Ryb Gabriel, Dischinger Patricia, Kleinberger Michael, Burch Cynthia, Ho Shiu
National Study Center for Trauma & EMS, University of Maryland Medical School, Baltimore, MD, USA.
Ann Adv Automot Med. 2008 Oct;52:227-34.
To determine the effect of aging on the occurrence of femoral and tibial fractures during vehicular crashes.
The Crash Injury Research and Engineering Network (CIREN), which includes occupants of a vehicle < 8 years old with at least one AIS > or = 3 or two AIS > or = 2 injuries in different body regions, comprised the study population. The occurrence of femoral and tibial fractures during vehicular crashes was analyzed in relation to age and other confounders [gender, BMI, stature, change in velocity (Deltav), restraint use, occupant position (driver vs. passenger) and principal direction of force (PDOF)] using chi2, Mantel-Haenszel chi2 and student t test. Multiple logistic regression (MLR) models were built for the prediction of femoral and tibial fractures with age as the independent variable and possible confounders as co-variates. An alpha = 0.05 was used for all statistics.
The incidence of femoral and tibial fractures in the study population (N=1,418) was 23% and 27%, respectively. Univariate analyses revealed a negative association between increasing age and femoral fractures and no association between age and tibial fractures. MLR models revealed no clear effect of increasing age on the occurrence of either femoral or tibial fractures. Obesity, frontal PDOF, and high Deltav affected the occurrence of femoral fractures. Tibial fractures were influenced by occupant position (driver), frontal PDOF, high Deltav and shorter stature.
Despite the known changes in bone composition and strength with aging, elderly vehicular occupants do not experience higher odds of incurring femoral and tibial fractures during crashes.
确定衰老对车祸期间股骨和胫骨骨折发生率的影响。
碰撞损伤研究与工程网络(CIREN)纳入了研究人群,其中包括年龄小于8岁、至少一处简明损伤定级标准(AIS)≥3级或不同身体部位有两处AIS≥2级损伤的车辆驾乘人员。使用卡方检验、Mantel-Haenszel卡方检验和学生t检验,分析车祸期间股骨和胫骨骨折的发生率与年龄及其他混杂因素[性别、体重指数(BMI)、身高、速度变化(Δv)、安全带使用情况、驾乘人员位置(驾驶员与乘客)和主要受力方向(PDOF)]之间的关系。构建多因素逻辑回归(MLR)模型,以年龄作为自变量、可能的混杂因素作为协变量来预测股骨和胫骨骨折。所有统计分析的α值均设定为0.05。
研究人群(N = 1418)中股骨和胫骨骨折的发生率分别为23%和27%。单因素分析显示,年龄增加与股骨骨折之间呈负相关,年龄与胫骨骨折之间无相关性。MLR模型显示,年龄增加对股骨或胫骨骨折的发生率没有明显影响。肥胖、前方PDOF和高Δv会影响股骨骨折的发生。胫骨骨折受驾乘人员位置(驾驶员)、前方PDOF、高Δv和身高较矮的影响。
尽管已知随着年龄增长骨成分和强度会发生变化,但老年车辆驾乘人员在车祸期间发生股骨和胫骨骨折的几率并未增加。