Changing Demographics and Injury Profile of New Traumatic Spinal, Cord Injuries in the United States, 1972-2014

Objective: To document trends in the demographic and injury profile of new spinal cord injury (SCI) over time. Design: Cross-sectional analysis of longitudinal data by injury years (1972-1979, 1980-1989, 1990-1999, 2000-2009, 2010-2014). Setting: Twenty-eight Spinal Cord Injury Model Systems centers throughout the United States. Participants: Persons with traumatic SCI (N=30,881) enrolled in the National Spinal Cord Injury Database. Interventions: Not applicable. Main Outcome Measures: Age, sex, race, education level, employment, marital status, etiology, and severity of injury. Results: Age at injury has increased from 28.7 years in the 1970s to 42.2 years during 2010 to 2014. This aging phenomenon was noted for both sexes, all races, and all etiologies except acts of violence. The percentage of racial minorities expanded continuously over the last 5 decades. Virtually among all age groups, the average education levels and percentage of single/never married status have increased, which is similar to the trends noted in the general population. Although vehicular crashes continue to be the leading cause of SCI overall, the percentage has declined from 47.0% in the 1970s to 38.1% during 2010 to 2014. Injuries caused by falls have increased over time, particularly among those aged >= 46 years. Progressive increases in the percentages of high cervical and motor incomplete injuries were noted for various age, sex, race, and etiology groups. Conclusions: Study findings call for geriatrics expertise and intercultural competency of the clinical team in the acute and rehabilitation care for SCI. This study also highlights the need for a multidimensional risk assessment and multifactorial intervention, especially to reduce falls and SCI in older adults. (C) 2016 by the American Congress of Rehabilitation Medicine