A National Cross-Sectional Survey on Community Spinal Cord Injury Patient Profiles, Health-Related Quality of Life and Support Services in China: Implications for Healthcare and Rehabilitation

Abstract

Abstract Background Spinal cord injury (SCI) is defined as a damage to the spinal cord that causes serious and permanent changes in function; it has a high incidence, high cost, high disability rate and adult onset and has become a global health priority. National epidemiological data on SCI in China are available for only a limited number of provinces and are mostly outdated. Therefore, the aim of this study was to provide a national cross-sectional investigation of epidemiological data on individuals with SCI in China. Methods A total of 3055 SCI patients aged 8–78 years were included in this cross-sectional study, which was conducted between May 2023 and September 2023. We collected detailed information, including general demographic characteristics, employment status, etiology, years lived with disability (YLD), family structure, caregiving status, income, available health insurance, paralysis type, and health-related quality of life (HRQoL). Descriptive statistics and Kolmogorov‒Smirnov analyses were also conducted to analyze demographic and injury features. The t test and Mann‒Whitney test were employed to evaluate differences across distinct groups. Logistic regression analysis was used to evaluate the associations between HRQoL and other factors. Results Overall, 88.89% of the survey respondents were aged 15 to 59 years. The male-to-female ratio was 2.36:1. The etiology of the disease varied: 45.36% of the quadriparesis cases were caused by car accidents, more than 1/3 (35.93%) of the paraplegia cases were caused by falls, and myelitis emerged as the leading cause of nontraumatic SCI. In terms of injury sites and paralysis type, 65.51% of the paraplegia patients had complete SCI, and 53.11% of the tetraplegia patients had incomplete SCI. Considering functional recovery, 9.58% of the patients reported improvement. A total of 50.28% of the respondents were unemployed. In addition, 75% of their income fell below both the national mean and median levels. Furthermore, the HRQoL was significantly lower in the SCI population than in the control group and was mainly affected by injury site, income and age (p < 0.05). Conclusions SCI patients in communities in China had low HRQoL and reemployment rates. Convenient and cost-effective community rehabilitation and vocational rehabilitation are conducive to promoting the reemployment of patients with SCI and reducing disease-related burdens, and national basic public medical services and sound healthcare systems are conducive to improving the HRQoL of individuals with SCI.