Traumatic Spinal Cord Injury in Ontario, Canada

Abstract
Few population-based analyses of spinal cord injuries exist from which to base Canadian prevention initiatives. This study aimed to calculate rates of traumatic spinal cord injury for the province of Ontario and describe these injuries by several epidemiologic parameters. Two thousand three hundred eighty-five hospital admissions were studied for April 1, 1994, through March 31, 1999. Annual age-standardized rates declined from a maximum of 46.2 hospitalizations per 1 million population (95% confidence interval, 42.1-50.3) to 37.2 per 1 million (95% confidence interval, 33.8-41.0). Male rates declined over the study period, whereas female rates remained stable. Leading external causes included unintentional falls (1,030 of 2,385 [43.2%]), especially among the elderly, and transport injuries (1,021 of 2,385 [42.8%]), especially among those aged less than 40 years. Intentional injuries were most commonly seen among those aged 20 to 39 years (48 of 86 [55.8%]). Misclassification of some elder fall cases as spinal cord injuries is a methodologic concern. The results indicate the relative importance of several external causes of injury and are useful in establishing rational priorities for prevention.