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Pediatric spinal cord injury in Sweden: incidence, etiology and outcome
Insights
Pediatric traumatic spinal cord injury (SCI) is rare in Sweden due to effective prevention. While traffic accidents are a major cause of fatalities, sports injuries are common among survivors. Care requires further specialization.
Area of Science:
- Pediatric Traumatology
- Epidemiology
- Public Health
Background:
- Traumatic spinal cord injury (SCI) in children presents unique challenges in incidence, causes, and outcomes.
- Effective preventative strategies and specialized care are crucial for improving outcomes in pediatric SCI.
- Understanding the specific risk factors and injury patterns is essential for targeted interventions.
Purpose of the Study:
- To determine the incidence and causes of traumatic spinal cord injury (SCI) in children (0-15 years) in Sweden between 1985-1996.
- To identify high-risk pediatric populations and situations to inform preventative measures.
- To assess the early outcomes and care patterns for pediatric SCI survivors.
Main Methods:
- A retrospective descriptive study utilizing population registers, habilitation center data, and informal sources.
- Data verification through hospital contacts, medical record reviews, and personal interviews.
- Identification of 92 pediatric SCI cases over a 12-year period (1985-1996).
Main Results:
- The overall incidence of pediatric SCI was 4.6 per million children per year; excluding prehospital fatalities, it was 2.4 per million.
- Traffic accidents were the leading cause of fatal injuries, while sports injuries and traffic accidents were equally common causes among survivors aged 10-15.
- Associated injuries were present in 41% of cases, and survivors received care across 18 different hospitals.
Conclusions:
- Pediatric SCI in Sweden is infrequent, likely due to successful primary prevention efforts.
- Preventative strategies should be tailored to specific age groups based on distinct risk profiles.
- Current care for pediatric SCI patients is fragmented and decentralized, necessitating improved specialization and centralization.
Study Design:
Retrospective descriptive study.
Objectives:
To assess incidence, causes and early outcome of traumatic spinal cord injury (SCI) among children in Sweden, thereby identifying high-risk groups and situations as a basis for preventative measures and improved care.
Methods:
Data from population registers, County Habilitation Centers as well as from informal sources were used to estimate the incidence of SCI in Sweden during the years 1985-1996 among children aged 0-15 years. Contacts with the treating hospitals, reviews of medical records and/or personal interviews were used to verify primary data. In total, 92 children were thus identified.
Results:
The incidence was found to be 4.6/million children/year (95% CI 3.6-5.5). When excluding prehospital fatalities, the incidence was 2.4 (95% CI 1.8-3.1). The main cause of injury among fatalities was traffic accidents. Associated injuries occurred in 41% of the children. Among survivors (10-15 years), sports-related injuries (43%) were as common a cause as traffic accidents (39%). The survivors were treated in 18 different hospitals.
Conclusion:
Pediatric SCI in Sweden is rare, presumably because of effective primary prevention. Preventative measures should be further differentiated for each age group of children in accordance with their differing risk profiles. In contrast to the effective preventative measures that have been implemented in Sweden, care of these patients is still too fractionated and decentralized for sufficient specialization to emerge.
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