Age-specific characterization of spinal cord injuries over a 19-year period at a Japanese rehabilitation center.

Abstract

Regional demographics of spinal cord injuries (SCIs) are fundamental to identifying and implementing appropriate preventive measures. The current study was conducted as a longitudinal analysis of all patients with SCIs admitted to the Hyogo Rehabilitation Center over a 19-year period. The sex and age of the patient, time and nature of injury (i.e., cause, level, and extent), and period from injury to admission were evaluated retrospectively. Pertinent tests, including Poisson regression analysis, and the Cochran-Armitage, Kruskal-Wallis, and chi-square tests, were applied to assess demographic variables, with statistical significance set at p < 0.05. Between 1995 and 2013, a total of 632 patients with SCIs (predominantly male and largely < 60 years old) were admitted to our center for rehabilitation. Although the male: female ratio remained unchanged throughout the study period, the ratio of older adults increased over time. In assessing the cause of injury, the majority of the patients involved in road traffic accidents were aged ≤ 44 years, whereas patients aged ≥ 45 years accounted for the majority of low-distance falls and disease-related SCIs, the proportions of which gradually increased. Complete paralysis and paraplegia primarily occurred in patients aged ≤ 44 years, whereas the majority of incomplete injuries and tetraplegia were limited to those aged ≥ 45 years. The patient age at the time of SCI and the nature of the injury sustained were interrelated. Age-specific strategies thus offered the best means of preventing/reducing the incidence of SCIs in Hyogo prefecture.