title: Epidemiology and contemporary risk profile of traumatic spinal cord injury in Switzerland.
abstract: BACKGROUND
  Traumatic spinal cord injury (TSCI) has a high personal and socio-economic impact. Effective public health prevention policies that aim to reduce this burden are reliant on contemporary information of the risk and underlying causes of TSCI. This study contextualizes Swiss annual incidence rates within the European context, and provides detailed estimates by age, gender and etiology towards informing targeted intervention strategies.
  
  
  METHODS
  TSCI cases that occurred in the years 2005 to 2012 were identified as part of the Swiss Spinal Cord Injury (SwiSCI) cohort study through a rehabilitation-based study of local medical files.
  
  
  RESULTS
  The crude annual incidence rate (IR) estimate of TSCI for the study period was 18.0 (95 % confidence interval 16.9-19.2) per one million population; standardized to the WHO world population IR was 21.7 (20.3-23.1) population. The injury rate of TSCI in Switzerland was intermediate in comparison to estimates for other European countries, which ranged from around 8.3 in Denmark to 33.6 per million in Greece. Males exhibited consistently higher IRs than females, with a highest IR ratio (IRR) of 3.9 (2.8-5.5) in young adults (aged 16 to 30). Sports and leisure and transport-related injuries were the predominant causes of TSCI in the youngest age group (aged 16 to 30); falls were the predominant cause among the oldest age group (76 years or over). With increasing age, a greater proportion of fall-related TSCIs were due to low-level falls, with more than 80 % of fall-related TSCIs due to low-level falls in the oldest age group.
  
  
  CONCLUSIONS
  Evidence suggests sports/leisure- and transport-related injuries in young men and falls among the elderly as prime targets for prevention policies and programs.
authors.affiliation: Swiss Paraplegic Research, Guido A. Zäch Strasse 4, CH-6207 Nottwil, Switzerland ; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
authors.forename: Jonviea D
authors.initials: JD
authors.lastname: Chamberlain
authors.affiliation: Clinique Romande de Réadaption (CCR) and Institut de recherche en réadaptation, Sion, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Deriaz
authors.affiliation: REHAB Basel, Basel, Switzerland.
authors.forename: Margret
authors.initials: M
authors.lastname: Hund-Georgiadis
authors.affiliation: Swiss Paraplegic Research, Guido A. Zäch Strasse 4, CH-6207 Nottwil, Switzerland.
authors.forename: Sonja
authors.initials: S
authors.lastname: Meier
authors.affiliation: Swiss Paraplegic Center, Nottwil, Switzerland ; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
authors.forename: Anke
authors.initials: A
authors.lastname: Scheel-Sailer
authors.affiliation: Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Schubert
authors.affiliation: Swiss Paraplegic Research, Guido A. Zäch Strasse 4, CH-6207 Nottwil, Switzerland ; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
authors.forename: Gerold
authors.initials: G
authors.lastname: Stucki
authors.affiliation: Swiss Paraplegic Research, Guido A. Zäch Strasse 4, CH-6207 Nottwil, Switzerland ; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
authors.forename: Martin Wg
authors.initials: MW
authors.lastname: Brinkhof
keywords: Chronic; Epidemiology; Incidence; Injury; Spinal cord injury