When walking is bad for your back: a cohort study of risk factors for traumatic spinal injury in Abuja

Abstract

Introduction: this study evaluates characteristics and risk factors of traumatic spinal injuries (TSIs) treated at a trauma center in Abuja, Nigeria.
TSIs are a global concern. They are frequently disabling, leading to economic, workforce, and quality of life strain. Little is known of the epidemiology
of TSIs in Nigeria. Methods: data were collected from National Hospital Abuja's trauma registry on 3025 patients treated at the hospital between
2014 and 2017. Patient characteristics were compared between spinal and nonspinal injury groups. Multiple logistic regression was used to identify
risk factors of TSIs. Results: 15% (452) of all injuries were spinal. Road traffic crashes were a significantly greater cause of spinal (77.4%) than
nonspinal (59.4%) injuries (p=0.0001). Pedestrians were involved in 19% (356) of total crashes, occupying a significantly larger proportion of spinal
(18.6%) than nonspinal (10.6%) injuries (p=0.0001). Three variables were modeled as risk factors of crash-related TSIs: mode of transportation,
age, and gender. Only mode of transportation demonstrated statistical significance, with involvement as a pedestrian showing an adjusted odds ratio
of 1.38 (95% confidence interval: 1.03-1.85, p=0.0329). Conclusion: determining characteristics and risk factors of TSIs is an essential step in
addressing this health concern in Nigeria. Crashes are a significant cause of TSIs, and a quarter of TSI patients involved in a crash are pedestrians.
Involvement in a crash as a pedestrian is associated with high risk of TSI. These results can help guide both the development of spinal injury
prevention policies and the allocation of resources.