The report is available in English with a French summary - KCE

KCE reports 57 Musculoskeletal & Neurological Rehabilitation 27
Early hospital mortality after major lower extremity amputation is 7.6%, after minor lower
extremity amputation 0.8% 72 .
2.2.2.5 Spinal Cord Injury
INCIDENCE
In literature, it was not always explained that only spinal cord injuries surviving the acute
phase were included. This may influence the incidence data. Additionally, it was not always
mentioned whether it concerned traumatic or non-traumatic spinal cord injuries. Looking
at Figure 2.2, a difference in incidence of both causes is suspected. Indeed, the traumatic
spinal cord injuries represent 67.5%, the non-traumatic 32.5% 75 .
A recent (2006) review of the literature published since 1995 on Pubmed was performed.
The incidence of spinal cord injury in Europe ranges from 1.04 to 2.97 per 100 000 (based
on data of 7 studies). This is the lowest incidence compared to other continents, South-
America and Africa being excluded because no studies from these continents were found.
76
.
Incidence rates for males are consistently higher for females 77 ; 78 .
In older publications, the crude incidence of SCIs ranges from 1.21 to 5.78 per 100 000 79
; 80, 81, 77 ; 82 ; 83 ; 78 . The crude incidence of SCIs surviving the acute phase ranges from 1.04 to
4.43 per 100 000 79 ; 77 . The crude incidence of traumatic spinal cord injury : 1.27 per 100
000 population per year 84 . Some caution with the interpretation is needed because it
concerns an old publication (1978).
The age adjusted incidence rate is 1.45 per 100 000 per year 85, 86, 83, 87 . The age and gender
adjusted incidence rate ranges from 2.71 to 7.1 per 100 000 85 ; 81 .
The results concerning mean incidence of SCI in a European survey (experts were
contacted in 21 countries), published in the December 2006 Newsletter of ISCOS
(International Spinal Cord Society), showed an incidence of 1.75 per 100 000 inhabitants.
PREVALENCE
A recent (2006) review of the literature published since 1995 on Pubmed was performed.
The prevalence of SCI ranges from 28 to 68.1 per 100 000. These data are based on the
results of only 2 studies: Australia and Finland. 76
80, 88, 81, 82
In older publications, the prevalence of SCI ranges from 7.2 to 112 per 100 000
The prevalence of traumatic SCI ranges from 25 per 100 000 84 .
MEAN AGE AND MORTALITY
Spinal cord injuries appear mostly in the age interval 33 years to 50 years 78, 76 . Limited to
traumatic spinal cord injuries, the mean age is situated around 29 years 84, 89 .
2.3 CONCLUSION
Diagnoses were identified respecting some well defined criteria. During discussions with
an expert panel, stroke, total hip replacement, multiple sclerosis, lower extremity
amputation and spinal cord injury were selected to investigate more in detail in the course
of this project.
Of the five selected pathologies, stroke has the highest incidence but affects the oldest
part of the population (mostly after retirement) and has the highest mortality rate within
the first year after the incident. Moreover, stroke has a high recurrence rate. Of the
survivors, less then 50% is independent for activities of daily living afterwards. Only one
report presents data related to LOS and discharge destination which is too limited to
make conclusions.
Total hip replacement also affects a rather large population and concerns mostly older
individuals (after retirement). The crude incidence in Belgium is about 160 per 100 000