Incidence and prevalence of traumatic spinal cord injury in Canada using health administrative data.

Nancy P Thorogood, Vanessa K Noonan, Xiaozhi Chen, Nader Fallah, Suzanne Humphreys, Nicolas Dea, Brian K Kwon, Marcel F Dvorak
Author Information
  1. Nancy P Thorogood: Praxis Spinal Cord Institute, Vancouver, BC, Canada.
  2. Vanessa K Noonan: Praxis Spinal Cord Institute, Vancouver, BC, Canada.
  3. Xiaozhi Chen: Praxis Spinal Cord Institute, Vancouver, BC, Canada.
  4. Nader Fallah: Praxis Spinal Cord Institute, Vancouver, BC, Canada.
  5. Suzanne Humphreys: Praxis Spinal Cord Institute, Vancouver, BC, Canada.
  6. Nicolas Dea: Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, BC, Canada.
  7. Brian K Kwon: Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, BC, Canada.
  8. Marcel F Dvorak: Combined Neurosurgery and Orthopaedic Spine Program, University of British Columbia, Vancouver, BC, Canada.

Abstract

Introduction: Incidence and prevalence data are needed for the planning, funding, delivery and evaluation of injury prevention and health care programs. The objective of this study was to estimate the Canadian traumatic spinal cord injury (TSCI) incidence, prevalence and trends over time using national-level health administrative data.
Methods: ICD-10 CA codes were used to identify the cases for the hospital admission and discharge incidence rates of TSCI in Canada from 2005 to 2016. Provincial estimates were calculated using the location of the admitting facility. Age and sex-specific incidence rates were set to the 2015/2016 rates for the 2017 to 2019 estimates. Annual incidence rates were used as input for the prevalence model that applied annual survivorship rates derived from life expectancy data.
Results: For 2019, it was estimated that there were 1,199 cases (32.0 per million) of TSCI admitted to hospitals, with 123 (10% of admissions) in-hospital deaths and 1,076 people with TSCI (28.7 per million) were discharged in Canada. The estimated number of people living with TSCI was 30,239 (804/million); 15,533 (52%) with paraplegia and 14,706 (48%) with tetraplegia. Trends included an increase in the number of people injured each year from 874 to 1,199 incident cases (37%), an older average age at injury rising from 46.6 years to 54.3 years and a larger proportion over the age of 65 changing from 22 to 38%, during the 15-year time frame.
Conclusion: This study provides a standard method for calculating the incidence and prevalence of TSCI in Canada using national-level health administrative data. The estimates are conservative based on the limitations of the data but represent a large Canadian sample over 15 years, which highlight national trends. An increasing number of TSCI cases among the elderly population due to falls reported in this study can inform health care planning, prevention strategies, and future research.

Keywords

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Word Cloud

Created with Highcharts 10.0.0dataTSCIprevalencehealthincidenceinjuryratesusingcasesCanadastudyspinalcordadministrativeestimates1peoplenumberIncidenceplanningpreventioncareCanadiantraumatictrendstimenational-levelused2019estimated199permillionageIntroduction:neededfundingdeliveryevaluationprogramsobjectiveestimateMethods:ICD-10CAcodesidentifyhospitaladmissiondischarge20052016ProvincialcalculatedlocationadmittingfacilityAgesex-specificset2015/20162017AnnualinputmodelappliedannualsurvivorshipderivedlifeexpectancyResults:320admittedhospitals12310%admissionsin-hospitaldeaths076287dischargedliving30239804/million1553352%paraplegia1470648%tetraplegiaTrendsincludedincreaseinjuredyear874incident37%olderaveragerising466 years543 yearslargerproportion65changing2238%15-yearframeConclusion:providesstandardmethodcalculatingconservativebasedlimitationsrepresentlargesample15 yearshighlightnationalincreasingamongelderlypopulationduefallsreportedcaninformstrategiesfutureresearchepidemiologyroutinelycollected

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