A spinal cord injury is any injury to the spinal cord via blunt or penetrating trauma. Extreme flexion or extension (particularly in the neck) of the spine can result in traction on the spinal cord with subsequent injury and the development of neurologic symptoms.
Spinal Cord Injury Facts:
Incidence:
It is estimated that the annual incidence of spinal cord injury (SCI), not including those who die at the scene of the accident, is approximately 40 cases per million population in the U. S. or approximately 11,000 new cases each year. Since there have not been any overall incidence studies of SCI in the U.S. since the 1970’s it is not known if incidence has changed in recent years.
Prevalence:
The number of people in the United States who are alive in December 2003 who have SCI has been estimated to be approximately 243,000 persons, with a range of 219,000 to 279,000 persons. (Note: Incidence and prevalence statistics are estimates obtained from several studies. These statistics are not derived from the National SCI Database.)
The National Spinal Cord Injury Database has been in existence since 1973 and captures data from an estimated 13% of new SCI cases in the U.S.
Since its inception, 25 federally funded Model SCI Care Systems have contributed data to the National SCI Database. As of November 2003 the database contained information on 22,599 persons who sustained traumatic spinal cord injuries. All the remaining statistics on this sheet are derived from this database or from collaborative studies conducted by the Model Systems.
Age at injury:
SCI primarily affects young adults. Fifty-three percent of SCIs occur among persons in the 16 to 30 year age group, and the average age at injury is 32.6 years. Since 1973 there has been an increase in the mean age at time of injury. Those who were injured before 1979 had a mean age of 28.6 while those injured after 2000 had a mean age of 35.9 years. Another trend is an increase in the proportion of those who were at least 61 years of age at injury. In the 1970’s persons older than 60 years of age at injury comprised 4.7% of the database. Since 2000 this has increased to 11.4% of new injuries. This trend is not surprising since the median age of the general population has increased from 27.9 years to 35.3 years during the same time period.
Gender:
Overall, 81.2% of all persons in the national database are male. Although this four-to-one male to female ratio has varied little throughout the 30 years of Model Systems data collection, since 1990, the percentage of males has decreased to 79.7% (from 81.8% in the 1970?s).
Ethnic groups:
A significant trend over time has been observed in the racial distribution of persons in the Model System database. Among persons injured between 1973 and 1978, 77.5% of persons in the database were Caucasian, 13.5% were African-American, 5.7% were Hispanic, 2% were American Indian and 0.8% were Asian. However, among those injured since 1990 only 59.1% were Caucasian, while 27.6% were African-American, 7.7% were Hispanic, 0.4% were American Indian, 2.1% were Asian (and 0.5% were unknown and 2.5% were unclassified).
Occupational status:
More than half (62.9%) of those persons with SCI admitted to a Model System reported being employed at the time of their injury. The post-injury employment picture is better among persons with paraplegia than among their tetraplegic counterparts. By post-injury year 10, 31.8% of persons with paraplegia are employed, while 26.4% of those with tetraplegia are employed during the same year.
Residence:
Today 88.3% of all persons with SCI who are discharged alive from the system are sent to a private, noninstitutional residence (in most cases their homes before injury.) Only 5.1% are discharged to nursing homes. The remaining are discharged to hospitals, group living situations or other destinations.
Marital status:
Considering the youthful age of most persons with SCI, it is not surprising that most (53%) are single when injured. Among those who were married at the time of injury, as well as those who marry after injury, the likelihood of their marriage remaining intact is slightly lower when compared to the uninjured population. The likelihood of getting married after injury is also reduced.
Length of stay:
Overall, average days hospitalized in the acute care unit for those who enter a Model System immediately following injury has declined from 25 days in 1974 to 17 days in 2001. Similar downward trends are noted for days in the rehab unit (from 115 to 44 days). Overall, mean days hospitalized (during acute care and rehab) were greater for persons with neurologically complete injuries.
Lifetime costs:
The average yearly health care and living expenses and the estimated lifetime costs that are directly attributable to SCI vary greatly according to severity of injury.
Life expectancy
Life expectancy is the average remaining years of life for an individual. Life expectancies for persons with SCI continue to increase, but are still somewhat below life expectancies for those with no spinal cord injury. Mortality rates are significantly higher during the first year after injury than during subsequent years, particularly for severely injured persons.
Cause of death:
In years past, the leading cause of death among persons with SCI was renal failure. Today, however, significant advances in urologic management have resulted in dramatic shifts in the leading causes of death. Persons enrolled in the National SCI Database since its inception in 1973 have now been followed for 30 years after injury. During that time, the causes of death that appear to have the greatest impact on reduced life expectancy for this population are pneumonia, pulmonary emboli and septicemia.
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