@article{ref1,
title="Relationship between level of economic development, age and etiology of spinal cord injury: a cross-sectional survey from 22 countries",
journal="Archives of physical medicine and rehabilitation",
year="2021",
author="Tederko, Piotr and Middleton, James and Mycielski, Jerzy and Joseph, Conran and Pagliacci, Maria Cristina and Rapidi, Christina-Anastasia and Tarnacka, Beata and Kujawa, Jolanta",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE: To examine relationships between age and spinal cord injury (SCI) and cause of SCI, and how this depends on economic development. <br><br>DESIGN: Cross-sectional survey. SETTING: Community, 22 countries representing all stages of economic development. PARTICIPANTS: 12,591 adults with SCI. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Interactions between age at injury and Gross Domestic Product per capita based on purchasing power parity (GDP PPP) quartiles calculated with the application of logistic regression with the Maximum Likelihood estimator. Independence between SCI cause and age was assessed with the Wald test. <br><br>RESULTS: In persons with traumatic SCI younger age was associated with a higher likelihood of injury in traffic accidents, while older individuals had a greater chance of SCI due to falls. Associations between increased likelihood of high-energy traumatic SCI and younger age, low-energy traumatic SCI with older age, non-traumatic SCI with older age in persons injured in adulthood, and a higher prevalence of incomplete SCI lesions in individuals injured at an older age were revealed. Higher GDP PPP influenced positively the likelihood of low-energy SCI in older individuals and was negatively associated with the chance of sustaining SCI in traffic accidents and the likelihood of having non-traumatic SCI at an older age. <br><br>CONCLUSION: SCI in older age is predominantly due to falls and non-traumatic injuries. Higher country income is associated with an increased proportion of SCI sustained later in life, due to low-energy trauma involving cervical injury, and a lower chance of being due to traffic accidents. An increased prevalence of NT SCI in older individuals associated with lower country income may reflect a higher exposure to socially preventable conditions and lower access to or efficacy of health care. Future studies on etiology of SCI should make the distinction between low and high falls and overcome underrepresentation of elderly persons.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2021.04.024",
url="http://dx.doi.org/10.1016/j.apmr.2021.04.024"
}