Medical College of Wisconsin
CTSICores SearchResearch InformaticsREDCap

Spinal cord injury etiology, severity, and care in East Asia: a cross-sectional analysis of the International Spinal Cord Society Database Project. Spinal Cord 2024 Jul;62(7):421-427

Date

06/25/2024

Pubmed ID

38914754

DOI

10.1038/s41393-024-01003-7

Scopus ID

2-s2.0-85196750085 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

STUDY DESIGN: Cross-sectional study.

OBJECTIVES: To evaluate etiologic factors associated with spinal cord injury (SCI) severity and to identify predictive factors of reduction in SCI severity in six countries.

SETTING: SCI centers in Bangladesh, India, Malaysia, Nepal, Sri Lanka, and Thailand.

METHODS: Data from centers collected between October 2015 and February 2021 were analyzed using descriptive statistics and logistic regression.

RESULTS: Among 2634 individuals, the leading cause of SCIs was falls (n = 1410, 54%); most occurred from ≥1 meter (n = 1078). Most single-level neurological injuries occurred in the thoracic region (n = 977, 39%). Greater than half of SCIs (n = 1423, 54%) were graded American Spinal Injury Association Impairment Scale (AIS) A. Thoracic SCIs accounted for 53% (n = 757) of all one-level AIS A SCIs. The percentage of thoracic SCIs graded AIS A (78%) was significantly higher than high cervical (52%), low cervical (48%), lumbar (24%), and sacral (31%) SCIs (p < 0.001). Regression analyses isolated predictive factors both of SCI severity and inpatient improvement. Four factors predicted severity: age, neurological level, etiology, and country of residence. Four factors predicted improvement: age, neurological level, AIS grade on intake, and country of residence.

CONCLUSIONS: Findings can be used by healthcare providers and public health agencies in these countries to inform the public of the risk of SCI due to falls. Future studies should examine the social and occupational milieux of falls. Country-to-country comparisons of prehospital and inpatient care are also justified. Fall prevention policies can encourage the use of safety equipment when performing tasks at heights ≥1 meter.

Author List

Holmes BD, Brazauskas R, Chhabra HS

Author

Ruta Brazauskas PhD Associate Professor in the Data Science Institute department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Accidental Falls
Adolescent
Adult
Aged
Bangladesh
Cross-Sectional Studies
Databases, Factual
Female
Humans
India
Malaysia
Male
Middle Aged
Nepal
Severity of Illness Index
Spinal Cord Injuries
Sri Lanka
Thailand
Young Adult