Golestani Ali, Shobeiri Parnian, Sadeghi-Naini Mohsen, Jazayeri Seyed Behnam, Maroufi Seyed Farzad, Ghodsi Zahra, Dabbagh Ohadi Mohammad Amin, Mohammadi Esmaeil, Rahimi-Movaghar Vafa, Ghodsi Seyed Mohammad
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Department of Neurosurgery, Lorestan University of Medical Sciences, Khoram-abad, Iran.
Neuroepidemiology. 2022;56(4):219-239. doi: 10.1159/000524867. Epub 2022 May 5.
Traumatic spinal cord injury (TSCI) is a catastrophic event with a considerable health and economic burden on individuals and countries. This study was performed to update an earlier systematic review and meta-analysis of epidemiological properties of TSCI in developing countries published in 2013.
Various search methods including online searching in database of EMBASE and PubMed, and hand searching were performed (2012 to May 2020). The keywords "Spinal cord injury," "epidemiology," "incidence," and "prevalence" were used. Based on the definition of developing countries by the International Monetary Fund, studies related to developing countries were included. Data selection was according to PRISMA guidelines. The quality of included studies was evaluated by Joanna Briggs Institute Critical Appraisal Tools. Results of meta-analysis were presented as pooled frequency, and forest, funnel, and drapery plots.
We identified 47 studies from 23 developing countries. The pooled incidence of TSCI in developing countries was 22.55/million/year (95% CI: 13.52; 37.62/million/year). Males comprised 80.09% (95% CI: 78.29%; 81.83%) of TSCIs, and under 30 years patients were the most affected age group. Two leading etiologies of TSCIs were motor vehicle crashes (43.18% [95% CI: 37.80%; 48.63%]) and falls (34.24% [95% CI: 29.08%; 39.59%], respectively). The difference among the frequency of complete injury (49.47% [95% CI: 43.11%; 55.84%]) and incomplete injury (50.53% [95% CI: 44.16%; 56.89%]) was insignificant. The difference among frequency of tetraplegia (46.25% [95% CI: 37.78%; 54.83%]) and paraplegia (53.75% [95% CI: 45.17%; 62.22%]) was not statistically significant. The most prevalent level of TSCI was cervical injury (43.42% [95% CI: 37.38%; 49.55%]).
In developing countries, TSCIs are more common in young adults and males. Motor vehicle crashes and falls are the main etiologies. Understanding epidemiological characteristics of TSCIs could lead to implant-appropriate cost-effective preventive strategies to decrease TSCI incidence and burden.
创伤性脊髓损伤（TSCI）是一种灾难性事件，给个人和国家带来了相当大的健康和经济负担。本研究旨在更新2013年发表的关于发展中国家TSCI流行病学特征的早期系统评价和荟萃分析。
采用多种检索方法，包括在EMBASE和PubMed数据库中进行在线检索以及手工检索（2012年至2020年5月）。使用了关键词“脊髓损伤”“流行病学”“发病率”和“患病率”。根据国际货币基金组织对发展中国家的定义，纳入了与发展中国家相关的研究。数据选择遵循PRISMA指南。采用乔安娜·布里格斯研究所的批判性评价工具评估纳入研究的质量。荟萃分析的结果以合并频率以及森林图、漏斗图和垂帘图呈现。
我们从23个发展中国家鉴定出47项研究。发展中国家TSCI的合并发病率为22.55/百万/年（95%置信区间：13.52；37.62/百万/年）。男性占TSCI患者的80.09%（95%置信区间：78.29%；81.83%），30岁以下患者是受影响最严重的年龄组。TSCI的两个主要病因是机动车碰撞（43.18% [95%置信区间：37.80%；48.63%]）和跌倒（34.24% [95%置信区间：29.08%；39.59%]）。完全性损伤频率（49.47% [95%置信区间：43.11%；55.84%]）和不完全性损伤频率（50.53% [95%置信区间：44.16%；56.89%]）之间的差异不显著。四肢瘫频率（46.25% [95%置信区间：37.78%；54.83%]）和截瘫频率（53.75% [95%置信区间：45.17%；62.22%]）之间的差异无统计学意义。TSCI最常见的损伤水平是颈椎损伤（43.42% [95%置信区间：37.38%；49.55%]）。
在发展中国家，TSCI在年轻成年人和男性中更为常见。机动车碰撞和跌倒是主要病因。了解TSCI的流行病学特征有助于制定合适的、具有成本效益的预防策略，以降低TSCI的发病率和负担。
