Jackson Amie B, Dijkers Marcel, Devivo Michael J, Poczatek Robert B
Spain Rehabilitation Center, University of Alabama at Birmingham, 35233, USA.
Arch Phys Med Rehabil. 2004 Nov;85(11):1740-8. doi: 10.1016/j.apmr.2004.04.035.
To evaluate epidemiologic trends in new spinal cord injuries (SCIs) in the United States over 3 decades.
Consecutive case series.
Model Spinal Cord Injury Systems (MSCIS) facilities.
Persons (N=30,532) admitted to MSCIS facilities within 365 days of injury between 1973 and 2003, and enrolled in the National Spinal Cord Injury Database.
Not applicable.
Data were collected at MSCIS admission and rehabilitation discharge. Variables included age, gender, race and ethnic group, year of injury, and level and extent of injury. Specific etiologies were grouped as motor vehicle collisions (MVCs), violence, falls, sports, and other. Demographic and injury severity trends were analyzed by year of injury groupings according to decades (1973-1979, 1980-1989, 1990-1999, 2000-2003.) Chi-square tests assessed statistical significance. One-way analysis of variance compared mean ages.
The male/female ratio remained fairly stable at 4:1, but the percentage of women increased slightly over time, especially from MVC etiologies ( P <.001). Over time, the mean age at injury increased significantly ( P <.001); it was 37.7+/-17.5 years in 2000-2003. The majority of cases were white (66.1%). Tetraplegia (54.1%) and complete injuries (55.6%) occurred more than paraplegia and incomplete injuries, respectively. MVCs (45.6%) remained the most common etiology; falls (19.6%) held the second position over violence (17.8%), except for the 1990-1999 period when the positions were reversed. Significantly increasing percentages of new injuries were seen for SCI due to automobile, motorcycle, bicycle, and all-terrain vehicle crashes, blunt object attacks, snow skiing, and medical and surgical mishaps.
Many previously seen SCI demographic trends continued into the 2000 decade.
评估美国30年间新发脊髓损伤（SCI）的流行病学趋势。
连续病例系列研究。
脊髓损伤示范系统（MSCIS）机构。
1973年至2003年间受伤后365天内入住MSCIS机构并纳入国家脊髓损伤数据库的人员（N = 30532）。
不适用。
在MSCIS入院时和康复出院时收集数据。变量包括年龄、性别、种族和族裔群体、受伤年份以及损伤水平和程度。具体病因分为机动车碰撞（MVC）、暴力、跌倒、运动和其他。根据年代（1973 - 1979年、1980 - 1989年、1990 - 1999年、2000 - 2003年）按受伤年份分组分析人口统计学和损伤严重程度趋势。卡方检验评估统计学意义。单因素方差分析比较平均年龄。
男女比例保持在4:1左右相对稳定，但女性比例随时间略有增加，尤其是因MVC病因导致的损伤（P <.001）。随着时间推移，受伤时的平均年龄显著增加（P <.001）；在2000 - 2003年为37.7±17.5岁。大多数病例为白人（66.1%）。四肢瘫（54.1%）和完全性损伤（55.6%）分别比截瘫和不完全性损伤更为常见。MVC（45.6%）仍然是最常见的病因；跌倒（19.6%）位居第二，超过暴力（17.8%），但在1990 - 1999年期间顺序相反。因汽车、摩托车、自行车和全地形车碰撞、钝器攻击、滑雪以及医疗和手术失误导致的SCI新发病例百分比显著增加。
许多先前观察到的SCI人口统计学趋势持续到21世纪。
