The epidemiology and disease burden of traumatic spinal cord injury in China: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

CHEN Xingyue ^1,2 , CHEN Dong ^1,2 , CHEN Chunhui ^1,2 , WANG Kai ^1,2 , TANG Li ^1,2 , LI Yuzhe ^1,2 ,  WU Aimin ^1,2

1. Department of Orthopaedic-Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, P.R.China;
2. The Second School of Medicine, Wenzhou Medical University, Wenzhou, 325027, P.R.China;

Corresponding?author：

WU Aimin, Email: aiminwu@wmu.edu.cn

Keywords：

Spinal cord injury; Epidemiology; Economic burden; Systematic review

DOI：

10.7507/1672-2531.201712034

Video：

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ObjectiveTo systematically review the epidemiological characteristics and economic burden of traumatic spinal cord injury (SCI) in China.MethodsPubMed, EMbase, WanFang Data, VIP and CNKI databases were electronically searched to collect studies of the epidemiological characteristics and economic burden of SCI in China from January 1^st, 1978 to August 30^th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using Stata 12.0 software.ResultsA total of 32 studies were included. The results of meta-analysis showed that: the prevalence of SCI in China was 37 persons per million per year (95%CI 21 to 53), with the average age ranged from 34.7 to 54.4 years. Men had a higher risk of SCI than Women. Motor vehicle collisions (MVCs) and falls were the two main causes of SCI. The neurological injury levels were varied, ASIA grade A was the most common and grade E was the least.ConclusionCurrent evidence shows that there is a high prevalence of SCI in China with heavy social and medical burden. The main reason of SCI is motor vehicle collisions and falls. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify above conclusion.

Citation： CHEN Xingyue, CHEN Dong, CHEN Chunhui, WANG Kai, TANG Li, LI Yuzhe, WU Aimin. The epidemiology and disease burden of traumatic spinal cord injury in China: a systematic review. Chinese Journal of Evidence-Based Medicine, 2018, 18(2): 143-150. doi: 10.7507/1672-2531.201712034 Copy

1.	Ropper AE, Ropper AH. Acute Spinal Cord Compression. N Engl J Med, 2017, 376(14): 1358-1369.
2.	Selvarajah S, Hammond ER, Haider AH, et al. The burden of acute traumatic spinal cord injury among adults in the United States: an update. J Neurotrauma, 2014, 31(3): 228-238.
3.	DeVivo MJ. Causes and costs of spinal cord injury in the United States. Spinal Cord, 1997, 35(12): 809-813.
4.	DeVivo MJ, Stover SL, Fine PR. The relationship between sponsorship and rehabilitation outcome following spinal cord injury. Paraplegia, 1989, 27(6): 470-479.
5.	Rostom A, Dubé C, Cranney A, et al. Celiac disease. Evid Rep Technol Assess (Summ), 2004, (104): 1-6.
6.	曾小峰, 朱松林, 譚愛春, 等.我國類風濕關節炎疾病負擔和生存質量研究的系統評價.中國循證醫學雜志, 2013, 13(3): 300-307.
7.	楊文清. 1 089例住院脊髓損傷患者的流行病學分析. 福州: 福建醫科大學, 2015.
8.	衛波. 2005年北京市脊髓損傷流行病學初步調查研究. 北京: 首都醫科大學, 2007.
9.	于鐵強. 2007年天津市區外傷性脊髓損傷流行病學調查. 天津: 天津醫科大學, 2010.
10.	王含飛. 安徽省兩家醫院的創傷性脊髓損傷的流行病學特征分析. 合肥: 安徽醫科大學, 2013.
11.	郝春霞, 李建軍, 周紅俊, 等. 1 264例住院脊髓損傷患者的流行病學分析.中國康復理論與實踐, 2007, 13(11): 1011-1013.
12.	郝定均, 賀寶榮, 閆亮, 等. 2011–2013年西安市紅會醫院脊柱脊髓損傷患者流行病學特點.中華創傷雜志, 2015, 31(7): 632-636.
13.	姜京城, 朱立強, 葉超群, 等. 423例脊髓損傷住院患者特征分析.中國康復理論與實踐, 2012, (7): 665-668.
14.	李建軍, 周紅俊, 洪毅, 等. 2002年北京市脊髓損傷發病率調查.中國康復理論與實踐, 2004, 10(7): 412-413.
15.	徐春歸, 顧銳, 王天兵, 等. 1 274例脊柱創傷患者的流行病學分析.今日健康, 2016, 15(11): 19-20.
16.	易超然. Epidemiological features of 261 hospitalized patients with spinal cord injury from multiple hospitals in Hunan province. 長沙: 南華大學, 2015.
17.	胡光宇, 湯華豐, 唐林安.上海市松江縣脊柱脊髓損傷流行病學調查.中國脊柱脊髓雜志, 1992, (4): 177-179.
18.	鈕晟佳. 蘇州市脊髓損傷患者流行病學分析及相關因素研究. 蘇州: 蘇州大學, 2016.
19.	陳軍, 陳伯華.外傷性脊髓損傷251例臨床資料分析.中國社區醫師(醫學專業半月刊), 2009, 11(19): 69.
20.	茹慶超. 大連市脊髓損傷流行病學調查研究. 大連: 大連醫科大學, 2014.
21.	Chen HY, Chiu WT, Chen SS, et al. A nationwide epidemiological study of spinal cord injuries in Taiwan from July 1992 to June 1996. Neurol Res, 1997, 19(6): 617-622.
22.	Ning GZ, Yu TQ, Feng SQ, et al. Epidemiology of traumatic spinal cord injury in Tianjin, China. Spinal Cord, 2011, 49(3): 386-390.
23.	Yang R, Guo L, Wang P, et al. Epidemiology of spinal cord injuries and risk factors for complete injuries in Guangdong, China: a retrospective study. PLoS One, 2014, 9(1): e84733.
24.	Chen CF, Lien IN. Spinal cord injuries in Taipei, Taiwan, 1978-1981. Paraplegia, 1985, 23(6): 364-370.
25.	Lan C, Lai JS, Chang KH, et al. Traumatic spinal cord injuries in the rural region of Taiwan: an epidemiological study in Hualien county, 1986-1990. Paraplegia, 1993, 31(6): 398-403.
26.	Yang NP, Deng CY, Lee YH, et al. The incidence and characterisation of hospitalised acute spinal trauma in Taiwan-a population-based study. Injury, 2008, 39(4): 443-450.
27.	Feng HY, Ning GZ, Feng SQ, et al. Epidemiological profile of 239 traumatic spinal cord injury cases over a period of 12 years in Tianjin, China. J Spinal Cord Med, 2011, 34(4): 388-394.
28.	Ning GZ, Mu ZP, Shangguan L, et al. Epidemiological features of traumatic spinal cord injury in Chongqing, China. J Spinal Cord Med, 2016, 39(4): 455-460.
29.	楊梟雄, 于前進, 秦江, 等.脊髓損傷住院患者1 027例流行病學分析.脊柱外科雜志, 2016, 14(5): 301-305.
30.	Hua R, Shi J, Wang X, et al. Analysis of the causes and types of traumatic spinal cord injury based on 561 cases in China from 2001 to 2010. Spinal Cord, 2013, 51(3): 218-221.
31.	程黎明, 曾至立, 楊志勇, 等.脊柱脊髓損傷流行病學特點分析和手術療效探討.中華創傷骨科雜志, 2008, 10(3): 245-248.
32.	潘杰, 李昕, 曾誠, 等. 2005–2007年上海市浦東新區脊柱脊髓損傷調查分析.同濟大學學報(醫學版), 2009, (5): 131-135.
33.	唐智生. 221例住院脊髓損傷患者流行病學調查及相關因素的分析. 南寧: 廣西醫科大學, 2011.
34.	陳銀海, 劉敏, 何井華.脊髓損傷患者流行病學調查.實用醫學雜志, 2011, 27(6): 1032-1034.
35.	鄧磊, 尚暉, 常巍, 等.脊柱脊髓損傷患者424例流行病學分析.中國臨床研究, 2015, 28(7): 858-860, 864.
36.	Chen R, Liu X, Han S, et al. Current epidemiological profile and features of traumatic spinal cord injury in Heilongjiang province, Northeast China: implications for monitoring and control. Spinal Cord, 2017, 55(4): 399-404.
37.	王磊, 周娟, 石秀秀, 等. 創傷性脊髓損傷的相關因素研究. 中國骨與關節雜志, 2017, 6(6): 139-144.
38.	ZHou Y, Wang X, Kan S, et al. Tran matic spinal cord injury in Tianjin, China: a single-center report of 354 cases. Spinal Cord, 2016, 54(9): 670-674.
39.	周文玉.中國的地理分區.地理教育, 2011, (1): 39.
40.	Ning GZ, Wu Q, Li YL, et al. Epidemiology of traumatic spinal cord injury in Asia: a systematic review. J Spinal Cord Med, 2012, 35(4): 229-239.
41.	Wyndaele M, Wyndaele JJ. Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Spinal Cord, 2006, 44(9): 523-529.
42.	Jackson AB, Dijkers M, Devivo MJ, et al. A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Arch Phys Med Rehabil, 2004, 85(11): 1740-1748.
43.	Jain NB, Ayers GD, Peterson EN, et al. Traumatic spinal cord injury in the United States, 1993-2012. JAMA, 2015, 313(22): 2236-2243.
44.	Kristinsdottir EA, Knutsdottir S, Sigvaldason K, et al. Epidemiology of Spinal Cord Injury in Iceland from 1975 to 2014. Laeknabladid, 2016, 102(11): 491-496.
45.	Bj?rnshave Noe B, Mikkelsen EM, Hansen RM, et al. Incidence of traumatic spinal cord injury in Denmark, 1990-2012: a hospital-based study. Spinal Cord, 2015, 53(6): 436-440.
46.	Selassie A, Cao Y, Saunders LL. Epidemiology of traumatic spinal cord injury among persons older than 21 years: a population-based study in South Carolina, 1998-2012. Top Spinal Cord Inj Rehabil, 2015, 21(4): 333-344.
47.	Chamberlain JD, Deriaz O, Hund-Georgiadis M, et al. Epidemiology and contemporary risk profile of traumatic spinal cord injury in Switzerland. Inj Epidemiol, 2015, 2(1): 28.
48.	Knútsdóttir S, Thórisdóttir H, Sigvaldason K, et al. Epidemiology of traumatic spinal cord injuries in Iceland from 1975 to 2009. Spinal Cord, 2012, 50(2): 123-126.

1. Ropper AE, Ropper AH. Acute Spinal Cord Compression. N Engl J Med, 2017, 376(14): 1358-1369.
2. Selvarajah S, Hammond ER, Haider AH, et al. The burden of acute traumatic spinal cord injury among adults in the United States: an update. J Neurotrauma, 2014, 31(3): 228-238.
3. DeVivo MJ. Causes and costs of spinal cord injury in the United States. Spinal Cord, 1997, 35(12): 809-813.
4. DeVivo MJ, Stover SL, Fine PR. The relationship between sponsorship and rehabilitation outcome following spinal cord injury. Paraplegia, 1989, 27(6): 470-479.
5. Rostom A, Dubé C, Cranney A, et al. Celiac disease. Evid Rep Technol Assess (Summ), 2004, (104): 1-6.
6. 曾小峰, 朱松林, 譚愛春, 等.我國類風濕關節炎疾病負擔和生存質量研究的系統評價.中國循證醫學雜志, 2013, 13(3): 300-307.
7. 楊文清. 1 089例住院脊髓損傷患者的流行病學分析. 福州: 福建醫科大學, 2015.
8. 衛波. 2005年北京市脊髓損傷流行病學初步調查研究. 北京: 首都醫科大學, 2007.
9. 于鐵強. 2007年天津市區外傷性脊髓損傷流行病學調查. 天津: 天津醫科大學, 2010.
10. 王含飛. 安徽省兩家醫院的創傷性脊髓損傷的流行病學特征分析. 合肥: 安徽醫科大學, 2013.
11. 郝春霞, 李建軍, 周紅俊, 等. 1 264例住院脊髓損傷患者的流行病學分析.中國康復理論與實踐, 2007, 13(11): 1011-1013.
12. 郝定均, 賀寶榮, 閆亮, 等. 2011–2013年西安市紅會醫院脊柱脊髓損傷患者流行病學特點.中華創傷雜志, 2015, 31(7): 632-636.
13. 姜京城, 朱立強, 葉超群, 等. 423例脊髓損傷住院患者特征分析.中國康復理論與實踐, 2012, (7): 665-668.
14. 李建軍, 周紅俊, 洪毅, 等. 2002年北京市脊髓損傷發病率調查.中國康復理論與實踐, 2004, 10(7): 412-413.
15. 徐春歸, 顧銳, 王天兵, 等. 1 274例脊柱創傷患者的流行病學分析.今日健康, 2016, 15(11): 19-20.
16. 易超然. Epidemiological features of 261 hospitalized patients with spinal cord injury from multiple hospitals in Hunan province. 長沙: 南華大學, 2015.
17. 胡光宇, 湯華豐, 唐林安.上海市松江縣脊柱脊髓損傷流行病學調查.中國脊柱脊髓雜志, 1992, (4): 177-179.
18. 鈕晟佳. 蘇州市脊髓損傷患者流行病學分析及相關因素研究. 蘇州: 蘇州大學, 2016.
19. 陳軍, 陳伯華.外傷性脊髓損傷251例臨床資料分析.中國社區醫師(醫學專業半月刊), 2009, 11(19): 69.
20. 茹慶超. 大連市脊髓損傷流行病學調查研究. 大連: 大連醫科大學, 2014.
21. Chen HY, Chiu WT, Chen SS, et al. A nationwide epidemiological study of spinal cord injuries in Taiwan from July 1992 to June 1996. Neurol Res, 1997, 19(6): 617-622.
22. Ning GZ, Yu TQ, Feng SQ, et al. Epidemiology of traumatic spinal cord injury in Tianjin, China. Spinal Cord, 2011, 49(3): 386-390.
23. Yang R, Guo L, Wang P, et al. Epidemiology of spinal cord injuries and risk factors for complete injuries in Guangdong, China: a retrospective study. PLoS One, 2014, 9(1): e84733.
24. Chen CF, Lien IN. Spinal cord injuries in Taipei, Taiwan, 1978-1981. Paraplegia, 1985, 23(6): 364-370.
25. Lan C, Lai JS, Chang KH, et al. Traumatic spinal cord injuries in the rural region of Taiwan: an epidemiological study in Hualien county, 1986-1990. Paraplegia, 1993, 31(6): 398-403.
26. Yang NP, Deng CY, Lee YH, et al. The incidence and characterisation of hospitalised acute spinal trauma in Taiwan-a population-based study. Injury, 2008, 39(4): 443-450.
27. Feng HY, Ning GZ, Feng SQ, et al. Epidemiological profile of 239 traumatic spinal cord injury cases over a period of 12 years in Tianjin, China. J Spinal Cord Med, 2011, 34(4): 388-394.
28. Ning GZ, Mu ZP, Shangguan L, et al. Epidemiological features of traumatic spinal cord injury in Chongqing, China. J Spinal Cord Med, 2016, 39(4): 455-460.
29. 楊梟雄, 于前進, 秦江, 等.脊髓損傷住院患者1 027例流行病學分析.脊柱外科雜志, 2016, 14(5): 301-305.
30. Hua R, Shi J, Wang X, et al. Analysis of the causes and types of traumatic spinal cord injury based on 561 cases in China from 2001 to 2010. Spinal Cord, 2013, 51(3): 218-221.
31. 程黎明, 曾至立, 楊志勇, 等.脊柱脊髓損傷流行病學特點分析和手術療效探討.中華創傷骨科雜志, 2008, 10(3): 245-248.
32. 潘杰, 李昕, 曾誠, 等. 2005–2007年上海市浦東新區脊柱脊髓損傷調查分析.同濟大學學報(醫學版), 2009, (5): 131-135.
33. 唐智生. 221例住院脊髓損傷患者流行病學調查及相關因素的分析. 南寧: 廣西醫科大學, 2011.
34. 陳銀海, 劉敏, 何井華.脊髓損傷患者流行病學調查.實用醫學雜志, 2011, 27(6): 1032-1034.
35. 鄧磊, 尚暉, 常巍, 等.脊柱脊髓損傷患者424例流行病學分析.中國臨床研究, 2015, 28(7): 858-860, 864.
36. Chen R, Liu X, Han S, et al. Current epidemiological profile and features of traumatic spinal cord injury in Heilongjiang province, Northeast China: implications for monitoring and control. Spinal Cord, 2017, 55(4): 399-404.
37. 王磊, 周娟, 石秀秀, 等. 創傷性脊髓損傷的相關因素研究. 中國骨與關節雜志, 2017, 6(6): 139-144.
38. ZHou Y, Wang X, Kan S, et al. Tran matic spinal cord injury in Tianjin, China: a single-center report of 354 cases. Spinal Cord, 2016, 54(9): 670-674.
39. 周文玉.中國的地理分區.地理教育, 2011, (1): 39.
40. Ning GZ, Wu Q, Li YL, et al. Epidemiology of traumatic spinal cord injury in Asia: a systematic review. J Spinal Cord Med, 2012, 35(4): 229-239.
41. Wyndaele M, Wyndaele JJ. Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey? Spinal Cord, 2006, 44(9): 523-529.
42. Jackson AB, Dijkers M, Devivo MJ, et al. A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Arch Phys Med Rehabil, 2004, 85(11): 1740-1748.
43. Jain NB, Ayers GD, Peterson EN, et al. Traumatic spinal cord injury in the United States, 1993-2012. JAMA, 2015, 313(22): 2236-2243.
44. Kristinsdottir EA, Knutsdottir S, Sigvaldason K, et al. Epidemiology of Spinal Cord Injury in Iceland from 1975 to 2014. Laeknabladid, 2016, 102(11): 491-496.
45. Bj?rnshave Noe B, Mikkelsen EM, Hansen RM, et al. Incidence of traumatic spinal cord injury in Denmark, 1990-2012: a hospital-based study. Spinal Cord, 2015, 53(6): 436-440.
46. Selassie A, Cao Y, Saunders LL. Epidemiology of traumatic spinal cord injury among persons older than 21 years: a population-based study in South Carolina, 1998-2012. Top Spinal Cord Inj Rehabil, 2015, 21(4): 333-344.
47. Chamberlain JD, Deriaz O, Hund-Georgiadis M, et al. Epidemiology and contemporary risk profile of traumatic spinal cord injury in Switzerland. Inj Epidemiol, 2015, 2(1): 28.
48. Knútsdóttir S, Thórisdóttir H, Sigvaldason K, et al. Epidemiology of traumatic spinal cord injuries in Iceland from 1975 to 2009. Spinal Cord, 2012, 50(2): 123-126.

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