LAUSR

OBJECTIVE No previous large population-based studies of traumatic spinal injury (TSI) rates, trends, and patterns exist. We aimed to fill this knowledge gap on TSI epidemiology using a population-based study of 13 million people. METHODS This is a descriptive cross-sectional cohort study that analyzes a national, mandatory reporting database for all emergency departments (ED) and ambulatory care centers in Ontario over 15 years. Demographics of TSI, trends in the TSI rate, etiology, transfer, disposition, comorbidities, and associated traumatic brain injury (TBI) or spinal cord injury were analyzed. RESULTS There were 167,357 TSI-related ED visits resulting in 70,684 hospitalizations and 376 deaths. The overall rate of TSI significantly increased from 66.94 to 118.61 per 100,000. Females had higher rates of TSI. Older patients had higher rates of TSI, especially related to falls. Fall was found to be the commonest mechanism of TSI, while motor vehicle collisions scaled down to the third commonest mechanism of TSI. Sport-related TSI had the highest percentage of increase in the rate over all mechanisms (221%, P<0.001). TSI with associated TBI comprised 6% of the cohort but had the highest percentage increase (91%) in the rate compared to all other TSI forms. CONCLUSIONS The rate of TSI continues to rise in Ontario as the population ages. The rise is primarily attributed to a shift in the epidemiology and etiology of TSI from a younger male population toward an older female population with falls as the primary injury mechanism. Establishing preventive measures to address this shift is essential.