Epidemiology of Traumatic Spinal Cord Injury Among Persons Older Than 21 Years: A Population-Based Study in South Carolina, 1998-2012.

backgroundA gap exists in the current knowledge regarding the epidemiology of traumatic spinal cord injury (TSCI) in a statewide population.

objectiveTo describe population-based epidemiology and trend of TSCI in persons 22 years and older in South Carolina over a 15-year period from 1998 through 2012.

methodsData on patients with TSCI were obtained from ongoing statewide TSCI surveillance and follow-up registry. Deaths were ascertained by linking surveillance files and the multiple cause-of-death dataset. Descriptive analyses were completed, and incidence and mortality rates were calculated based on the civilian adult population of the state.

resultsOver the 15 years, 3,365 persons with incident TSCI were discharged alive from acute care hospitalization, of whom 555 died during the period of observation. Age-standardized cumulative mortality rate was 14 per million, and the average incidence rate was estimated at 70.8 per million population per year. Age-standardized incidence rate of TSCI increased significantly from 66.9 in 1998 to 111.7 per million in 2012. Standardized incidence rates were significantly higher among non-Whites and males. Motor vehicle crashes and falls were the leading causes, accounting for nearly 70% of TSCI.

conclusionsStandardized incidence and mortality rates of TSCI in South Carolina are higher than reported rates for the US population. Motor vehicle crashes and falls are the leading causes of TSCI. There was a significant increase in the overall trend of the incidence rates over the 15 years. A well-coordinated preventive strategy is needed to reduce incidence and improve survival of persons with TSCI.