Who Gets Traumatic Spinal Cord Injury? - A Finnish Tertiary Trauma Centre Study

Elina Luoto^1*Eerika Koskinen¹Tuomo Thesleff²Heikki Mäntymäki²Jaakko Långsjö³Esa Jämsen⁴Teemu M. Luoto⁵

• ¹Tampere University Hospital, Department of Neurology, Wellbeing Services County of Pirkanmaa, Tampere, Finland
• ²Tampere University Hospital, Department of Neurosurgery, Wellbeing Services County of Pirkanmaa, Tampere, Finland
• ³Tampere University Hospital, Department of Intensive Care, Wellbeing Services County of Pirkanmaa, Tampere, Finland
• ⁴Faculty of Medicine (Clinicum), University of Helsinki, and Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
• ⁵Tampere University Hospital and Tampere University, Department of Neurosurgery, Wellbeing Services County of Pirkanmaa, Tampere, Finland

ABSTRACT Study design: Prospective cohort study. Objectives: To characterize patients with a new traumatic spinal cord injury and their pre-injury profiles. Setting: Tampere University Hospital, Finland. Methods: Newly injured patients (n=46, male=89%, mean age=66y) with an acute cervical or thoracic traumatic spinal cord injury (TSCI) were recruited. They were evaluated and interviewed within 72h postinjury. Health and medication history was gathered by interview and from electronic medical records. The International Standards for Neurological Classification of Spinal Cord Injury were used to classify the neurological consequences of TSCI. Epidemiological characteristics were recorded according to the International SCI Core Data Sets. Results: The leading causes of injury were low-level falls (48%), high-level falls (26%), and transport accidents (15%). Among patients >60 years, 63% were injured by low-level falls. Tetraplegia occurred in 87% of patients >60, compared to 63% ≤60 years. AIS D was the most common injury grade (44%). Complete injuries were seen in 38% of younger patients and 17% of older patients. Most patients had prior medication (72%) and at least one diagnosed disease (87%), both increasing in the older group. Overweight and low physical activity were common pre-injury characteristics. Alcohol preceded injury in 37% of cases. Low-level falls mostly caused cervical injuries (96%) and the patients seemed to have more diseases, fall-risk-increasing drugs and reduced physical activity levels compared to other etiologies. Conclusions: Low-level falls, particularly in older patients, were the leading cause of TSCI, often resulting in incomplete tetraplegia. Age-specific prevention strategies, especially fall prevention for older adults, are essential.