伊朗德黑兰外伤性脊柱骨折的负担。
Burden of traumatic spine fractures in Tehran, Iran.
机构信息
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Iran.
出版信息
BMC Public Health. 2011 Oct 11;11:789. doi: 10.1186/1471-2458-11-789.
BACKGROUND
The Disability-Adjusted Life Year (DALY) was designed by the World Health Organization (WHO) to measure, compare, and analyze the burden of various diseases. To the best of our knowledge, this is the first study on the assessment of burden of traumatic spinal fracture (TSF) in an Iranian community. We estimated burden of TSF includes both isolated (iTSF) and associated injuries related to traumatic spinal fractures (aTSF) in Tehran, the capital of Iran, for the year 2006-2007 using DALYs.
METHODS
Burden of TSF was estimated based on information provided by the national data on Iranian trauma, data from the WHO, and literature data using disease modeling (DISMOD). Incidence of TSF and associated injuries were obtained from two population based studies and National Trauma Data Bank in Iran, while duration, and relative risk of mortality (RRM) were obtained from WHO data and the literature. The incidence, duration, and relative risk of mortality (RRM) were used to calculate DALY for TSF. To calculate DALY, the years of life lost because of premature mortality (YLL) were added to the number of years lost because of disability (YLD). DALYs were calculated separately for both iTSF and aTSF. In-hospital YLD and post-hospital YLL for iTSF and in-hospital YLL and YLD were calculated for aTSFs.
RESULTS
TSF incidence was 16.35 (95%CI: 3.4-48.0) per 100,000. The incidence of TSF in males was more than twice that of females. The largest DALYs were seen in 15-29 years. The highest burden of associated injuries of TSF was related to spinal cord and head injury. DALYs for aTSF were estimated to be 2496.9 years (32.0 DALY/100,000 population). The YLD and YLL were almost similar. Total DALY for iTSF and aTSF was 2568.9 years (32.92 DALY/100,000 population). Based on the risk extracted from the literature, post-hospital increased risk of mortality was increased by 1318 DALY (16.89 DALY/100,000 population).
CONCLUSION
This study showed a considerable burden for TSFs mainly due to associated injuries and increased lifelong RRM in patients with TSF.
背景
残疾调整生命年（DALY）是世界卫生组织（WHO）设计的，用于衡量、比较和分析各种疾病的负担。据我们所知，这是第一项关于伊朗社区创伤性脊柱骨折（TSF）负担评估的研究。我们使用 DALY 估计 2006-2007 年德黑兰（伊朗首都）TSF 的负担，包括单纯性（iTSF）和与创伤性脊柱骨折相关的损伤（aTSF）。
方法
根据伊朗创伤的国家数据、WHO 数据和文献数据，使用疾病建模（DISMOD），我们基于提供的信息估计 TSF 的负担。TSF 的发病率和相关损伤是从两项基于人群的研究和伊朗国家创伤数据库获得的，而发病率、持续时间和相对死亡率（RRM）是从 WHO 数据和文献中获得的。发病率、持续时间和相对死亡率（RRM）用于计算 TSF 的 DALY。为了计算 DALY，将因过早死亡而损失的年数（YLL）加在因残疾而损失的年数（YLD）上。分别为 iTSF 和 aTSF 计算 DALY。计算了 iTSF 的住院期间 YLD 和住院后 YLL，以及 aTSFs 的住院期间 YLL 和 YLD。
结果
TSF 的发病率为 16.35（95%CI：3.4-48.0）/100,000。男性 TSF 的发病率是女性的两倍多。15-29 岁的 DALYs 最大。TSF 相关损伤的最大负担与脊髓和头部损伤有关。估计 aTSF 的 DALY 为 2496.9 年（32.0 DALY/100,000 人口）。YLD 和 YLL 几乎相同。iTSF 和 aTSF 的总 DALY 为 2568.9 年（32.92 DALY/100,000 人口）。基于文献中提取的风险，住院后死亡率增加的风险增加了 1318 DALY（16.89 DALY/100,000 人口）。
结论
这项研究表明，TSF 的负担相当大，主要是由于相关损伤和 TSF 患者终生风险增加。
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