Traumatic spinal cord injury and concomitant brain injury: a cohort study

Objective - To assess the temporal trends in the incidence and demographic characteristics of traumatic spinal cord injury (TSCI) with clinical concomitant traumatic brain injury (TBI), in an unselected, geographically defined cohort, 1952-2001. Material and methods - The patients were identified from hospital records. TBI was classified as none, mild, moderate, and severe. Results - Of 336 patients, 157 (46.7%) patients had a clinical concomitant TBI. Clinical TBI was classified as mild in 30.1%, moderate in 11.0% and severe in 5.7%. The average annual incidence increased from 3.3 per million in the first decade to 10.7 per million in the last. Alcohol was the strongest risk factor of clinical TBI (OR = 3.69) followed by completeness of TSCI (OR = 2.18). Conclusions - The incidence of TSCI with concomitant TBI has increased during the last 50 years. Alcohol and completeness of injury are strong risk factors. Increased awareness of dual diagnoses is necessary.