Incidence of traumatic spinal cord injury worldwide: A systematic review, data integration, and update

Seyed Behnam Jazayeri; Seyed Farzad Maroufi; Esmaeil Mohammadi; Mohammad Amin Dabbagh Ohadi; Ellen-Merete Hagen; Maryam Chalangari; Seyed Behzad Jazayeri; Mahdi Safdarian; Shayan Abdollah Zadegan; Zahra Ghodsi; Vafa Rahimi-Movaghar

doi:10.1016/j.wnsx.2023.100171

Incidence of traumatic spinal cord injury worldwide: A systematic review, data integration, and update

World Neurosurg X. 2023 Feb 1:18:100171. doi: 10.1016/j.wnsx.2023.100171. eCollection 2023 Apr.

Authors

Seyed Behnam Jazayeri^{1

2}, Seyed Farzad Maroufi^{1

2}, Esmaeil Mohammadi¹, Mohammad Amin Dabbagh Ohadi^{1

2}, Ellen-Merete Hagen^{3

4

5}, Maryam Chalangari¹, Seyed Behzad Jazayeri¹, Mahdi Safdarian^{1

6}, Shayan Abdollah Zadegan^{1

7}, Zahra Ghodsi¹, Vafa Rahimi-Movaghar^{1

8

9

10

11

12}

Affiliations

¹ Sina Trauma and Surgery Research Center (STSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran.
² Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
³ Autonomic Unit, National Hospital for Neurology & Neurosurgery, UCLH, UK.
⁴ Department of Brain Repair and Rehabilitation, Queen Square Institute of Neurology, UCL, UK.
⁵ Department of Clinical Medicine, Aarhus University, Denmark.
⁶ Department of Neurology, Christian Doppler Medical Center, University Hospital Salzburg, Austria.
⁷ Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.
⁸ Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁹ Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
¹⁰ Universal Scientific Education and Research Network (USERN), Tehran, Iran.
¹¹ Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran.
¹² Spine Program, University of Toronto, Toronto, Canada.

Abstract

Objectives: This review was designed to update our earlier systematic review which evaluated both published and unpublished evidence on the incidence of traumatic spinal cord injury (TSCI) worldwide.

Methods: We used various search methods including strategic searching, reference checking, searching for grey literature, contacting registries, authors, and organizations requesting unpublished data, browsing related websites, and hand searching key journals. The quality of included studies was evaluated by Joanna Briggs Institute Critical Appraisal Tools. Records published between April 2013 and May 2020 were added to the original systematic review.

Results: Overall, 58 resources including 45 papers, 10 SCI registry reports, 1 book, and 2 theses were retrieved. We found TSCI incidence data for eight new countries, which overall shapes our knowledge of TSCI incidence for 49 countries. The incidence of TSCI ranges from 3.3 to 195.4 cases per million (cpm) based on subnational studies and from 5.1 to 150.48 cpm based on national studies. Most of the studies were low quality, lacked consistent case selection due to unclear definition of TSCI and unclear ascertainment methods.

Conclusions: There is an increasing number of publications in the literature focusing on the epidemiologic data of TSCI. The absence of a standard form of reporting TSCI hinders the comparability of data across different data sources. Use of various definitions for TSCI may lead to heterogeneity in reports. Use of sensitivity analyses based on reasonable classification criteria can aid in offering a uniform set of case identification and ascertainment criteria for TSCI.

Keywords: AMR, American region; ASCIR, Australian Spinal Cord Injury Register; CPM, Cases Per Million; CoCoPop, Condition, Context, and Population; EMR, Eastern Mediterranean region; EUR, European Region; Epidemiology; ICD, International Codes of Disease; ISCoS, International Spinal Cord Society; InSCI, The International Spinal Cord Injury; Incidence; JBI, Joanna Briggs Institute; PHM, Prehospital mortality; PICO, Population, Intervention, Comparator, and Outcome; SEAR, South East Asia Region; Spinal cord injury; SwiSCI, Swiss Spinal Cord Injury; TSCI, Traumatic Spinal Cord Injury; TSI, Traumatic spinal injuries; WPR, Western Pacific Region.

Publication types

Review