Epidemiological features of traumatic spinal cord injury in China: A systematic review and meta-analysis.

Youpeng Hu, Lianxin Li, Binxue Hong, Yizhou Xie, Tong Li, Chaoqun Feng, Fei Yang, Yehui Wang, Jie Zhang, Yang Yu, Xiaohong Fan
Author Information
  1. Youpeng Hu: The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
  2. Lianxin Li: The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
  3. Binxue Hong: West China School of Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
  4. Yizhou Xie: The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
  5. Tong Li: The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
  6. Chaoqun Feng: The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
  7. Fei Yang: The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
  8. Yehui Wang: The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
  9. Jie Zhang: The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
  10. Yang Yu: The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
  11. Xiaohong Fan: The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

Abstract

Background: Traumatic spinal cord injury (TSCI) is a highly fatal and disabling event, and its incidence rate is increasing in China. Therefore, we collated the epidemiological factors of TSCI in different regions of China to update the earlier systematic review published in 2018.
Method: We searched four English and three Chinese electronic databases from 1978 to October 1, 2022. From the included reports, information on sample characteristics, incidence, injury characteristics, prognostic factors, and economic burden was extracted. The selection of data was based on the PRISMA statement. The quality of the included studies was assessed by the Agency for Healthcare Research and Quality (AHRQ) tool. The results of the meta-analysis were presented in the form of pooled frequency and forest plots.
Results: A total of 59 reports (60 studies) from 23 provinces were included, of which 41 were in the Chinese language. The random pooled incidence of TSCI in China was estimated to be 65.15 per million (95% CI: 47.20-83.10 per million), with a range of 6.7 to 569.7 per million. The pooled male-to-female ratio was 1.95:1. The pooled mean age of the cases at the time of injury was 45.4 years. Motor vehicle accidents (MVAs) and high falls were found to be the leading causes of TSCI. Incomplete quadriplegia and AISA/Frankel grade D were the most common types of TSCI. Cervical level injury was the most prevalent. The pooled in-hospital mortality and complication rates for TSCI in China were 3% (95% CI: 2-4%) and 35% (95% CI: 23-47%). Respiratory problems were the most common complication and the leading cause of death.
Conclusion: Compared with previous studies, the epidemiological data on TSCI in China has changed significantly. A need to update the data over time is essential to implement appropriate preventive measures and formulate interventions according to the characteristics of the Chinese population.

Keywords

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Word Cloud

Created with Highcharts 10.0.0TSCIinjuryChinapooledincidencespinalcordepidemiologicalfactorssystematicreviewChineseincludedcharacteristicsdatastudiesmeta-analysispermillion95%CI:update1reports7timeleadingcommoncomplicationtraumaticBackground:TraumatichighlyfataldisablingeventrateincreasingThereforecollateddifferentregionsearlierpublished2018Method:searchedfourEnglishthreeelectronicdatabases1978October2022informationsampleprognosticeconomicburdenextractedselectionbasedPRISMAstatementqualityassessedAgencyHealthcareResearchQualityAHRQtoolresultspresentedformfrequencyforestplotsResults:total596023provinces41languagerandomestimated65154720-8310range6569male-to-femaleratio95:1meanagecases454yearsMotorvehicleaccidentsMVAshighfallsfoundcausesIncompletequadriplegiaAISA/FrankelgradeDtypesCervicallevelprevalentin-hospitalmortalityrates3%2-4%35%23-47%RespiratoryproblemscausedeathConclusion:ComparedpreviouschangedsignificantlyneedessentialimplementappropriatepreventivemeasuresformulateinterventionsaccordingpopulationEpidemiologicalfeaturesChina:

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