Spinal Cord Injuries:
Facts and Figures at a Glance
It is estimated that the annual incidence of spinal cord injury (SCI), not including those who die at the scene of the accident, is approximately 40 cases per million population in the U. S., or approximately 11,000 new cases each year. Since there have not been any overall incidence studies of SCI in the U.S. since the 1970's it is not known if incidence has changed in recent years.
The number of people in the United States who are alive today and who have SCI has been estimated to be between 721 and 906 per million population. This corresponds to between 183,000 and 230,000 persons. Note: Incidence and prevalence statistics are estimates obtained from several studies. These statistics are not derived from the National SCI Database.
Age at injury
SCI primarily affects young adults. Fifty-five percent of SCIs occur among persons in the 16 to 30 year age group, and the average age at injury is 32.1 years. Since 1973 there has been an increase in the mean age at time of injury. Those who were injured before 1979 had a mean age of 28.6 while those injured after 1990 had a mean age of 35.3 years. Another trend is an increase in the proportion of those who were at least 61 years of age at injury. In the 1970's persons older than 60 years of age at injury comprised 4.7% of the database. Since 1990 this has increased to 10%. This trend is not surprising since the median age of the general population has increased from 27.9 years to 35.3 years during the same time period.
Overall, 81.6% of all persons in the national database are male. Although this four-to-one male to female ratio has varied little throughout the 25 years of the Model Systems data collection, since 1990, the percentage of males has decreased to 80.5% (from 81.8% in the 1970's).
A significant trend over time has been observed in the racial distribution of persons in the Model System database. Among persons injured between 1973 and 1978, 77.5% of persons in the database were Caucasian, 13.5% were African-American, 5.7% were Hispanic, 2% were American Indian and 0.8% were Asian. However, among those injured since 1990 only 59.1% were Caucasian, while 27.6% were African-American, 7.7% were Hispanic, 0.4% were American Indian, 2.1% were Asian (and 0.5% were unknown and 2.5% were unclassified).
Since 1990, motor vehicle crashes account for 38.5% of the SCI cases reported. The next largest contributor is acts of violence (primarily gunshot wounds), followed by falls and recreational sporting activities. Interesting trends in the database show the proportions of injuries due to motor vehicle crashes and sporting activities have declined while the proportion of injuries from acts of violence and falls has increased steadily since 1973. The graph shows the percentage breakdown of causes. For text description of graph click here.
Etiology of SCI Since 1990
Vehicular Crashes: 38.5%
More than half (56.9%) of those persons with SCI admitted to a Model System reported being employed at the time of their injury. The post-injury employment picture is better among persons with paraplegia than among their tetraplegic counterparts. By post-injury year 10, 31.9% of persons with paraplegia are employed, while 24.4% of those with tetraplegia are employed during the same year.
Today 88.7% of all persons with SCI who are discharged alive from the system are sent to a private, noninstitutional residence (in most cases their homes before injury.) Only 4.8% are discharged to nursing homes. The remaining are discharged to hospitals, group living situations or other destinations.
Considering the youthful age of most persons with SCI, it is not surprising that most (53.4%) are single when injured. Among those who were married at the time of injury, as well as those who marry after injury, the likelihood of their marriage remaining intact is slightly lower when compared to the uninjured population. The likelihood of getting married after injury is also reduced.
Length of stay
Overall, average days hospitalized in the acute care unit for those who enter a Model System immediately following injury has declined from 26 days in 1974 to 16 days in 1999. Similar downward trends are noted for days in the rehab unit, from 115 days to 44 days. Overall, mean days hospitalized (during acute care and rehab) were greater for persons with neurologically complete injuries.