Incidence and mortality of spinal cord injury from 2008 to 2020: a retrospective population-based cohort study in the Piedmont Region, Italy

Spinal Cord, 2023 · DOI: https://doi.org/10.1038/s41393-022-00842-6 · Published: August 6, 2022

Simple Explanation

This study examined the occurrence and death rates of spinal cord injuries (SCI) in the Piedmont region of Italy from 2008 to 2020. Researchers used administrative databases to identify individuals admitted to SCI rehabilitation centers and analyzed the data based on age and cause of injury (traumatic or non-traumatic). The study found a decreasing trend in both the occurrence and death rates of SCI, but an increase in the proportion of cases that resulted in death, especially in non-traumatic SCI.

Study Duration

2008 to 2020

Participants

892 cases identified (56.4% TSCI)

Evidence Level

Retrospective population-based cohort study

Key Findings

1
The average annual crude incidence rate was 17.9 per million population, decreasing from 26.0 in 2008 to 10.8 in 2020.
2
The mortality rate per 1000 person-years decreased from 16.3 in 2009 to 8.5 in 2020.
3
Case lethality more than tripled (from 17.2 in 2009 to 57.1 in 2020).

Research Summary

This retrospective cohort study aimed to determine the incidence and mortality of SCI over an extended time period. A ﬂuctuating, decreasing trend in SCI incidence rates was shown over the study period, with a further decrease in 2020, which deserves speciﬁc attention due to the impact of the COVID-19 pandemic. Given the observed changes in the epidemiology of SCI, community services offered after acute rehabilitation should be strengthened to enhance their effectiveness.

Practical Implications

Strengthen Community Services

Enhance community services after rehabilitation to improve the effectiveness of chronic condition management and reduce secondary conditions.

Implement Early Detection Systems

Develop early detection systems to identify vulnerable individuals and improve long-term care.

Establish National SCI Registry

Create a national SCI registry to estimate the true prevalence of SCI and facilitate more comprehensive follow-up.

Study Limitations

1
Use of administrative databases may have missed cases admitted to facilities other than the three SCI rehabilitation centres.
2
Data are only available starting from 2008, precluding a reliable estimate of SCI prevalence to date.
3
The absence of retrospective information collected using the International Spinal Cord Injury Core Data Set made it impossible to determine the causes of SCI.

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