Incidence of traumatic
spinal cord injury
Annibale Biggeri, Lorenzo Cecconi
Dipartimento di Statistica, Informatica, Applicazioni
Università degli studi di Firenze
Objective
To estimate the incidence rate of traumatic spinal cord injury in the
Italian Regions in the period October 1, 2013 – new diagnsSeptember
30, 2014.
The incidence rate is the number of new cases of spinal cord injury per
person-time .
Case definition
All patients with new diagnosis of traumatic spinal cord injury between
October 2013 and September 2014 in the Italian regions enrolled.
Based population
Residents in the Italian Regions enrolled (Piemonte, Lombardia,
Veneto, Friuli Venezia Giulia, Emilia Romagna, Toscana, Umbria,
Sicilia, Marche, Liguria).
555 traumatic spinal cord injuries observed
120 (21%) without an admission to a Spinal Cord Unit
Etiology of injury
Violence
Road accident
Fall
Fall to the ground
Sport
Dip
Other*
Level of lesion
3%
35%
25%
14%
4%
3%
15%
Paraplegic
Tetraplegic
Unknown*
37%
48%
15%
* SCI without admission in a
Spinal Cord Unit
Cases distribution by Region
Emilia-Romagna
Friuli-Venezia Giulia
Lazio
Liguria
Lombardia
Marche
Piemonte
Puglia
Sicilia
Toscana
Umbria
Veneto
events
83
15%
22
4%
37
7%
24
4%
98
18%
21
4%
54
10%
30
5%
53
10%
49
9%
15
3%
69
12%
555 100%
Case distribution by Month of the year
january
february
march
april
may
june
july
august
september
october
november
december
33
32
43
46
57
75
54
50
38
46
37
44
6%
6%
8%
8%
10%
14%
10%
9%
7%
8%
7%
8%
Traumatic spinal cord injury by month
16%
14%
14%
12%
10%
10%
8%
6%
4%
2%
0%
8%
6%
6%
8%
10%
9%
8%
7%
8%
7%
Crude incidence rate (per million) by Region
Emilia Romagna
Friuli Venezia Giulia
Lazio
Liguria
Lombardia
Marche
Piemonte
Puglia
Sicilia
Toscana
Umbria
Veneto
Totale
rate
19
18
6
15
10
14
12
7
10
13
17
14
12
95% confidence interval
Lower
Upper
15
23
11
27
4
9
10
22
8
12
8
21
9
16
5
10
8
14
10
17
9
28
11
18
11
13
Incidence rate (per million) by Region and Gender
Emilia Romagna
Friuli Venezia Giulia
Lazio
Liguria
Lombardia
Marche
Piemonte
Puglia
Sicilia
Toscana
Umbria
Veneto
Totale
rate
32
24
10
21
16
24
18
12
18
21
26
25
19
Male
95% CI
25
13
7
12
12
14
13
7
13
14
13
19
17
40
39
14
34
20
38
25
17
24
28
46
32
21
rate
7
13
3
10
4
4
6
3
3
6
9
4
5
Female
95% CI
4
5
1
4
2
1
3
1
2
3
2
2
4
11
25
6
19
6
11
10
7
7
11
22
7
6
Incidence rate (per million) by Age and Gender
Age rate
0-9
0
10-19
15
20-29
19
30-39
17
40-49
17
50-59
22
60-69
22
70-79
35
80-89
31
908
Totale
19
Male
95% CI
0
2
10
21
14
25
12
22
13
22
17
28
16
28
27
44
21
44
0
42
17
21
rate
1
3
5
4
3
4
6
10
8
3
5
Female
95% CI
0
3
1
7
3
9
2
7
2
6
2
7
3
9
7
15
4
13
0
14
4
6
Incidence rate (per million ) by Age and Gender
Discussion
• For some Regions there is a lack of coverage
• Registration completeness is not addressed
• Capture-recapture design may be helpful
Prevalence data may be obtained by Hospital Discharge
records and are in the odds of 10:1
they reflect the care need during the life
Prevalence is proportional to incidence and duration
( P/(1-p) = I x D )
Survival studies may be the main future priority
Prevalence Incidence
(per milion)
(per milion)
2013-14
SCI
ER men 2003-2007; 2008-2012
ER women 2003-2007; 2008-2012
Toscana men 2001-2006
Toscana women 2001-2006
290; 220
120; 120
112
59
32
7
21
6
(2) Western Europe incidence 16 per milion, prevalence 280 per milion BB Lee, RA Cripps, M Fitzharris and
PC Wing. The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate.
Spinal Cord (2014) 52, 110–116
ICD-IX 806; 952
International comparison of SCI incidence rates
Conclusions