Sociodemographic and neurological profile of patients with spinal cord injury in a trauma hospital in Bangladesh

Traumatic spinal cord injury (TSCI) is a severe public health problem associated with long-term motor, sensory, and autonomic impairments, resulting in substantial physical, psychological, and socio-economic consequences for affected individuals and health systems [1, 2]. The global incidence of TSCI ranges from 15 to 40 cases per million population annually, with clear disparities between high-income countries and low- and middle-income countries (LMICs) [3]. Although improved safety measures have contributed to stable or declining trends in many developed settings, the burden of TSCI continues to increase in LMICs due to rapid urbanisation, expanding road traffic, inadequate enforcement of safety regulations, and persistent occupational hazards [4, 5].

In South Asia, including Bangladesh, reliable epidemiological data on TSCI remain limited because of under-reporting and weak health information systems. Available evidence suggests that falls and road traffic accidents are the leading causes of injury. Individuals with TSCI frequently experience long-term complications that necessitate prolonged and multidisciplinary rehabilitation. However, access to specialized rehabilitation services in resource-constrained settings is often insufficient, exacerbating disability, loss of productivity, and socioeconomic vulnerability for patients and their families.

Neurological classification is fundamental for assessing injury severity and guiding clinical management. Comprehensive data on the socio-demographic and neurological characteristics of TSCI patients in Bangladesh are scarce, particularly for injuries related to rural and occupational exposures. This lack of context-specific evidence limits the development of targeted prevention strategies and the effective allocation of healthcare resources. To address this gap, the present study aims to investigate the socio-demographic and neurological profiles of patients with TSCI admitted through the emergency department of a specialised hospital.

This cross-sectional study was conducted at the National Institute of Traumatology, Orthopaedics and Rehabilitation, Dhaka, the largest tertiary-level referral centre for trauma and rehabilitation in Bangladesh. Adult patients (aged = 18 years) with a confirmed diagnosis of TSCI admitted between June 2022 and November 2023 were included. Diagnosis was established through clinical evaluation and radiological investigations. Patients with non-traumatic spinal cord conditions, pre-existing neurological deficits that could confound assessment, or those who died before complete evaluation were excluded. A convenience sampling strategy was applied, enrolling all eligible patients admitted during the study period.

Patients were initially identified from hospital records and subsequently screened in the inpatient departments based on predefined eligibility criteria. After obtaining written informed consent, data were collected using a structured case record form by trained postgraduate residents in physical medicine and rehabilitation. Information was gathered through patient interviews, caregiver reports when required, clinical examinations, and review of medical records. Collected data included socio-demographic characteristics (age, sex, residence, and occupation), mechanism and level of injury, associated injuries, and time since injury.

Neurological assessment was performed within 24 hours of admission using the International Standards for Neurological Classification of Spinal Cord Injury, and injury severity was graded according to the Asia Impairment Scale. Participant confidentiality and anonymity were strictly maintained throughout the research process.

Data were analysed using SPSS statistics software. Descriptive statistics, including frequencies, percentages, means, and standard deviations, were used to summarize sociodemographic and clinical characteristics, while neurological profiles were presented by injury level and Impairment Scale grades.

Sociodemographic factors

A total of 182 patients with TSCI were analysed. Majority (63.7%) of them were examined within three days of the injury. The mean (standard deviation) of age was 38.0 (14.6) years; most patients were male (93%) and from rural areas (90%). One-third (32%) of them were farmers and one-fourth (24.7%) had no formal education. Fifteen per cent of them had injuries other than spinal injuries.