Centralized spinal cord injury care in Finland: unveiling the hidden incidence of traumatic injuries

Study design: Population-based prospective study. Objectives: To determine the incidence and evaluate the characteristics of newly injured patients with traumatic spinal cord injury (TSCI) admitted to two of the three national spinal cord injury (SCI) centers during the first year after the centralization of SCI care in Finland. Setting: Oulu and Tampere University Hospital SCI centers, Finland. Methods: The designated rehabilitation teams evaluated all of the patients with a new SCI and persisting neurological symptoms. The data were recorded according to the International Spinal Cord Injury Core Data Set. Results In a 1-year period, 77 new patients with TSCI were admitted to the study centers serving a population of 3 065 946. In the whole catchment area, the mean annual incidence of TSCI was 25.1 per million, and in the hospital districts of the SCI centers, the incidence was even higher, at 38.1 per million. The mean age of the patients was 58.7 years. Falls were the leading cause of injury (64.9%), and the injury resulted in tetraplegia in 70.1% of the cases. Alcohol use was a contributing factor in 39% of the cases in the entire sample and in 58.6% of cases among patients aged younger than 60 years. Conclusion The incidence rates of TSCI were markedly higher than expected, demonstrating the previously hidden morbidity. The epidemiological features of TSCI appeared to follow the trends in developed countries, highlighting the increasing incidence of cervical lesions due to falling among the elderly. The results need to be confirmed in an extended follow-up.