ORCID
- Tim Nutbeam: 0000-0003-0814-9240
Abstract
Introduction: Road traffic injuries (RTIs) are a leading cause of death globally, especially in low- (LICs) and middle-income countries (LMICs). Despite this burden, post-crash care remains underdeveloped. Many clinical principles of post-crash care focus on spinal cord injury (SCI), yet its incidence is poorly understood. The aim of this study was to describe the incidence of death and non-fatal RTI with a specific focus on SCIs using Global Burden of Disease (GBD) 2019 data. Methods: A retrospective ecological analysis was conducted using GBD 2019 data for 204 countries and territories (2012–2019). We examined the MVC-related mortality, SCIs, and major non-fatal injuries stratified by income group and sex. Incidence rate ratios (IRRs) were compared across income groups using regression models. SCIs were analysed as a proportion of all non-fatal injuries across income groups. Results: MVC-related mortality incidence rates were significantly lower in high-income (HICs) [IRR 0.79 (95% CI: 0.69–0.91); p = 0.001], UMICs [IRR 0.72 (95% CI 0.63–0.82); p < 0.001], and LMICs [IRR 0.67 (95% CI: 0.59–0.76); p < 0.001] compared with LICs. SCIs accounted for ~ 0.5% of non-fatal injuries, with a significantly higher proportion in LICs (p < 0.001). Males consistently showed higher injury and mortality incidence rates than females. Conclusions: SCIs from MVCs are relatively rare, but disproportionately affect LICs. Strengthening bystander response, developing context-specific post-crash protocol, and improving prehospital systems may reduce disparities and improve outcomes, especially in resource-limited settings.
DOI Link
Publication Date
2025-12-27
Publication Title
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Volume
34
Issue
1
ISSN
1757-7241
Acceptance Date
2025-12-23
Deposit Date
2026-06-30
Additional Links
Keywords
Ecological analysis, Injury epidemiology, Post-crash care, Road Injury, Spinal cord injury
Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Nutbeam, T., Caterson, J., Saunders, C., Sawe, H., Jamaluddin, S., Roberts, I., Smith, J., Ambunda, P., & Stassen, W. (2025) 'Spinal cord injury in the context of major motor vehicle collision trauma: a retrospective ecological analysis of global estimates across income groups', Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 34(1). Available at: 10.1186/s13049-025-01536-7
