Background Dynamics of incident traumatic accidents, a case in point being traumatic spinal cord injury (TSCI), have changed over the past forty years in many high income countries due to changes in demographic structure, lifestyle and policy. Rehabilitation following a TSCI can result in significant improvements and prolongation of life and reduced societal and personal burden. Monitoring contemporary and historical trends can help inform future projections for targeted interventions towards prevention and resource allocation.

Methods TSCI cases admitted for first rehabilitation between 1970 and 2014 were identified in four specialised rehabilitation centres in Switzerland included in the Swiss Spinal Cord Injury (SwiSCI) cohort. Multinomial logistic regression was used to determine relative risk ratios (RRR) of admission to first rehabilitation. Incidence rate ratios (IRRs) were calculated using Poisson regression with reference to the Swiss general population.

Results There were 4,095 incident cases of TSCI. Between 1971–2000 there was an overall 2.1% increase in patient admission, followed by a 1.2% decrease in 2000–2014. The relative proportion of the elderly patient population increased from 1990 onwards in comparison with 1970–1974 (RRR range compared to the youngest: 4.2–14.6). Relative to the youngest patients, the oldest patients had a nearly 18-fold increase in odds for falls in comparison with transport-related accidents. Assessment of IRRs revealed an increase in risk of admission for sports-related accidents TSCIs among the youngest ages; risk of falls among older ages appeared to increase, especially after 2000.

Conclusions This study provides evidence for increasing admission to first rehabilitation of the elderly for TSCIs, which can in part be attributed to an increase in risk of TSCI with increasing age. Potential lifestyle changes among the youngest, especially for sports and leisure-related TSCIs, as well as the oldest, possibly due to increase in activity, could contribute to the observed increase in risk.