National School of Occupational Medicine, Carlos III Institute of Health, Madrid, Spain.
Neuroepidemiology. 2010;34(3):184-92; discussion 192. doi: 10.1159/000279335. Epub 2010 Feb 2.
Incidence studies of spinal cord injury (SCI) are important for health-care planning and epidemiological research. This review gives a quantitative update on SCI epidemiology worldwide through a statistical evaluation of incidence rates.
A systematic review was conducted. For each study, the crude rate ratio was calculated and, when possible, age- and gender-adjusted incidence rate ratios with 95% CI were determined by direct adjustment or using Poisson regression.
Thirteen studies were included. Annual crude incidence rates in traumatic SCI varied from 12.1 per million in The Netherlands to 57.8 per million in Portugal. Compared to the Portuguese reference study, incidence rates showed a 3-fold variation, with the highest rates in Canada and Portugal. Most traumatic SCI studies showed a bimodal age distribution. The first peak was found in young adults between 15 and 29 years and a second peak in older adults (mostly > or = 65 years). Motor vehicle accidents and falls were the most prevalent causes of injury accounting for nearly equal percentages. In contrast, another age pattern in non-traumatic SCI reflected steadily increasing incidence with advancing age.
The results show significant variation in SCI incidence with changing epidemiological patterns. A trend towards increased incidence in the elderly was observed, likely due to falls and non-traumatic injury.
脊髓损伤 (SCI) 的发病率研究对于医疗保健规划和流行病学研究至关重要。本综述通过对发病率进行统计评估，对全球 SCI 流行病学进行了定量更新。
进行了系统综述。对于每一项研究，计算了粗发病率比值，并且在可能的情况下，通过直接调整或使用泊松回归，确定了年龄和性别调整后的发病率比值及其 95%CI。
共纳入 13 项研究。创伤性 SCI 的年粗发病率从荷兰的 12.1/100 万到葡萄牙的 57.8/100 万不等。与葡萄牙的参考研究相比，发病率差异高达 3 倍，其中加拿大和葡萄牙的发病率最高。大多数创伤性 SCI 研究显示出双峰年龄分布。第一个高峰出现在 15 至 29 岁的年轻人中，第二个高峰出现在老年人（大多数为≥65 岁）中。机动车事故和跌倒是最常见的损伤原因，占比几乎相等。相比之下，另一种非创伤性 SCI 的年龄模式反映了发病率随年龄增长而稳步上升。
研究结果表明 SCI 的发病率存在显著差异，具有不同的流行模式。观察到老年人的发病率呈上升趋势，这可能归因于跌倒和非创伤性损伤。
