People With Spinal Cord Injuries Prone To Premature Death: WHO Report

WHO Spinal Cord Injuries 120313

People with spinal cord injuries are two to five times more likely to die prematurely, with worse survival rates in low- and middle-income countries, says a new report by the World Health Organization (WHO).

As many as 500,000 people suffer a spinal cord injury each year, it is estimated.

The report, titled "International perspectives on spinal cord injury," summarizes the best available evidence on the causes, prevention, care and lived experience of people with spinal cord injury.

The report was developed in association with the International Spinal Cord Society and Swiss Paraplegic Research, and launched on the occasion of the International Day of Persons with Disabilities, which falls on December 3.

Males are most at risk of spinal cord injury between the ages of 20-29 years and 70 years and older, while females are most at risk between the ages of 15-19 years and 60 years and older. Studies report male to female ratios of at least 2:1 among adults.

Up to 90 percent of spinal cord injury cases are due to traumatic causes such as road traffic crashes, falls and violence. Variations exist across regions. For example, road accidents are the main contributor to spinal cord injury in the African Region (nearly 70 percent of cases) and the Western Pacific Region (55 percent of cases) and falls the leading cause in the South-East Asia and Eastern Mediterranean Regions (40 percent of cases). Non-traumatic spinal cord injury results from conditions such as tumors, spina bifida, and tuberculosis. A third of non-traumatic spinal cord injury is linked to tuberculosis in sub-Saharan Africa.

Most people with spinal cord injury experience chronic pain, and an estimated 20-30 percent show clinically significant signs of depression. People with spinal cord injury also risk developing secondary conditions that can be debilitating and even life-threatening, such as deep vein thrombosis, urinary tract infections, pressure ulcers and respiratory complications.

Spinal cord injury is associated with lower rates of school enrollment and economic participation. Children with spinal cord injury are less likely than their peers to start school, and once enrolled, less likely to advance. Adults with spinal cord injury face similar barriers to socio-economic participation, with a global unemployment rate of more than 60 percent. Spinal cord injury carries substantial individual and societal costs.

Many of the consequences associated with spinal cord injury do not result from the condition itself, but from inadequate medical care and rehabilitation services, and from barriers in the physical, social and policy environments that exclude people with spinal cord injury from participation in their communities. Full Implementation of the Convention on the Rights of Persons with Disabilities is urgently required to address these gaps and barriers.

"Spinal cord injury is a medically complex and life-disrupting condition," notes Dr. Etienne Krug, Director of WHO's Department of Violence and Injury Prevention and Disability. "However, spinal cord injury is preventable, survivable, and need not preclude good health and social inclusion," according to him.

Essential measures for improving the survival, health and participation of people with spinal cord injury are detailed in the report.

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