Trends in persisting cases of SCI

The assessment of the rate of persisting cases of SCI in 1996/97 was affected by missing information for 12 cases. Given that a neurological deficit is the predominant outcome of SCI cases referred to SUs, these 12 cases were included as persisting cases with an age distribution matching that of the reported cases. This enabled a national age adjusted rate to be estimated using direct standardisation, taking the Australian population in 1991 as the standard.

Based on the cases identified as having been discharged from a SU with a neurological deficit (229 cases), plus 12 missing cases, the age adjusted incidence rate of persisting cases of SCI in 1996/97 was estimated to be 13.2 per million of population in 1996/97. This was a slight decrease from 1995/96 (13.4 per million of population).

Figure 1 shows the age adjusted rate of persisting cases of SCI from 1986 to 1990 and 1995/96, as presented in the earlier 'Bulletin'1, and for 1996/97. It is evident that whilst there was no statistically significant difference in the rates of persisting SCI over the period, the reported values had been trending downwards to a small degree from 1988 to 1990 and from 1995/96 to 1996/97. In the absence of information for the period 1991 to 1994 it cannot be determined whether the trend has been uniformly downward from 1988 or whether it has been broken by the year to year fluctuations evident from 1986 to 1988. Registration of all cases incident in the period 1991 to 1994 would improve the utility of the ASCIR in monitoring changes in SCI incidence over time. This would be important for the development and assessment of national targets for SCI reduction. During the 1998 International Medical Society of Paraplegia (IMSOP) Australasian Branch meeting, SU Directors agreed to provide these data to the ASCIR.

Figure 1: Incidence of persisting SCI from traumatic causes by year, Australia 1996/97 (age adjusted rates)