Epidemiology and functional dependence of spinal cord injury survivors in Pakistan: a prospective study

Abstract

Objective: To assess the epidemiology of traumatic spinal cord injury survivors in Pakistan, and to investigate the level of functional dependence of patients on their caregivers.

Method: The cross-sectional study was conducted from January 2021 to June 2023 after approval from the institutional ethics review board of the National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan, and comprisedpatients with spinal cord injury. Data was collected from spinal units of various public and private hospitals across the country. Demographic data, nature of injury, neurological level, aetiological factors of the injury, and functional dependence of patients were noted. Modified Barthel Index was used to measure the level of functional independence of the patients. Data was analysed using SPSS 26.

Results: Of the 205 patients, 121(59%) were males and 84(41%) were females. The overall mean age was 37.82±21.17 years, with 84(41%) being young adults, 50(26.3%) middle adults and 30(14.6%) adolescents. The most common cause was fall 74(36.1%), followed by road traffic accidents 64(30.2%), firearm injuries 40(19.5%) and sports injuries 11(5.4%). Majority of the patients had quadriplegic nature of injury 115(56.1%), involved cervical region 114(55.6%) and had American Spinal Injury Association neurological level A 152(74.1%). Total functional dependence was noted in 154(75.9%) cases.

Conclusion: In view of the specific epidemiology of spinal cord injury in Pakistani patients, it is crucial to develop a national registry for such patients.

Key Words: Epidemiology, Functional dependence, Rehabilitation, Spinal cord injuries.