Epidemiological profile of people with spinal cord injury in Ecuador: A population-based design and cohort profile

This study serves a methodological reference and provides epidemiological profile for Ecuador's first population-based survey on spinal cord injury. We determined sample size and eligibility using data from the National Council for Disability Equality. The survey was developed with translation, cultural adaptation, and pilot testing. In collaboration with the National Federation of People with Physical Disabilities of Ecuador, data were collected. Participants were classified by SCI etiology and severity to describe the cohort profile. Additionally, incidence and mortality rates from 2017 to 2022 were estimated using hospital discharge data. The survey involved 633 individuals, with a final cohort of 521 eligible participants, 75.2% of whom were male. The mean age was 45 years. Traumatic SCIs constituted 83.4% of cases, with 80.8% being paraplegic. The median age at onset was 27 years, and participants had lived with the injury for a median of 14 years. Traffic accidents were the leading cause of traumatic injuries (36.1%), followed by violence (16.6%) and work accidents (15.9%). Nontraumatic injuries primarily resulted from spinal degeneration (31.4%) and infections (29.1%). Traumatic injuries were more common in younger males, while nontraumatic injuries were more frequent among older females. Annually, Ecuador sees 516 new SCI cases, equating to three cases per 100,000 people, with a hospital mortality rate during the acute period of 3%. This study presents the first national epidemiological profile of SCI in Ecuador, showing that injuries predominantly affect young individuals, primarily due to traffic accidents. The findings highlight areas for intervention and provide valuable insights into data collection and rehabilitation strategies for future research.