title: Contemporary trends in the epidemiology of traumatic spinal cord injury: changes in age and etiology.
abstract: BACKGROUND
  Epidemiological features of spinal cord injury (SCI) have been changing over the last decades. We evaluated the contemporary trends in the epidemiology of traumatic SCI patients from a rehabilitation center.
  
  
  METHODS
  In a cross-sectional study, a consecutive series of 348 patients with traumatic SCI were evaluated. Variables were collected through an epidemiological form, which included gender, age at injury, duration and cause of SCI. We investigated SCI epidemiological trends over time including the association between gender and age at injury with SCI features such as etiology, injury severity and level.
  
  
  RESULTS
  The mean age at SCI has increased from 26.0 ± 11.8 in patients with SCI before 2003 to 37.9 ± 15.7 in those with SCI after 2009 (p < 0.001). Gunshot wounds were the main cause of injury in patients with SCI before 2003, dropping from 40.6 to 16.9% after 2009 and being surpassed by road traffic injuries (38.6%) and falls (31.4%) after 2009 (p < 0.001). Gender, SCI severity and level have not changed significantly over the time.
  
  
  CONCLUSIONS
  There was a major increase in the average age of patients as well as changes in the etiology of SCI over the past fifteen years, including a significant decrease in gunshot wounds and an increase in the frequency of road traffic injuries and falls. These changes and accompanying risk factors must be taken into consideration when planning measures to prevent SCI.
authors.affiliation: Division of Urology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil.
authors.forename: Carlos Henrique Suzuki
authors.initials: CH
authors.lastname: Bellucci
authors.forename: Jose Everton de
authors.initials: JE
authors.lastname: Castro Filho
authors.forename: Cristiano Mendes
authors.initials: CM
authors.lastname: Gomes
authors.forename: José de
authors.initials: Jd
authors.lastname: Bessa Junior
authors.forename: Linamara Rizzo
authors.initials: LR
authors.lastname: Battistella
authors.forename: Daniel Rubio de
authors.initials: DR
authors.lastname: Souza
authors.forename: Márcia
authors.initials: M
authors.lastname: Scazufca
authors.forename: Homero
authors.initials: H
authors.lastname: Bruschini
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
authors.forename: Tarcisio E P
authors.initials: TE
authors.lastname: Barros Filho
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000209:etiology*