脊髓损伤（NTSCI）发病率、患病率、生存率、损伤水平和病因。为 NTSCI 预防提出研究框架，并建立 NTSCI 数据存储库。
国际脊髓学会预防委员会倡议。
对 Medline 和 Embase（1959 年至 2011 年 6 月）进行文献检索。纳入所有关于成人 NTSCI 的相关文献，无论语言如何。将发病率和患病率信息分为绿色/黄色/橙色/红色数据质量“区域”，并对世界卫生组织（WHO）区域和国家进行比较。
共审查了 377 篇摘要，其中 45 篇来自 24 个国家的 12 个 WHO 全球区域，这些国家有相关信息。仅有一篇文献有生存率数据。仅两个国家有 NTSCI 患病率数据，印度（每百万人口 2310 人，克什米尔地区）和加拿大（每百万人口 1120 人）。WHO 区域的发病率如下：亚太地区，高收入国家 20/百万人口/年；澳大拉西亚（26/百万人口/年）；西欧中位数为 6/百万人口/年；北美，高收入国家中位数为 76/百万人口/年（基于低质量研究）；大洋洲为 9/百万人口/年。发达国家的退行性疾病和肿瘤病例比例较高。相比之下，发展中国家的感染，尤其是结核病和艾滋病毒感染，比例较高，尽管一些国家也报告肿瘤是一个主要原因。
本综述的主要发现是缺乏生存、患病率和发病率数据。NTSCI 流行病学报告的零碎方法，特别是未能包括合理的区域人口分母，已经失去了其效用。需要制定最低数据收集标准。
