Epidemiological characteristics of traumatic spinal cord injury in China: a meta-analysis

English Keywords:Traumatic spinal cord injury  Epidemiology  Meta-analysis

English Abstract:

  【Abstract】 Objectives: To evaluate the epidemiological characteristics of traumatic spinal cord injury(TSCI) in China by meta-analysis. Methods: PubMed, The Cochrane Library, Web of TSCIence, Wanfang databases, VIP citation databases(VIP) and China national knowledge infrastructure(CNKI) were searched to retrieve studies published from August 31, 2017 to February 28, 2023. Studies on the epidemiological characteristics of TSCI in China and related complications and combined injuries were collected. Data such as incidence, age, male/female ratio, etiology proportion, injury segment and injury degree were extracted. Two researchers independently searched and screened the literature, extracted data, and evaluated the quality of the literature included in the study according to AHRQ(Agency for Healthcare Research and Quality) cross-sectional study evaluation criteria. Stata 17.0 software was used for a meta-analysis of single arm research data and integrating various epidemiological data, and the analysis results were represented by forest maps. Results: A total of 21 Chinese and English literature were included. Meta-analysis results showed that the annual incidence of TSCI in China was 0.06‰[95%CI(0.04‰-0.08‰)], males were more than females with a gender ratio of (1.86-4.73)∶1, and the average age of patients was 32.09-53.92 years old. The main causes of TSCI in China were high fall(30%), traffic accident(31%), and low fall(25%). The main injury sites of TSCI patients in China were cervical(55%) and thoracic(21%) segments. The severity of TSCI damage was more of grade A(30%) and grade D(38%) as assessed according to the American Spinal Injury Association(ASIA) classification. The probability of combined injuries in Chinese TSCI patients was 56%[95%CI(45%-67%)], including mainly head injuries and limb fractures. The probability of complications after TSCI was 31%[95%CI(24%-38%)], mainly respiratory system infection and urinary system infection. Conclusions: At present, the incidence rate of TSCI in China is high, and low falls and traffic accidents are the main causes. The damaged segment is mainly the cervical segment, and ASIA grade A and grade D account for the most. More than half of the patients have combined injuries to other parts of the body, and nearly 1/3 of the patients have complications after TSCI.