Traumatic and non-traumatic spinal cord impairment in New Zealand: incidence and characteristics of people admitted to spinal units

Abstract

This paper estimates the incidence (all ages) of spinal cord neurological impairment (SCI; traumatic and non-traumatic) in New Zealand and describes pre-SCI characteristics and early post-SCI outcomes for participants (16–64 years) in this longitudinal study. Demographic and clinical data on all people admitted to New Zealand's two spinal units (mid-2007 to mid-2009) were included for the estimate of incidence. Participants in this longitudinal study were asked at first interview about pre-SCI socio-demographic, health and behavioural characteristics, and about post-SCI symptoms, general health status (EQ-5D) and disability (WHODAS 12-item). Age-adjusted incidence rates (95% CI) for European, Māori, Pacific and ‘Other’ ethnicities were 29 (24–34), 46 (30–64), 70 (40–100) and 16 (9–22) per million, respectively. Interviews with 118 (73%) participants (16–64 years), occurred 6.5 months post-SCI. Most reported bother with symptoms, and problems with health status and disability. Compared with Europeans, the incidence of SCI is high among Māori and particularly high among Pacific people. Six months after SCI, proximate to discharge from the spinal units, considerable symptomatic, general health and disability burden was borne by people with SCI.

Socioeconomic outcomes following spinal cord injury and the role of no-fault compensation: longitudinal study

“…We have previously reported that participants were less likely to be of Ma %ori and Pacific ethnicity than non-participants. 1 The mean time from date of SCI to first interview was 6.5 months (median 6.4; inter-quartile range (IQR) 4.8-7.6 months). Of the 118 participants completing the first interview, 103 (87%) were followed-up to the second interview (mean 16.6 months; median 16.5; IQR 15.0-17.6 months-hereafter referred to as 18-month interview), and 91 (77%) to the third interview (mean 31.5 months; median 30.2; IQR 29.2-32.8 months-referred to as 30-month interview).…”

“…In New Zealand, we have estimated the incidence of SCI as 30/million/year, but age-adjusted rates are higher among Ma %ori (the indigenous population), 46/million, and especially Pacific people, 70/million. 1 Loss of employment and income consequent to SCI can lead to a decline in socioeconomic status, the amplification of disadvantage, and inability to meet the extra costs associated with disability. [2][3][4] One purpose of social security systems is to protect against financial difficulties in times of unemployment due to illness and injury.…”

Migrants and disability following injury: findings from a prospective study in New Zealand

“…16 A spinal cord injury study found that a greater percentage of participants (including New Zealand European, Māori, Pacific and Other ethnicities) reported moderate, severe or extreme difficulties to perform daily activities and participations (measured by the WHODAS) at six months post-injury. 17 Even people of the same ethnicity may have different patterns of pre-injury characteristics and use of healthcare services, depending on whether they were born in New Zealand or overseas. A qualitative study conducted among 113 Asians (including claimants and nonclaimants of the ACC, community leaders, and healthcare providers) in Auckland found that barriers to accessing the ACC and injury-related healthcare services were personal or cultural factors (e.g.…”

“…Previous analyses of the Prospective Outcome of Injury Study (POIS) – a New Zealand population‐based prospective cohort study – found the risk of disability measured by the World Health Organization Disability Assessment Schedule (WHODAS) was 22% higher among Pacific compared to non‐Pacific participants at three months post‐injury 16 . A spinal cord injury study found that a greater percentage of participants (including New Zealand European, Māori, Pacific and Other ethnicities) reported moderate, severe or extreme difficulties to perform daily activities and participations (measured by the WHODAS) at six months post‐injury 17 . Even people of the same ethnicity may have different patterns of pre‐injury characteristics and use of healthcare services, depending on whether they were born in New Zealand or overseas.…”

Pacific peoples three months after injury: a comparison of outcomes between Pacific and non‐Pacific participants in a NZ cohort study

“…4,6 Pacific peoples in NZ have a high incidence of head injury and spinal cord impairment (60% attributed to injury). 7,8 Pacific rugby players have been found to be at an increased risk of sustaining injuries compared to players of Māori descent. 9 Qualitative research focused upon injury among Pacific workers in the Manukau manufacturing industry identified high injury reporting rates.…”