A description of nonfatal spinal cord injury using a hospital-based registry.

To formulate an epidemiologic description of West Virginia spinal cord injury (SCI) resulting in hospitalization, we used data collected during the West Virginia Spinal Cord Injury Registry's first three years of operation, July 1985 through June 1988, supplemented by data from registries in neighboring states. The West Virginia registry was established to detect newly injured persons potentially in need of rehabilitation services. Because reporting is hospital based, the registry records only injured patients surviving until hospitalization. The overall incidence of hospitalized SCI patients was 25 per million per year; the sex-specific rate among men was 4.6 times the rate among women. Age-specific rates peaked in the 15-24 years age group and declined with increasing age. Motor vehicle crashes accounted for 69% of all hospitalized SCI; falls, for 21%; and sports, falling objects, and violence, for less than 10% each. Most cause-specific incidence rates were highest for young males; however, falls were more common for the elderly. At least 25% of victims used drugs or alcohol shortly before injury, and none injured in auto or truck crashes reported wearing seat belts. Quadriplegia resulted for 56% of recorded SCI patients, whereas paraplegia resulted for the remaining 44%. SCI was more common in the summer months, on weekends, and during late afternoon hours. Both neurologic deficit and time of occurrence varied by cause. Although limitations exist, registry data has proved useful in describing spinal cord injury in West Virginia and has potential public health use in guiding prevention programs.