What is SCI?
Spinal Cord Injury (SCI) is a condition defined by damage to the spinal cord and associated nerves that results in a partial or complete loss of both mobility and/or sensation. It is estimated that approximately 250,000 individuals are currently living with SCI in the United States, with around 11,000 persons sustaining new spinal cord injuries every year.
The major causes of SCI are automotive and athletic accidents, violence, falls, and industrial or work-related injuries. Incidence of SCI due to automotive accidents has been declining steadily for several years. The most rapidly growing cause of SCI is now violence. Diving accidents are the most common sports-related SCI cause.
Types of SCI
Spinal cord injuries are typically classified as paraplegic or tetraplegic and their effect can be described as complete or incomplete. Paraplegia is described as an SCI that results in substantial loss of mobility or sensation in the legs and feet, but full or partial use or sensation in the arms and hands. In contrast, tetraplegia occurs when an SCI results in the substantive loss of sensation or motion in all four major limbs.
Often, these terms can also be used more rigidly and quantitatively to define the area where spinal cord injuries occur. In paraplegia, damage to the spinal cord is confined to the lower chest or back. In tetraplegia, the injury is typically sustained in the upper back or neck.
The terms complete and incomplete refer to the degree of sensation and motion lost by the injured individual. An SCI that results in total loss of sensation and motion below the area of damage is considered complete. Incomplete injuries result in partial sensation or limited motion below the area of damage. Among the various categories of SCI, incomplete tetraplegia is the most common type of injury and complete tetraplegia the least common.
Demographic Profile of SCI
The vast majority of those with SCI are men (82%). Non-Hispanic Whites are the most heavily represented ethnic/racial group among those with SCI, and Asian Americans are among the least represented. The average individual with SCI is 31 years of age, but most injuries occur between 16 and 30 years of age. The average age at time of injury is 33 years, but the most frequent age at time of injury is 19.
Financial Trends in SCI
At the time of injury, a little more than half of SCI patients (53%) have private health insurance. About 5% receive health care under Medicare and 25% of individuals are covered by Medicaid. Many newly-injured persons are covered under vocational rehabilitation programs (12%) or worker's compensation programs (14%).* Upon release from the acute care setting, 43% of individuals with SCI continue to have long-term coverage through private insurance. Medicaid covers 31% and Medicare 25% of those with SCI. Worker's compensation and vocational rehabilitation continue to cover 11% and 16% of injured individuals, respectively.
The average lifetime cost of living and health care expenses for a person with paraplegia (age of injury = 25) is $428,000. The average lifetime cost for a person with tetraplegia (age of injury = 25) is $1.35 million. These costs do not include loss of wages due to lost worker productivity which may result from an SCI. These costs vary widely depending on level of injury, education and pre-injury work experience.
Life Trends in SCI
Upon release from acute care institutions, 89% of those with SCI are discharged to a residential setting (usually their homes before injury). Approximately 4% of patients are discharged to a skilled nursing facility. The remaining individuals are transferred to another hospital or group home.
Individuals with SCI are less likely to get married or stay married as compared to non-injured persons. Approximately 88% of those with SCI are still single after 5 years of injury, compared to 65% among the non-SCI population. Individuals with SCI are also much more likely to be unemployed than their non-SCI cohorts. Eight years after injury, only 34% of those with paraplegia are employed. Less than a quarter of individuals with tetraplegia are employed after 8 years.
Survival rates are lower among those sustaining spinal cord injuries. In the 10-year period following injury, individuals with SCI have 13.3% greater chance of dying than someone without SCI. The leading cause of death in persons with SCI is respiratory ailment.
For more information on spinal cord injury statistics, visit the Spinal Cord Injury Information Network on the Internet at: http://www. spinalcord.uab.edu/
*With regard to both acute and long-term care, many individuals with SCI are covered through multiple entities.
