The changing demographics of traumatic spinal cord injury in Beijing, China: a single-centre report of 2448 cases over 7 years

Abstract

Study design

Retrospective study.

Objectives

To investigate the epidemiological changes in persons with traumatic spinal cord injury (TSCI) over the past 7 years in Beijing Bo’ai Hospital, China Rehabilitation Research Center, China.

Setting

Beijing Bo’ai Hospital, China Rehabilitation Research Center (CRRC).

Methods

A database containing the records of all persons treated with SCI from 1 January 2013 to 31 December 2019 was reviewed. Variables including demographic and clinical data were analysed. Comparisons were made with data previously published in 2002.

Results

During the study period, 2448 persons with recent TSCI were included in the analysis. The mean age at the time of injury increased from 38.1 years to 40.2 years (P = 0.025). The percentage of elderly persons increased (8.8–14.6%, P = 0.036) and was higher than that in 2002. The percentage of retirees increased. Transport related injuries were the leading cause of injury and the percentage of TSCI due to low falls increased 6%. Low falls were the most common cause for elderly persons (y ≥ 60) and were even higher for elderly women. Persons with cervical injuries increased compared to the 2002-data (44.1% vs 4.9%). The percentage of persons with incomplete SCI increased significantly over the study duration.

Conclusions

Persons with TSCI are becoming older, and the percentage of elderly persons is increasing year by year. These changes are likely due to a combination of population ageing in the region and changes in aetiology, with corresponding changes including an increase in persons with cervical TSCI and persons with incomplete injury.

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Fig. 1: Selection of persons with TSCI for the study cohort.
Fig. 2: Proportion of women and changes in sex among persons with TSCI relative to age.
Fig. 3: Distribution line chart for aetiology according to age.

References

  1. 1.

    Chen Y, He Y, DeVivo MJ. Changing demographics and injury profile of new traumatic spinal cord injuries in the United States, 1972–2014. Arch Phys Med Rehabil. 2016;97:1610–9.

    Article  Google Scholar 

  2. 2.

    Thompson C, Mutch J, Parent S, Mac-Thiong JM. The changing demographics of traumatic spinal cord injury: an 11-year study of 831 patients. J Spinal Cord Med. 2015;38:214–23.

    Article  Google Scholar 

  3. 3.

    Barbara-Bataller E, Mendez-Suarez JL, Aleman-Sanchez C, Sanchez-Enriquez J, Sosa-Henriquez M. Change in the profile of traumatic spinal cord injury over 15 years in Spain. Scand J Trauma Resusc Emerg Med. 2018;26:27.

    Article  Google Scholar 

  4. 4.

    Halvorsen A, Pettersen AL, Nilsen SM, Halle KK, Schaanning EE, Rekand T. Epidemiology of traumatic spinal cord injury in Norway in 2012–2016: a registry-based cross-sectional study. Spinal Cord. 2019;57:331–8.

    Article  CAS  Google Scholar 

  5. 5.

    Rahimi-Movaghar V, Sayyah MK, Akbari H, Khorramirouz R, Rasouli MR, Moradi-Lakeh M, et al. Epidemiology of traumatic spinal cord injury in developing countries: a systematic review. Neuroepidemiology 2013;41:65–85.

    Article  Google Scholar 

  6. 6.

    Ahn H, Bailey CS, Rivers CS, Noonan VK, Tsai EC, Fourney DR, et al. Effect of older age on treatment decisions and outcomes among patients with traumatic spinal cord injury. CMAJ. 2015;187:873–80.

    Article  Google Scholar 

  7. 7.

    Kudo D, Miyakoshi N, Hongo M, Kasukawa Y, Ishikawa Y, Ishikawa N, et al. An epidemiological study of traumatic spinal cord injuries in the fastest aging area in Japan. Spinal Cord. 2019;57:509–15.

    Article  Google Scholar 

  8. 8.

    Yin XF, Wang TB, Zhang PX, Kou YH, Zhang DY, Yu K, et al. Evaluation of the effects of standard rescue procedure on severe trauma treatment in china. Chin Med J. 2015;128:1301–5.

    Article  Google Scholar 

  9. 9.

    China-WHO. Country cooperation strategy 2016–2020. https://iris.wpro.who.int/handle/10665.1/13088, Accessed 14 April 2020.

  10. 10.

    Yuan S, Shi Z, Cao F, Li J, Feng S. Epidemiological features of spinal cord injury in China: a systematic review. Front Neurol. 2018;9:683.

    Article  Google Scholar 

  11. 11.

    http://www.phic.org.cn/tjsj/, Accessed 14 April 2020.

  12. 12.

    Li J, Liu G, Zheng Y, Hao C, Zhang Y, Wei B, et al. The epidemiological survey of acute traumatic spinal cord injury (ATSCI) of 2002 in Beijing municipality. Spinal Cord. 2011;49:777–82.

    Article  CAS  Google Scholar 

  13. 13.

    Biering-Sorensen F, DeVivo MJ, Charlifue S, Chen Y, New PW, Noonan V, et al. International Spinal Cord Injury Core Data Set (version 2.0)-including standardization of reporting. Spinal Cord. 2017;55:759–64.

    Article  CAS  Google Scholar 

  14. 14.

    Waring WP III, Biering-Sorensen F, Burns S, Donovan W, Graves D, Jha A, et al. Review and revisions of the international standards for the neurological classification of spinal cord injury. J Spinal Cord Med. 2009;2010(33):346–52.

    Google Scholar 

  15. 15.

    Ferro S, Cecconi L, Bonavita J, Pagliacci MC, Biggeri A, Franceschini M. Incidence of traumatic spinal cord injury in Italy during 2013-2014: a population-based study. Spinal Cord. 2017;55:1103–7.

    Article  CAS  Google Scholar 

  16. 16.

    Zhou Y, Wang XB, Kan SL, Ning GZ, Li YL, Yang B, et al. Traumatic spinal cord injury in Tianjin, China: a single-center report of 354 cases. Spinal Cord. 2016;54:670–4.

    Article  CAS  Google Scholar 

  17. 17.

    Xie H, Chang F, Shen C, Shen X, Zhang J, Lin P, et al. Factors influencing the outcomes of specialized institution-based rehabilitation in spinal cord injury.Chinese. J Spine Spinal Cord. 2018;28:529–34.

    Google Scholar 

  18. 18.

    Wang T, Yin X, Zhang P, Kou Y, Jiang B. Road traffic injury and rescue system in China. Lancet. 2015;385:1622.

    Article  Google Scholar 

  19. 19.

    Wang T, Zhang J, Wang F, Liu H, Yin X, Zhang P, et al. Changes and trends of pre-hospital emergency disease spectrum in Beijing in 2003–12: a retrospective study. Lancet. 2015;386:S39.

    Article  Google Scholar 

  20. 20.

    Chen Z, Yu J, Song Y, Chui D. Aging Beijing: challenges and strategies of health care for the elderly. Ageing Res Rev. 2010;9(Suppl 1):S2–S5.

    Article  Google Scholar 

  21. 21.

    Zhao S, Cao Y, Lei Y, Liu F, Shao S, Liu J, et al. Population ageing and injurious falls among one million elderly people who used emergency medical services from 2010 to 2017 in Beijing, China: a longitudinal observational study. BMJ Open. 2019;9:e028292.

    Article  Google Scholar 

  22. 22.

    Wang X, Yu H, Nie C, Zhou Y, Wang H, Shi X. Road traffic injuries in China from 2007 to 2016: the epidemiological characteristics, trends and influencing factors. PeerJ. 2019;7:e7423.

    Article  Google Scholar 

  23. 23.

    Pang D. Editorial comment to article: Pediatric thoracic SCIWORA after back bend during dance practice: a retrospective case series and analysis of trauma mechanisms. Childs Nerv Syst. 2017;33:1199.

    Article  Google Scholar 

  24. 24.

    Wu Y, Liu Z, Liu X, Sun Y, Chen Z, Dang G. An analysis of social characteristics of hospitalized spinal degenerative disease patients in the orthopedic department of Peking University Third Hospital during a period of 2008 to 2014. Chinese. J Spine Spinal Cord. 2016;26:70–76.

    Google Scholar 

  25. 25.

    Shigematsu H, Cheung JP, Mak KC, Bruzzone M, Luk KD. Cervical spinal canal stenosis first presenting after spinal cord injury due to minor trauma: an insight into the value of preventive decompression. J Orthop Sci. 2017;22:22–26.

    Article  Google Scholar 

  26. 26.

    Fassett DR, Harrop JS, Maltenfort M, Jeyamohan SB, Ratliff JD, Anderson DG, et al. Mortality rates in geriatric patients with spinal cord injuries. J Neurosurg Spine. 2007;7:277–81.

    Article  Google Scholar 

  27. 27.

    Inoue T, Suzuki S, Endo T, Uenohara H, Tominaga T. Efficacy of early surgery for neurological improvement in spinal cord injury without radiographic evidence of trauma in the elderly. World Neurosurg. 2017;105:790–5.

    Article  Google Scholar 

  28. 28.

    Truchon C, Fallah N, Santos A, Vachon J, Noonan VK, Cheng CL. Impact of therapy on recovery during rehabilitation in patients with traumatic spinal cord injury. J Neurotrauma. 2017;34:2901–9.

    Article  Google Scholar 

  29. 29.

    Lu D. Current situation and demand analysis of rehabilitation personnel by stratified sampling. Chin J Rehabil Theory Pract. 2019;25:859–64.

    Google Scholar 

  30. 30.

    Zhang Q, Zhang D. Study on select of pension methods of the elderly and its influencing factors in Beijing. Res Econ Manag. 2014;35:102–6.

    Google Scholar 

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Acknowledgements

We are deeply grateful to Pengkun Li of medical record statistics room for his assistance of collection data.

Funding

This study was supported by grants from China Rehabilitation Research Center (No. 2019ZX-04); National Key Research and Development Program (No. 2018YFF0301104).

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Authors

Contributions

HL was responsible for convening researchers, collecting, aggregating and analysing data, interpreting results and writing the report. JL and MS were responsible for collecting and analysing data. XY was responsible for the statistical analysis and graphing. LD and MY contributed to the design of the study protocol and interpreting results. JL and FG contributed to writing the report, providing important references and interpreting results. JL was responsible for designing and writing the study protocol and interpreting results. He is the corresponding author. All authors approved the final manuscript.

Corresponding author

Correspondence to Jianjun Li.

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The authors declare that they have no conflict of interest.

Statement of ethics

Approval from the hospital ethics committee was obtained before commencing the study (No. CRRC-IEC-RF-SC-005-01).

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Liu, H., Liu, J., Shen, M. et al. The changing demographics of traumatic spinal cord injury in Beijing, China: a single-centre report of 2448 cases over 7 years. Spinal Cord (2020). https://doi.org/10.1038/s41393-020-00564-7

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