Tuomo Thesleff1, Tero Niskakangas2, Teemu M Luoto2, Juha Öhman2, Antti Ronkainen2. 1. Department of Neurosurgery, Tampere University Hospital, P.O. Box 2000, Tampere FI-33521, Finland. Electronic address: tuomo.thesleff@pshp.fi. 2. Department of Neurosurgery, Tampere University Hospital, P.O. Box 2000, Tampere FI-33521, Finland.
Abstract
BACKGROUND CONTEXT: The number of cervical spine injuries (CSIs) is increasing. Cervical spine injuries are associated with high morbidity and mortality. Identifying those who are at risk for CSI-related death can help develop national and international interventions and policies to reduce mortality. PURPOSE: This study aimed to determine the trends in the incidence and the characteristics of fatal CSIs in Finland over a 24-year study period from 1987 to 2010. STUDY DESIGN/ SETTING: A large nationwide, retrospective, register-based study was carried out. PATIENT SAMPLE: The population-based sample was collected from death certificates issued in Finland between 1987 and 2010. The death certificates were obtained from the official Cause-of-Death Register, coordinated by Statistics Finland, which covers all deaths occurring in Finland. OUTCOME MEASURES: Sociodemographics and injury- and death-related data were used for outcome measures. METHODS: All death certificates issued in Finland (1987-2010) containing a CSI as the cause of death were carefully reviewed. RESULTS: A total of 2,041 fatal CSIs were identified. These constituted 0.17% of all deaths in Finland within the study period. The average annual incidence of fatal CSIs was 16.5 per million (range: 12.5-21.2). The majority of the victims were male (72.9%) and had concurrent spinal cord injury (83.0%). Traffic accidents (40.1%) and falls (45.0%) were the most common injury mechanisms. Almost one-third (29.8%) of the deaths were alcohol-related. Among the young victims (<60 years) with upper CSI (C0-C2), the majority (91.8%) died within 24 hours post-injury. One-third of elderly victims' (≥60 years) CSI-related deaths occurred after 1 week post-injury and were mostly (74.2%) caused by respiratory and circulatory system diseases. Within the 24-year period, the incidence of fatal CSIs (+2/million), as well as the average age of sustaining a fatal CSI (+13.5 years), increased markedly. Fall-induced accidents among elderly males were the most prominently increasing subpopulation of fatal CSI victims. CONCLUSIONS: In recent decades, fatal CSI incidence (death certificate-based) has increased, being 18.6 per million in Finland in 2010. Victims of fatal CSIs tend to be older than in the past, and for a substantial number of males, low-energy falls lead to cervical trauma and death.
BACKGROUND CONTEXT: The number of cervical spine injuries (CSIs) is increasing. Cervical spine injuries are associated with high morbidity and mortality. Identifying those who are at risk for CSI-related death can help develop national and international interventions and policies to reduce mortality. PURPOSE: This study aimed to determine the trends in the incidence and the characteristics of fatal CSIs in Finland over a 24-year study period from 1987 to 2010. STUDY DESIGN/ SETTING: A large nationwide, retrospective, register-based study was carried out. PATIENT SAMPLE: The population-based sample was collected from death certificates issued in Finland between 1987 and 2010. The death certificates were obtained from the official Cause-of-Death Register, coordinated by Statistics Finland, which covers all deaths occurring in Finland. OUTCOME MEASURES: Sociodemographics and injury- and death-related data were used for outcome measures. METHODS: All death certificates issued in Finland (1987-2010) containing a CSI as the cause of death were carefully reviewed. RESULTS: A total of 2,041 fatal CSIs were identified. These constituted 0.17% of all deaths in Finland within the study period. The average annual incidence of fatal CSIs was 16.5 per million (range: 12.5-21.2). The majority of the victims were male (72.9%) and had concurrent spinal cord injury (83.0%). Traffic accidents (40.1%) and falls (45.0%) were the most common injury mechanisms. Almost one-third (29.8%) of the deaths were alcohol-related. Among the young victims (<60 years) with upper CSI (C0-C2), the majority (91.8%) died within 24 hours post-injury. One-third of elderly victims' (≥60 years) CSI-related deaths occurred after 1 week post-injury and were mostly (74.2%) caused by respiratory and circulatory system diseases. Within the 24-year period, the incidence of fatal CSIs (+2/million), as well as the average age of sustaining a fatal CSI (+13.5 years), increased markedly. Fall-induced accidents among elderly males were the most prominently increasing subpopulation of fatal CSI victims. CONCLUSIONS: In recent decades, fatal CSI incidence (death certificate-based) has increased, being 18.6 per million in Finland in 2010. Victims of fatal CSIs tend to be older than in the past, and for a substantial number of males, low-energy falls lead to cervical trauma and death.
Authors: Akram H Guirgis; Venugopal K Menon; Neelam Suri; Nilay Chatterjee; Emil Attallah; Maged Y Saad; Shereen Elshaer Journal: Sultan Qaboos Univ Med J Date: 2016-11-30
Authors: Elina Johansson; Teemu M Luoto; Aki Vainionpää; Anna-Maija Kauppila; Mauri Kallinen; Eija Väärälä; Eerika Koskinen Journal: Spinal Cord Date: 2020-11-04 Impact factor: 2.473