Cobb Jason D, MacLennan Paul A, McGwin Gerald, Metzger Jesse S, Rue Loring W
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
J Spinal Cord Med. 2005;28(4):314-9. doi: 10.1080/10790268.2005.11753826.
BACKGROUND/OBJECTIVE: Motor vehicle collision (MVC)-related spinal cord injury (SCI) is the most prevalent etiology of SCI. Few studies have defined SCI risk factors. Vehicle mismatch occurs in 2-vehicle MVCs in which there are significant differences in vehicle weight, stiffness, and height. This study examined SCI risk and vehicle mismatch.
A matched case-control study using the 1995 to 2003 National Automotive Sampling System (NASS). Study subjects were identified from 2-vehicle MVCs. Cases were occupants who had suffered a cervical, thoracic, or lumbar SCI. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.
There were 101,682 cases of SCI matched to 805,091 controls. Occupants of passenger vehicles involved in MVCs with a light truck or van (LTV) were at increased risk for SCI (OR = 1.87, 95% CI = 1.07-3.24) and this risk was greatest for thoracic SCI (OR = 5.09, 95% CI = 2.33-11.13). In addition, occupants of LTVs involved in MVCs with passenger vehicles were at significant increased risk for cervical (OR = 1.39) and lumbar (OR = 2.65) SCI; and occupants of LTVs involved in MVCs with other LTVs were at increased risk of any SCI (OR = 2.02, 95% CI = 1.52-2.69). For these subjects, significant increased risks were seen for all spine regions: cervical (OR = 1.41), thoracic (OR = 2.86), and lumbar (OR = 2.38).
The results of this study suggest that occupants of passenger vehicles are at increased SCI risk when involved in 2-vehicle MVCs with LTVs; and that occupants of LTVs are at increased SCI risk, regardless.
背景/目的:机动车碰撞(MVC)相关的脊髓损伤(SCI)是SCI最常见的病因。很少有研究明确SCI的风险因素。车辆不匹配发生在两车MVC中,即车辆重量、刚度和高度存在显著差异的情况。本研究调查了SCI风险与车辆不匹配情况。
采用1995年至2003年国家汽车抽样系统(NASS)进行匹配病例对照研究。研究对象从两车MVC中确定。病例为患有颈、胸或腰段SCI的乘车人员。计算比值比(OR)和95%置信区间(CI)。
有101,682例SCI病例与805,091例对照匹配。乘用车驾乘人员在与轻型卡车或货车(LTV)发生MVC时,发生SCI的风险增加(OR = 1.87,95%CI = 1.07 - 3.24),且这种风险在胸段SCI中最大(OR = 5.09,95%CI = 2.33 - 11.13)。此外,LTV驾乘人员在与乘用车发生MVC时,发生颈段(OR = 1.39)和腰段(OR = 2.65)SCI的风险显著增加;LTV驾乘人员在与其他LTV发生MVC时,发生任何SCI的风险增加(OR = 2.02,95%CI = 1.52 - 2.69)。对于这些受试者,所有脊柱区域的风险均显著增加:颈段(OR =