Spinal Cord Injury in Mississippi

STUDY DESIGN: The Mississippi spinal cord injury surveillance system is both active and passive, designed to capture all cases of spinal cord injury through mandated reporting by multiple sources. Each case is confirmed by medical record review. OBJECTIVES: To describe the development of a state-wide spinal cord injury surveillance system, discuss findings from the system, and evaluate sensitivity. SUMMARY OF BACKGROUND DATA: In the United States, the annual incidence rate of spinal cord injury requiring hospital admission has been estimated at 32-50 per million. With prehospital fatalities included, the estimated incidence rate ranges from 43 to 55 per million population annually. METHODS: In the current study all cases identified during the first 2 years of operation of the spinal cord injury (SCI) system were included. To evaluate the sensitivity of the system, International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes from each hospital's discharge database were used. RESULTS: The incidence rate among patients in hospitals and prehospital fatal cases was 77 per million. The rate for patients in hospitals was 59 per million. The incidence rate of spinal cord injury among males was 4.4 times higher than among females. Rates of spinal cord injury were highest among persons 20-24 years of age. Rates were similar for whites and blacks. The most frequent causes of spinal cord injury were motor vehicle collisions, violence, and falls. Additional cases were identified during the evaluation, resulting in a 94% sensitivity. CONCLUSIONS: Mississippi's spinal cord injury incidence rates are substantially higher than rates reported for other states except Alaska. The surveillance system was found to be very complete. Prevention efforts should focus on increasing safety belt usage, increasing alcohol awareness, and reducing violence.