Epidemiologic Aspects of Spinal Cord Trauma Cases among Traffic Accident Victims

  • Maria Aparecida De Freitas Silveira
  • Tatiana Farias Teódulo Palitot
  • Alessandro Leite Cavalcanti
  • Gláucia de Souza Abreu
  • Liege Helena Freitas Fernandes
  • Cibele da Cruz Prates
  • Gabriela Pereira Batista
  • Priscilla Maria da Silva Nascimento
  • Elaine Cristina Batista Tavares
  • Marcia Maria Almeida da Silva


Objective: To describe and analyze characteristics of cases of spinal cord Trauma (SCT) among traffic accident victims admitted to a referral hospital.

Method: Descriptive, analytical, cross-sectional study with quantitative approach, developed in the city of Campina Grande, in the state of Paraíba, Brazil. The population consists of 1,884 medical records of patients admitted to hospital after damage caused by traffic accidents from January to December 2016. Data were analyzed using descriptive and inferential statistics, adopting a significance level of 5%.

Results: Among the victims of traffic accidents, there was a male predominance (85.4%). The most affected age group was 21 to 30 years (29%). Accidents involving motorcyclists were predominant (82.9%) and 43 victims (2.3%) suffered spinal injury. Among these ones, there was a prevalence of males (86%), in the age group between 21 and 30 years (35.7%). In 30 cases (69.8%), the victims had spinal injuries. The cervical level (55.8%) was dominant. In addition, 46.7% of the victims were classified as ASIA and there were 9 cases (30%) of paraplegia and 1 case (3.3%) of tetraplegia. A bivariate analysis revealed a significant association between the variable presence of SCT and type of accident (p <0.001), use of cervical collar (p <0.005), injuries in other anatomical regions (p <0.001), surgical treatment (p < 0.001) and outcome of the patient’s situation (p <0.005).

Conclusions: Among the victims of traffic accidents and SCT there was a predominance of males, young individuals and motorcyclists.

Keywords: Epidemiology. Traffic-accidents. Public health. Spinal injuries. Spinal cord trauma.


1. Selassie A, Cao Y, Saunders LL. Epidemiology of traumatic spinal cord injury among person older than 21 years: a population-based study in South Carolina, 1998-2012. Top Spinal Cord Inj Rehabil. 2015 Nov;21(4):333-344. doi: 10.1310/sci2104-333. PubMed PMID: 26689698; PubMed Central PMCID: PMC4750818.

2. Jain NB, Ayers GD, Peterson EN, Harris MB, Morse L, O’Connor KC et al. Traumatic Spinal Cord Injury in the United States, 1993–2012. JAMA. 2015 Jun;313(22):2236-2243. doi: 10.1001/jama.2015.6250. PubMed PMID: 26057284; PubMed Central PMCID: PMC4712685.

3. World Health Organization [Online]. International perspectives on spinal cord injury. Malta; 2013 [cited in February 18, 2018]. Available at: http://apps.who.int/iris/bitstream/10665/94190/1/9789241564663_eng.pdf?ua=1.

4. Craig A, Tran Y, Guest R, Gopinath B, Jagnoor J, Bryant RA et al. Psychological impact of injuries sustained in motor vehicle accidents: systematic review and meta-nalysis. BMJ Open. 2016 Sep;6(9):e011993. doi:10.1136 / bmjopen-2016-011993. PubMed PMID: 27609849; PubMed Central PMCID: PMC5020848.

5. Munakomi S, Bhattarai B, Cherian L. Prospective observational research on the clinical profile and outcome analysis among a cohort of patients sustaining traumatic cervical spine and cord injury in a peripheral tertiary spine care centre in Nepal. F1000Res. 2017 Nov;6:1957. doi:10.12688/f1000research.12911.1. PubMed PMID: 29250317; PubMed Central PMCID: PMC5701450.

6. Wang H, Liu X, Zhao Y, Ou L, Zhou Y, Li C et al. Incidence and pattern of traumatic spinal fractures and associated spinal cord injury resulting from motor vehicle collisions in China over 11 years. Medicine (Baltimore). 2016 Out;95(43):e5220.
doi:10.1097/MD.0000000000005220. PubMed PMID: 27787384; PubMed Central PMCID: PMC5089113.

7. Moshi H, Sundelin G, Sahlen K-G, Sörlin A. Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively. Glob Health Action. 2017 Aug;10(1):1355604. doi: 10.1080/16549716.2017.1355604. PubMed PMID: 28856978; PubMed Central PMCID: PMC5645664.

8. Sabre L, Rekand T, Asser T, Kõrv J. Mortality and causes of death after traumatic spinal cord injury in Estonia. J Spinal Cord Med. 2013 Nov;36(6):687–694. doi:10.1179/2045772313Y.0000000120. PubMed PMID: 24090049; PubMed Central PMCID: PMC3831332.

9. Verma V, Singh A, Singh GK, Kumar S, Sharma V, Kumar A et al. Epidemiology of trauma victims admitted to a level 2 trauma center of North India. Int J Crit Illn Inj Sci. 2017 Jun;7(2):107-112. doi:10.4103/IJCIIS.IJCIIS_27_16. PubMed PMID: 28660164; PubMed Central PMCID: PMC5479072.

10. Kalfópulos BZ, González AJ, Sánchez AR, Ortiz RR, Aldana EEC, Olivarez LMR. Demographic and clinical characteristics of patients with spinal cord injury: a single hospital-based study. Spinal Cord. 2016 Nov;54(11):1016-1019. doi:10.1038/sc.2016.41. PubMed PMID:27067655.

11. Singh A, Tetreault L, Kalsi-Ryan S, Nouri A, Fehlings MG. Global prevalence and incidence of traumatic spinal cord injury. Clin Epidemiol. 2014 Set;309-331.
doi: 10.2147/CLEP.S68889. PubMed PMID: 25278785; PubMed Central PMCID: PMC4179833.

12. Fakharian E, Mohammadzadeh M, Saberi HR, Fazel MR, Rejali M, Akbari H et al. Spine injury resulting from the car accident: focus on prevention. Asian J Neurosurg. 2017 Abr-Jun;12(2):180-184. doi: 10.4103/1793-5482.152110. PubMed PMID: 28484526; PubMed Central PMCID: PMC5409362.

13. Lin W, Gong L, Xia M, Dai W. Prevalence of posttraumatic stress disorder among road traffic accident survivors. A PRISMA-compliant meta-analysis. Medicine (Baltimore). 2018 Jan;97(3):e9693. doi: 10.1097/MD.0000000000009693. PubMed PMID: 29505023; PubMed Central PMCID: PMC5779792.

14. Copanitsanou P, Drakoutos E, Kechagias V. Posttraumatic stress, depressive emotions, and satisfaction with life after a road traffic accident. Orthopaedic Nursing. 2018 Jan;37(1):43-53. doi: 10.1097/NOR.0000000000000417. PubMed PMID: 29369134.

15. Ramadani N, Zhjeqi V, Berisha M, Hoxha R, Begolli I, Salihu D et al. Public health profile of road traffic accidents in Kosovo 2010-2015. Maced J Med Sci. 2017 Dec;5(7):1036–1041. doi: 10.3889/oamjms.2017.214. PubMed PMID: 29362641; PubMed Central PMCID: PMC5771275.

16. Instituto Brasileiro de Geografia e Estatística [Online]. Censo Demográfico 2010 [cited in February 12, 2016]. Available at: https://cidades.ibge.gov.br/brasil/pb/campina-grande/panorama.

17. Governo da Paraíba [Online]. Hospital de Trauma de Campina Grande realiza 47 mil atendimentos no primeiro semestre; 2016 [cited in February 12, 2018]. Available at: http://paraiba.pb.gov.br/hospital-de-trauma-de-campina-grande-realiza-47-mil-atendimentos-no-primeiro-semestre/.

18. Ministério dos Transportes [Online]. Departamento Nacional de Estradas de Rodagem. Diretoria de Desenvolvimento Tecnológico. Glossário de termos técnicos rodoviários; 1997 [cited in February 13, 2018]. Available at: http://www1.dnit.gov.br/arquivos_internet/ipr/ipr_new/manuais/DNER-700-GTTR.pdf.

19. Romero DE, Cunha CB. Avaliação da qualidade das variáveis sócio-econômicas e demográficas dos óbitos de crianças menores de um ano registrados no Sistema de Informações sobre Mortalidade do Brasil (1996/2001). Cad. Saúde Pública. 2006 Mar [cited in March 14, 2018];22(3). Available at: http://www.scielosp.org/pdf/csp/v22n3/22.pdf.

20. Romero DE, Cunha CB. Avaliação da qualidade das variáveis epidemiológicas e demográficas do Sistema de Informações sobre Nascidos Vivos, 2002. Cad. Saúde Pública. 2007 Mar [cited in March 14, 2018];23(3). Available at: http://www.scielo.br/pdf/csp/v23n3/28.pdf.

21. World Health Organization – WHO [Online]. Malta: International perspectives on spinal cord injury; 2013 [cited 2018 Mar 04]. Available at: http://apps.who.int/iris/bitstream/10665/94190/1/9789241564663_eng.pdf?ua=1.

22. Mascarenhas MDM, Souto RMCV, Malta DC, Silva MMA, Lima CM, Montenegro MMS. Characteristics of motorcyclists involved in road traffic accidents attended at public urgent and emergency services. Ciênc. saúde coletiva. 2016 Dez;21(12).

23. Wiedemann K, Naujoks F, Wörle J, Kenntner-Mabiala R, Kaussner Y, Neukum A. Effect of different alcohol levels on take-over performance in conditionally automated driving. Accid Anal Prev. 2018 Jun;115:89-97. doi: 10.1016/j.aap.2018.03.001. PubMed PMID:29550612.

24. Ghaffari-fam S, Sarbazi E, Daemi A, Sarbazi MR, Nikbakht HA , Salarilak S. The Epidemilogical Characteristics of Motorcyclists Associated Injuries in Road Traffics Accidents; A Hospital-Based Study. Bull Emerg Trauma. 2016 Oct [cited 2018 Feb 20];4(4):223-229. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5118575/.

25. Corassa RB, Falci DM, Gontijo CF, Machado GVC, Alves PAB. Evolução da mortalidade por causas externas em Diamantina (MG), 2001 a 2012. Cad. saúde colet. 2017 Out;25(3).

26. Organização das Nações Unidas [Online]. Ruas e estradas do Brasil estão entre as mais perigosas do mundo, alerta Banco Mundial; 2015 [cited in March 4, 2018]. Available at: https://nacoesunidas.org/ruas-e-estradas-do-brasil-estao-entre-as-mais-perigosas-do-mundo-alerta-banco-mundial/.

27. Martin J-L, Gadegbeku B, Wu D, Viallon V, Laumon B. Cannabis, alcohol and fatal road accidents. PLoS One. 2017 Nov;12(11):e0187320.
DOI: 10.1371/journal.pone.0187320. PubMed PMID: 29117206; PubMed Central PMCID: PMC5678710

28. Golias ARC, Caetano R. Accidents between motorcycles: analysis of cases that occurred in the state of Paraná between July 2010 and June 2011. Cienc. Saude Coletiva. 2013 Maio [cited 2018 Feb 20];18(5):1235-46. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232013000500008&lng=en&nrm=iso&tlng=en.

29. Bacchieri G, Barros AJD. Acidentes de trânsito no Brasil de 1998 a 2010: muitas mudanças e poucos resultados. Saude Publica. September 2011 [cited in February 20, 2018];45(5):949-963. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102011000500017&lng=en&nrm=iso&tlng=pt.

30. Pavanitto DR, Menezes RAM, Nascimento LFC. Accidents involving motorcycles and potential years of life lost. An ecological and exploratory study. São Paulo Med J. 2018 Jan [cited 2018 Mar 10];136(1):4-9. Available at: http://www.scielo.br/pdf/spmj/2018nahead/1806-9460-spmj-1516-3180-2017-0098070817.pdf.

31. Vasconcelos EA. Risco no trânsito, omissão e calamidade [livro eletrônico]: impactos do incentivo à motocicleta no Brasil. São Paulo: Ed. do Autor; 2013 [cited in march 5, 2018]. Available at: http:// http://files-server.antp.org.br/_5dotSystem/download/dcmDocument/2013/08/29/0D2E1C9E-38D9-478A-A24D-BB121A3A295A.pdf.

32. Departamento Nacional de Trânsito [online]. Frota de veículos, por tipo e com placa, segundo as Grandes Regiões e Unidades da Federação. Statistical reports - 2013 to 2015 - [cited in March 4, 2018]. Available at: http://www.denatran.gov.br/estatistica/237-frota-veiculos.

33. World Health Organization [Online]. Geneva: Global status report on road safety 2015; 2015 [cited 2018 Mar 06]. Available at: http://www.who.int/violence_injury_prevention/road_safety_status/2015/Summary_GSRRS2015_POR.pdf?ua=1.

34. Bolandparvaz S, Yadollahi M, Abbasi HR, Anvar M. Injury patterns among various age and gender groups of trauma patients in southern Iran: A cross-sectional study. Medicine (Baltimore). 2017 Out; 96(41):e7812. doi:10.1097/MD.0000000000007812. PubMed PMID: 29019874; PubMed Central PMCID: PMC5662297.

35. Sherafati F, Homaie-Rad E, Afkar A, Gholampoor-Sigaroodi R, Sirusbakht S. Risk Factors of Road Traffic Accidents Associated Mortality in Northern Iran; A Single Center Experience Utilizing Oaxaca Blinder Decomposition. Bull Emerg Trauma. 2017 Apr [cited 2018 Apr 3];5(2):116-121. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406182/

36. Mahdian M, Sehat M, Fazel MR, Akbari H, Rahimi H, Mohammadzadeh M. Road traffic deaths in Kashan region, Iran: An eight-year study (2006-2013). Chin J Traumatol. 2018 Fev;21(1):54-57. doi: 10.1016/j.cjtee.2017.05.004. PubMed PMID: 29426796; PubMed Central PMCID: PMC5835547.

37. Salari M, Kazemnejad A, Zayeri F. Using Growth Mixture Modeling for Clustering Asian and North African Countries on the Road Injury Death Trend (1990-2010). Oman Med J. 2017 Set; 32(5):417-424. doi: 10.5001/omj.2017.78. PubMed PMID: 29026474; PubMed Central PMCID: PMC5632695.

38. Ladeira RM, Malta DC, Morais Neto OL , Montenegro MMS, Soares Filho AM , Vasconcelos CH et al. Road traffic accidents: Global Burden of Disease study, Brazil and federated units, 1990 and 2015. Rev Bras Epidemiol. 2017 May [cited 2018 Feb 21];20(supl 01):157-170. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1415-790X2017000500157&lng=en&nrm=iso&tlng=en.

39. Bazeli J, Aryankhesal A, Khorasani-Zavareh D. Epidemiology of special incidents: Results from national mortality and morbidity registry and the associated factors in Iran in 2014. Electron Physician. 2017 Aug;9(8):5113–5121. doi: 10.19082/5113. PubMed PMID: 28979750; PubMed Central PMCID: PMC5614300.

40. Ekeke ON, Okonta KE. Trauma: a major cause of death among surgical inpatients of a Nigerian tertiary hospital. Pan Afr Med J. 2017 Sep;28:6.
doi: 10.11604/pamj.2017.28.6.10690. PubMed PMID: 29138652; PubMed Central PMCID: PMC5681011

41. Charry JD, Ochoa JD, Tejada JH, Navarro-Parra SL, Esquivel N, Vasques Y. Education in trauma: An educational alternative that promotes injury prevention. Chin J Traumatol. 2017 Oct;20(5):275-277. doi: 10.1016/j.cjtee.2017.04.006. PubMed PMID: 28684038; PubMed Central PMCID: PMC5831044

42. Ramadani N, Zhjeqi V, Berisha M, Hoxha R, Begolli I, Salihu D et al. Public Health Profile of Road Traffic Accidents in Kosovo 2010-2015. Maced J Med Sci. 2017

43. Lalwani S, Singh V, Trikha V, Sharma V, Kumar S, Bagla R et al. Mortality profile of patients with traumatic spine injuries at a trauma center in India. Indian J Med Res. 2014 Jul [cited 2018 Mar 16]; 140(1):40-45. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4181158/

44. Choi J-H, Park PJ, Din V, Sam N, Iv V, Park KB. Epidemiology and Clinical Management of Traumatic Spine Injuries at a Major Government Hospital in Cambodia. Spine J Asian. 2017 Dez;11(6):908-916. doi: 10.4184 / asj.2017.11.6.908. PubMed PMID: 29279746; PubMed Central PMCID: PMC5738312
Dec;5(7):1036-1041. doi: 10.3889/oamjms.2017.214. PubMed PMID: 29362641; PubMed Central PMCID: PMC5771275

45. Nulle A, Tjurina U, Erts R, Vetra A. A profile of traumatic spinal cord injury and medical complications in Latvia. Spinal Cord Ser Cases. 2017 Dez;3:17088.
doi: 10.1038/s41394-017-0002-2. PubMed PMID: 29423294; PubMed Central PMCID: PMC5798906.

46. Commichou C, Marrotta JT, Janjua N. Lesões Raquianas. In. Rowland LP. Merritt. Tratado de neurologia. 11. ed. Rio de Janeiro: Guanabara Koogan; 2007. p. 466-473.

47. Mcswain Jr NE et al. Atendimento pré-hospitalar ao traumatizado, PHTLS/NAEMT [Tradução Renata Scavone et. al.] 7. ed. Rio de Janeiro: Elsevier; 2011.

48. Resolução CONTRAN nº 518 de 29/01/2015. DOU 06/02/2015 [cited in March 6, 2018]. Available at: http://imprensanacional.gov.br/.

49. Chamberlain JD, Deriaz O, Hund-Georgiadis M, Meier S, Scheel-Sailer A, Schubert M et al. Epidemiology and contemporary risk profile of traumatic spinal cord injury in Switzerland. Injury Epidemiology. 2015 Dez;2(1):28. doi: 10.1186/s40621-015-0061-4. PubMed PMID: 26550554; PubMed Central PMCID: PMC4630259.

50. Smeltzer SC, Bare BG. Brunner & Suddarth: Tratado de Enfermagem Médico-Cirúrgica. 12. ed. Rio de Janeiro: Guanabara Koogan; 2011.

51. DeVivo M, Biering-Sørensen F, Charlifue S, Noonan V, Post M, Stripling et al. International data set of spinal cord lesions. Spinal Cord. 2006 Sep [cited 2018 Feb 16];44:535-540. Available at: https://www.nature.com/articles/3101958.

52. Andrade SSCA, Jorge MHPM. Hospitalization due to road traffic injuries in Brazil, 2013: hospital stay and costs. Epidemiol Serv Saude. 2017 Mar [cited 2018 apr 11];26(1):31-38. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-96222017000100031&lng=en&nrm=iso&tlng=en.

53. Pincus D, Wasserstein D, Nathens AB, Bai YQ, Redelmeier DA, Wodchis WP.
Direct medical costs of motorcycle crashes in Ontario. CMAJ. 2017 Nov [cited 2018 Apr 11];189(46):E1410-E1415. Available at: http://www.cmaj.ca/content/189/46/E1410.

54. Seerig LM, Bacchieri G, Nascimento GG, Barros AJ, Demarco FF. Use of motorcycle in Brazil: users profile, prevalence of use and traffic accidents occurrence - a population-based study. Cien Saude Colet. 2016 Dec [cited 2018 Apr 12];21(12):3703-3710. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232016001203703&lng=en&nrm=iso&tlng=en

55. Kuo SCH, Kuo P-J, Rau C-S, Chen Y-C, Hsieh H-Y, Hsieh C-H. The protective effect of helmet use in motorcycle and bicycle accidents: a propensity score–matched study based on a trauma registry system. BMC Public Health. 2017 Aug;17:639. doi: 10.1186/s12889-017-4649-1. PubMed PMID: 28784110; PubMed Central PMCID: PMC5545860

56. Mukherjee S, Abhinav K, Revington PJ. A review of cervical spine injury associated with maxillofacial trauma at a tertiary referral center in the UK. Ann R Coll Surg Engl. 2015 Jan;97(1):66-72. doi: 10.1308/003588414X14055925059633. PubMed PMID: 25519271; PubMed Central PMCID: PMC4473904.

57. Bárbara-Bataller E, Méndez-Suárez JL, Alemán-Sánchez C, Sánchez-Enríquez J, Sosa-Henríquez M. Change in the profile of traumatic spinal cord injury over 15 years in Spain. Scand J Trauma Resusc Emerg Med. 2018 Apr;26(1):27. doi: 10.1186/s13049-018-0491-4. PubMed PMID: 29622032; PubMed Central PMCID: PMC5887209.

58. Sarrami P, Ekmejian R, Naylor JM, Descallar J, Chatterji R, Harris IA. Spine surgery outcome in patients who sought compensation after a motor vehicle accident: a retrospective cohort study. BMC Surg. 2016 Nov;16(1):76. doi: 10.1186/s12893-016-0192-8. PubMed PMID: 27871323; PubMed Central PMCID: PMC5116816.

59. Yu W, Chen H, Lv Y, Deng Q, Kang P, Zhang L. Comparison of influencing factors on outcomes of single and multiple road traffic injuries: A regional study in Shanghai, China (2011-2014). PLoS One. 2017 May;12(5):e0176907. doi:10.1371/journal.pone.0176907. PubMed PMID: 28493893; PubMed Central PMCID: PMC5426634

60. Tékpa BJD, Diemer HC, Issa Mapouka PA, Ndoma Ngatchokpo V, Gassima B, Nali MN. Mortality during road traffic accidents in Bangui, Central African Republic.
Med Sante Trop. 2017 Nov;27(4):426-430. doi: 10.1684/mst.2017.0745. PubMed PMID:29313512.

61. Ministério da Saúde [online]. Brasília: Diretrizes de Atenção à Pessoa com Lesão Medular; 2013 [cited in March 6, 2018]. Available at: http://bvsms.saude.gov.br/bvs/publicacoes/diretrizes_atencao_pessoa_lesao_medular.pdf.

62. Pan American Health Organization [online]. Acidentes de trânsito (news-sheet); 2016 [cited in March 7, 2018]. Available at: http://www.paho.org/bra/index.php?option=com_content&view=article&id=5147:acidentes-de-transito-folha-informativa&Itemid=779.
How to Cite
DE FREITAS SILVEIRA, Maria Aparecida et al. Epidemiologic Aspects of Spinal Cord Trauma Cases among Traffic Accident Victims. International Archives of Medicine, [S.l.], v. 13, mar. 2020. ISSN 1755-7682. Available at: <http://imedicalpublisher.com/ojs/index.php/iam/article/view/2919>. Date accessed: 20 jan. 2021. doi: https://doi.org/10.3823/2624.