A demographic profile of new traumatic spinal cord injuries: Change and stability over 30 years

Objective: To evaluate epidemiologic trends in new spinal cord injuries (SCIs) in the United States over 3 decades. Design: Consecutive case series. Setting: Model Spinal Cord Injury Systems (MSCIS) facilities. Participants: Persons (N=30,532) admitted to MSCIS facilities within 365 days of injury between 1973 and 2003, and enrolled in the National Spinal Cord Injury Database. Interventions: Not applicable. Main Outcome Measures: Data were collected at MSCIS admission and rehabilitation discharge. Variables included age, gender, race and ethnic group, year of injury, and level and extent of injury. Specific etiologies were grouped as motor vehicle collisions (MVCs), violence, falls, sports, and other. Demographic and injury severity trends were analyzed by year of injury groupings according to decades (1973-1979, 1980-1989, 1990-1999, 2000-2003.) Chi-square tests assessed statistical significance. One-way analysis of variance compared mean ages. Results: The male/female ratio remained fairly stable at 4: 1, but the percentage of women increased slightly over time, especially from MVC etiologies (P<.001). Over time, the mean age at injury increased significantly (P<.001); it was 37.7 +/- 17.5 years in 2000-2003. The majority of cases were white (66.1%). Tetraplegia (54.1%) and complete injuries (55.6%) occurred more than paraplegia and incomplete injuries, respectively. MVCs (45.6%) remained the most common etiology; falls (19.6%) held the second position over violence (17.8%), except for the 1990-1999 period when the positions were reversed. Significantly increasing percentages of new injuries were seen for SCI due to automobile, motorcycle, bicycle, and all-terrain vehicle crashes, blunt object attacks, snow skiing, and medical and surgical mishaps. Conclusions: Many previously seen SCI demographic trends continued into the 2000 decade.