Spinal cord injury in the context of major motor vehicle collision trauma: a retrospective ecological analysis of global estimates across income groups
摘要
Road traffic injuries (RTIs) are a leading cause of death globally, especially in low- (LICs) and middle-income countries (LMICs). Despite this burden, post-crash care remains underdeveloped. Many clinical principles of post-crash care focus on spinal cord injury (SCI), yet its incidence is poorly understood. The aim of this study was to describe the incidence of death and non-fatal RTI with a specific focus on SCIs using Global Burden of Disease (GBD) 2019 data.
MethodsA retrospective ecological analysis was conducted using GBD 2019 data for 204 countries and territories (2012–2019). We examined the MVC-related mortality, SCIs, and major non-fatal injuries stratified by income group and sex. Incidence rate ratios (IRRs) were compared across income groups using regression models. SCIs were analysed as a proportion of all non-fatal injuries across income groups.
ResultsMVC-related mortality incidence rates were significantly lower in high-income (HICs) [IRR 0.79 (95% CI: 0.69–0.91); p = 0.001], UMICs [IRR 0.72 (95% CI 0.63–0.82); p < 0.001], and LMICs [IRR 0.67 (95% CI: 0.59–0.76); p < 0.001] compared with LICs. SCIs accounted for ~ 0.5% of non-fatal injuries, with a significantly higher proportion in LICs (p < 0.001). Males consistently showed higher injury and mortality incidence rates than females.
ConclusionsSCIs from MVCs are relatively rare, but disproportionately affect LICs. Strengthening bystander response, developing context-specific post-crash protocol, and improving prehospital systems may reduce disparities and improve outcomes, especially in resource-limited settings.