Epidemiological survey of cervical spinal cord injury in China from 1990 to 2019

English Keywords:Cervical spinal cord injury  Epidemiological survey  Global Burden of Diseases, Injuries, and Risk Factors Study 2019  Incidence  Prevalence

English Abstract:

  【Abstract】 Objectives: To study the epidemiological features such as incidence, prevalence, etiology, geographical distribution and annual trends of cervical spinal cord injury(CSCI) in China from 1990 to 2019. Methods: Data from the Global Burden of Diseases, Injuries, and Risk Factors Study(GBD) 2019 were used to estimate the incidence, prevalence, age-standardized incidence and age-standardized prevalence of CSCI in China. The data of 33 provincial-level administrative regions excluding Taiwan(including 31 provinces/autonomous regions/municipalities directly under the Central Government, Hong Kong and Macao Special Administrative Regions) provided by the National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention were used to systematically analyze the provincial etiology, geographical distribution and annual trends of CSCI. Results: From 1990 to 2019, the number of CSCI patients in China increased by 140.51%, from 1.034 million to 2.486 million, and the age-standardized prevalence increased from 0.09% to 0.13%. The prevalence of CSCI peaked at the age of 65-69 years old in 1990(male 50-54 years old, female 75-79 years old), and it peaked at 90-94 years old in 2019(male 65-69 years old, female 85-89 years old). In 2019, the age-standardized incidence and age-standardized prevalence rates were the highest in developed eastern provinces and cities, such as Zhejiang[11.44(7.34-17.48) per 100,000] and [212.00(196.52-229.10) per 100,000], Shanghai[10.84(7.15-16.24) per 100,000] and [226.43(209.93-246.36) per 100,000], and Jiangsu[9.68 (6.31-14.70) per 100,000] and [180.44(167.29-193.92) per 100,000]. In addition, the age-standardized incidence rate[0.79(0.64-0.92) per 100,000] and age-standardized prevalence rate[0.85(0.73-1.01) per 100,000] changed the most in Sichuan from 1990 to 2019. The main causes of CSCI in 2019 were low falls and road injuries, but the prevalence and specific causes varied by provinces. Conclusions: The disease burden of CSCI increased significantly in China in the past three decades, and it varied by regions. Given that falls and road injuries are the main causes of CSCI, precise prevention and treatment strategies should be formulated for patients in developed areas and elderly patients, so as to control and reduce the heavy burdens on individuals, families and society as soon as possible.