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Epidemiology of spinal cord injury in China: A systematic review of the chinese and english literature

Subjects

Abstract

Study design

Systematic review.

Objectives

We aimed to provide a comprehensive overview of the English and Chinese literature reporting epidemiological data on spinal cord injury (SCI) in China.

Methods

3 English and 3 Chinese language electronic databases were searched from the earliest record to 15 March 2020. Sociodemographic characteristics, incidence rates, etiology and lesion characteristics, in-hospital mortality, and secondary health conditions and complications were extracted from included reports.

Results

A total of 51 studies were included, 32 in the Chinese language. Forty-seven studies were based on hospital records. Mean age of incident cases ranged from 34 to 55 years and male-to-female ratios ranged from 0.35:1 to 15.3:1. SCI incidence varied from 14.6 to 60.6 per million. Thirty-five studies reported only on traumatic SCI with traffic accidents, high falls, low falls and being hit by objects being the most common causes. Specific causes for non-traumatic SCI were poorly reported. Proportions with tetraplegia and complete injury ranged from 37.4% to 82.0% and 14.1% to 73.9%, respectively. Reported in-hospital mortality attributed to SCI varied from 1.1% to 18.4%. Leading cause of in-hospital mortality for acute SCI was respiratory problems; respiratory problems, urinary tract infections and pressure sores were the most common complications.

Conclusion

Epidemiological data on SCI in China are only available for a limited number of provinces and mostly outdated. Updated data on incidence with accurate geographical information and etiology across all Chinese provinces are needed for targeted implementation of preventive strategies. Research on community outcomes needs to be developed in China.

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Fig. 1: Flow diagram of study selection in the review.
Fig. 2: Map of SCI research across China.

Data availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

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Acknowledgements

The authors wish to thank Ruiling Lian, MS and Chuanteng Feng, MPH for their support in creating Fig. 2 and former Editor in Chief of Spinal Cord Dr. Lisa Harvey for encouraging us to undertake this review.

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Authors

Contributions

CC wrote the first draft of this manuscript and JR, WL, and CF revised the manuscript for important intellectual content. CC and WL contributed in literature search, screening and data extraction; CC, XQ, WL, CF and JR designed the study and analyzed and interpreted the data and wrote the manuscript; CC, XQ, CF, WL, and JR have approved the submitted version of the manuscript. Each author had participated sufficiently in the work to take public responsibility for appropriate portions of the content.

Corresponding author

Correspondence to Jan D. Reinhardt.

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The authors declare no competing interests.

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Chen, C., Qiao, X., Liu, W. et al. Epidemiology of spinal cord injury in China: A systematic review of the chinese and english literature. Spinal Cord (2022). https://doi.org/10.1038/s41393-022-00826-6

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