Rehabilitation of spinal cord injury in France: a nationwide multicentre study of incidence and regional disparities

Study design: Multicentre retrospective 1-year survey during 2000. Objectives: To describe the network of physical medicine and rehabilitation units in France that care for people with traumatic spinal cord injuries (SCI), and secondly, to evaluate the incidence of SCI persons who have postinjury rehabilitation care. Setting: Every rehabilitation unit involved in rehabilitation of SCI patients in metropolitan France. Methods: During the first phase of the survey, a questionnaire was used to list the rehabilitation units that treat SCI people among a total of 380 centres. An additional survey was then carried out on a sample of 30 units that did not answer this questionnaire. In the second phase, the units involved were asked about the number of SCI patients received for a first rehabilitation stay during the year 2000 and their demographic and clinical characteristics. The incidence was calculated on the basis of the population census in metropolitan France aged 15 years, above. Results: Of the 275 respondent units, 148 declared that they treat SCI people on a regular or occasional basis. The survey on the sample of 30 randomly selected nonrespondents enabled us to estimate that 10% of the 105 nonrespondent units were concerned. Among the 148 units contributing to the study, 131 identified all the SCI patients received during the year 2000. After a series of adjustments, an extrapolation for all of metropolitan France leads to an annual incidence of 19.4 SCI persons per million inhabitants, or 934 new cases per year. Conclusion: This is the first nationwide survey aiming to estimate the incidence of SCI patients in France. The finding is based on the incidence of SCI persons treated in rehabilitation units. It therefore concerns the incidence of patients who will remain severely disabled. Sponsorship: Association Francophone Internationale des Groupes d'Animation de la Paraplegie ( AFIGAP) and the Institut de Recherche sur la Moelle Epiniere (IRME) and the Association des Paralyses de France (APF).