Spinal cord injury in Mississippi - Findings and evaluation, 1992-1994

Study Design. The Mississippi spinal cord injury surveillance system is bot h active and passive, designed to capture all cases of spinal cord injury t hrough mandated reporting by multiple sources. Each case is confirmed by me dical record review. Objectives. To describe the development of a statewide spinal cord injury s urveillance system, discuss findings from the system, and evaluate sensitiv ity. Summary of Background Data. In the United States, the annual incidence rate of spinal cord injury requiring hospital admission has been estimated at 3 2-50 per million. With prehospital fatalities included, the estimated incid ence 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 eval uate 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 fat al 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 m ost frequent causes of spinal cord injury were motor vehicle collisions, vi olence, and falls. Additional cases were identified during the evaluation, resulting in a 94% sensitivity. Conclusions. Mississippi's spinal cord injury incidence rates are substanti ally higher than rates reported for other states except Alaska. The surveil lance system was found to be very complete. Prevention efforts should focus on increasing safety belt usage, increasing alcohol awareness, and reducin g violence.