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, 谭爱春, 等.我国类风湿关节炎疾病负担和生存质量研究的系统评价.中国循证医学杂志, 2013, 13(3): 300-307.
7.	杨文清. 1 089例住院脊髓损伤患者的流行病学分析. 福州: 福建医科大学, 2015.
8.	卫波. 2005年北京市脊髓损伤流行病学初步调查研究. 北京: 首都医科大学, 2007.
9.	于铁强. 2007年天津市区外伤性脊髓损伤流行病学调查. 天津: 天津医科大学, 2010.
10.	王含飞. 安徽省两家医院的创伤性脊髓损伤的流行病学特征分析. 合肥: 安徽医科大学, 2013.
11.	郝春霞, 李建军, 周红俊, 等. 1 264例住院脊髓损伤患者的流行病学分析.中国康复理论与实践, 2007, 13(11): 1011-1013.
12.	郝定均, 贺宝荣, 闫亮, 等. 2011–2013年西安市红会医院脊柱脊髓损伤患者流行病学特点.中华创伤杂志, 2015, 31(7): 632-636.
13.	姜京城, 朱立强, 叶超群, 等. 423例脊髓损伤住院患者特征分析.中国康复理论与实践, 2012, (7): 665-668.
14.	李建军, 周红俊, 洪毅, 等. 2002年北京市脊髓损伤发病率调查.中国康复理论与实践, 2004, 10(7): 412-413.
15.	徐春归, 顾锐, 王天兵, 等. 1 274例脊柱创伤患者的流行病学分析.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. 长沙: 南华大学, 2015.
17.	胡光宇, 汤华丰, 唐林安.上海市松江县脊柱脊髓损伤流行病学调查.中国脊柱脊髓杂志, 1992, (4): 177-179.
18.	钮晟佳. 苏州市脊髓损伤患者流行病学分析及相关因素研究. 苏州: 苏州大学, 2016.
19.	陈军, 陈伯华.外伤性脊髓损伤251例临床资料分析.中国社区医师(医学专业半月刊), 2009, 11(19): 69.
20.	茹庆超. 大连市脊髓损伤流行病学调查研究. 大连: 大连医科大学, 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.	杨枭雄, 于前进, 秦江, 等.脊髓损伤住院患者1 027例流行病学分析.脊柱外科杂志, 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, 杨志勇, 等.脊柱脊髓损伤流行病学特点分析和手术疗效探讨.中华创伤骨科杂志, 2008, 10(3): 245-248.
32.	潘杰, 李昕, 曾诚, 等. 2005–2007年上海市浦东新区脊柱脊髓损伤调查分析.同济大学学报(医学版), 2009, (5): 131-135.
33.	唐智生. 221例住院脊髓损伤患者流行病学调查及相关因素的分析. 南宁: 广西医科大学, 2011.
34.	陈银海, 刘敏, 何井华.脊髓损伤患者流行病学调查.实用医学杂志, 2011, 27(6): 1032-1034.
35.	邓磊, 尚晖, 常巍, 等.脊柱脊髓损伤患者424例流行病学分析.中国临床研究, 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. 创伤性脊髓损伤的相关因素研究. 中国骨与关节杂志, 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.中国的地理分区.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.	Bjørnshave 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, 谭爱春, 等.我国类风湿关节炎疾病负担和生存质量研究的系统评价.中国循证医学杂志, 2013, 13(3): 300-307.
7. 杨文清. 1 089例住院脊髓损伤患者的流行病学分析. 福州: 福建医科大学, 2015.
8. 卫波. 2005年北京市脊髓损伤流行病学初步调查研究. 北京: 首都医科大学, 2007.
9. 于铁强. 2007年天津市区外伤性脊髓损伤流行病学调查. 天津: 天津医科大学, 2010.
10. 王含飞. 安徽省两家医院的创伤性脊髓损伤的流行病学特征分析. 合肥: 安徽医科大学, 2013.
11. 郝春霞, 李建军, 周红俊, 等. 1 264例住院脊髓损伤患者的流行病学分析.中国康复理论与实践, 2007, 13(11): 1011-1013.
12. 郝定均, 贺宝荣, 闫亮, 等. 2011–2013年西安市红会医院脊柱脊髓损伤患者流行病学特点.中华创伤杂志, 2015, 31(7): 632-636.
13. 姜京城, 朱立强, 叶超群, 等. 423例脊髓损伤住院患者特征分析.中国康复理论与实践, 2012, (7): 665-668.
14. 李建军, 周红俊, 洪毅, 等. 2002年北京市脊髓损伤发病率调查.中国康复理论与实践, 2004, 10(7): 412-413.
15. 徐春归, 顾锐, 王天兵, 等. 1 274例脊柱创伤患者的流行病学分析.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. 长沙: 南华大学, 2015.
17. 胡光宇, 汤华丰, 唐林安.上海市松江县脊柱脊髓损伤流行病学调查.中国脊柱脊髓杂志, 1992, (4): 177-179.
18. 钮晟佳. 苏州市脊髓损伤患者流行病学分析及相关因素研究. 苏州: 苏州大学, 2016.
19. 陈军, 陈伯华.外伤性脊髓损伤251例临床资料分析.中国社区医师(医学专业半月刊), 2009, 11(19): 69.
20. 茹庆超. 大连市脊髓损伤流行病学调查研究. 大连: 大连医科大学, 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. 杨枭雄, 于前进, 秦江, 等.脊髓损伤住院患者1 027例流行病学分析.脊柱外科杂志, 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, 杨志勇, 等.脊柱脊髓损伤流行病学特点分析和手术疗效探讨.中华创伤骨科杂志, 2008, 10(3): 245-248.
32. 潘杰, 李昕, 曾诚, 等. 2005–2007年上海市浦东新区脊柱脊髓损伤调查分析.同济大学学报(医学版), 2009, (5): 131-135.
33. 唐智生. 221例住院脊髓损伤患者流行病学调查及相关因素的分析. 南宁: 广西医科大学, 2011.
34. 陈银海, 刘敏, 何井华.脊髓损伤患者流行病学调查.实用医学杂志, 2011, 27(6): 1032-1034.
35. 邓磊, 尚晖, 常巍, 等.脊柱脊髓损伤患者424例流行病学分析.中国临床研究, 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. 创伤性脊髓损伤的相关因素研究. 中国骨与关节杂志, 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.中国的地理分区.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. Bjørnshave 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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