Abstract
BackgroundFew studies focus on pediatric spinal cord injury (SCI) and there is little information regarding the cause, anatomic level, and high risk population of SCI in children. This study aims to investigate the incidence and risk factors of pediatric SCI.MethodsA nationwide cohort of 8.7 million children aged<18 years in an 11-year period was analyzed for causes, age at injury, anatomic sites, disability, and familial socio-economic factors. Incidence rates and Cox regression analysis were conducted.ResultsA total of 4949 SCI patients were analyzed. The incidence rates of cervical, thoracic, lumbar, and other SCI were 4.06, 0.34, 0.75, and 0.85 per 100,000 person-years, respectively. The proportional composition of gender, age, and socio-economic status of SCI patients were significantly different than those of non-SCI patients (all p<0.001). Male children were significantly more likely to have SCI than females in both the cervical and the other SCI groups [Incidence rate ratio (IRR) = 2.03 and 1.52; both p<0.001]. Young adults and teenagers were also significantly more likely to have SCI than pre-school age children in the cervical SCI (IRR = 28.55 and 10.50, both p<0.001) and other SCI groups (IRR = 18.8 and 7.47, both p<0.001). Children in families of lower socio-economic status were also significantly more likely to have SCI (p<0.05).ConclusionsIn the pediatric population, the overall SCI incidence rate is 5.99 per 100,000 person-years, with traumatic cervical SCI accounting for the majority. The incidence rate increases abruptly in male teenagers. Gender, age, and socio-economic status are independent risk factors that should be considered.
Highlights
Spinal cord injury (SCI) is a catastrophic medical condition requiring chronic care
Spinal cord injury without radiographic abnormality (SCIWORA) is a unique pattern of spinal cord injury (SCI) described exclusively in children, depicting patients with signs of myelopathy but without radiographic evidence of spinal column injury on plain radiograph or computed tomography. [10,11,12,13] As such, specific data of pediatric SCI patients in terms of anatomic site of injury, proportional distribution of age and gender, causes, and socio-economic status are invaluable for future care and prevention
This study aimed to describe patterns and risks of SCI in children and young adults using a nationwide pediatric cohort in a developed economy (i.e. Taiwan)
Summary
Spinal cord injury (SCI) is a catastrophic medical condition requiring chronic care. Life expectancy after SCI is reduced due to complications like pneumonia, septicemia, urinary and cardiac diseases, and proportional to the severity of injury or remaining neurologic function. [1,2,3,4] For those injured as children, the life expectancy may be lower, 50–83% of normal. [5] given the early occurrence, pediatric SCI patients substantially require even more long-term care than adults.The exact incidence rate of pediatric SCI is unclear. Spinal cord injury (SCI) is a catastrophic medical condition requiring chronic care. [5] given the early occurrence, pediatric SCI patients substantially require even more long-term care than adults. Due to the scarcity of SCI in children and the lack of population-based database for investigation, the causes, patterns of injury, and risk factors remain speculative. [10,11,12,13] As such, specific data of pediatric SCI patients in terms of anatomic site of injury, proportional distribution of age and gender, causes, and socio-economic status are invaluable for future care and prevention. Few studies focus on pediatric spinal cord injury (SCI) and there is little information regarding the cause, anatomic level, and high risk population of SCI in children. This study aims to investigate the incidence and risk factors of pediatric SCI
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