Burden of spinal cord injury in Tehran, Iran

Study Design: Investigation of burden of traumatic spinal cord injury (SCI) using disease modeling. Objectives: The present paper is intended to estimate the SCI burden for the year 2008. Setting: Tehran, capital of Iran. Methods: Epidemiological data needed to calculate Disability-Adjusted Life-Years (DALYs) for SCI, was estimated according to prevalence, duration and relative risk of mortality using DISMOD software. For DALY calculation, the years of life lost because of premature mortality (YLL) was added to the number of years lost because of disability (YLD). To calculate DALYs for SCI, first year DALY calculated separately and for the next years, the DALY was assessed for six different clinical presentations of traumatic SCI including quadriplegia, quadriparesis, paraplegia, paraparesis, hemiplegia and hemiparesis. Results: In first year following SCI, the DALY was 3772 years, which has 0.5 DALY per 1000 people and YLL/DALY was 89.3%. Following the first year, the DALY was 435 for quadriplegia, 163 for quadriparesis, 868 for paraplegia, 164 for paraparesis, 26 for hemiplegia and 14 for hemiparesis. The total YLL for traumatic SCI was 4077 years and total YLD was 1364 years (total YLL/DALY was 74.9%) and total DALY was 5441 years, (M/F=2.0), which has 0.7 DALY per 1000 people in Tehran in 2008. Conclusions: This study showed a high burden for SCI. Identifying the risk factors of SCI, and performing cost-effective preventive interventions for reducing burden of SCI is recommended.