National Rehabilitation Hospital, Dublin, Ireland.
Mater Misericordiae University Hospital, Dublin, Ireland.
Neuroepidemiology. 2018;51(1-2):19-24. doi: 10.1159/000488146. Epub 2018 May 15.
The International Spinal Cord Society and World Health Organisation recommend the collection of epidemiological data on traumatic spinal cord injury (TSCI). A 1-year prospective study is ongoing in Ireland. While the results of this study are awaited, it was concluded from a feasibility exercise that a complete retrospective dataset, 2010-2015, could be obtained and would be useful for service planning.
All patients with TSCI discharged from the national SCI acute and rehabilitation centres were included. Data was collected on gender, age, aetiology, level of injury, American Spinal Injuries Association impairment scale, length of rehabilitation admission and discharge destination. Population denominators were national census figures 2006 and 2011, rolled forward.
The incidence of TSCI remained constant throughout the study period, 11.5-13.3 per million per year. The mean age of injury onset was 48.9 (SD 19.8) years. Males accounted for 71.5%. The most common injury level/AIS was incomplete tetraplegia, accounting for 43.2% of all TSCI. Leading aetiology was falls, accounting for 53.3% of injuries. Patients with incomplete tetraplegia were older than those with all other injuries (p < 0.001).
The epidemiological trends identified are similar to those prevalent elsewhere in the developed world. More incomplete tetraplegia among an older patient population necessitates a review of how acute care and rehabilitation services are delivered.
国际脊髓学会和世界卫生组织建议收集外伤性脊髓损伤(TSCI)的流行病学数据。爱尔兰正在进行一项为期 1 年的前瞻性研究。在等待这项研究的结果的同时,从一项可行性研究中得出结论,即可以获得一个完整的回顾性数据集(2010-2015 年),这对于服务规划将是有用的。
所有从国家脊髓损伤急性和康复中心出院的 TSCI 患者均被纳入研究。收集的数据包括性别、年龄、病因、损伤程度、美国脊髓损伤协会损伤量表、康复住院时间和出院去向。人口基数是 2006 年和 2011 年的全国人口普查数字,向前滚动。
在整个研究期间,TSCI 的发病率保持不变,每年为每百万人口 11.5-13.3 人。损伤起始时的平均年龄为 48.9(标准差 19.8)岁。男性占 71.5%。最常见的损伤程度/损伤分级是不完全性四肢瘫痪,占所有 TSCI 的 43.2%。主要病因是跌倒,占损伤的 53.3%。不完全性四肢瘫痪患者比其他所有损伤患者年龄更大(p<0.001)。
确定的流行病学趋势与发达世界其他地方普遍存在的趋势相似。更年长的患者人群中出现更多的不完全性四肢瘫痪,需要重新审视急性护理和康复服务的提供方式。