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中国重庆老年人脊柱骨折的流行病学。

Epidemiology of spinal fractures among the elderly in Chongqing, China.

机构信息

Department of Orthopedics, Xinqiao Hospital, The Third Military Medical University, Chongqing 400037, China.

出版信息

Injury. 2012 Dec;43(12):2109-16. doi: 10.1016/j.injury.2012.04.008. Epub 2012 May 2.

Abstract

OBJECTIVE

To illustrate the epidemiology of spinal fractures including traumatic spinal fractures and osteoporotic spinal fracture with no specific cause, spinal fracture caused by tumour and tuberculosis among the elderly.

DESIGN

We retrospectively reviewed hospital records on all patients who was 60 years of age or older with spinal fracture at two university-affiliated hospitals between January 2001 and May 2011 (n=996). Variables assessed included age, gender, incidence of hospital admission, mechanism of spinal fracture, anatomic distribution, neurologic deficit, therapeutic method, length of hospitalisation and hospitalisation cost.

SETTING

Two university-affiliated hospitals from January 2001 to May 2011.

RESULTS

A total of 996 patients with spinal fractures were identified, of whom 34.8% were males. The annual incidence of spinal fractures among the elderly was 24 cases per 100,000 hospital admission in 2001 and then gradually increased to 130 cases per 100,000 hospital admission in 2010. The causes of spinal fractures include traumatic spinal fractures (n=714, 71.7%), osteoporotic fracture with no specific cause (n=264, 26.5%) and spinal fracture caused by tumour and tuberculosis (n=18, 1.8%). The lumbar region was the most common region of spinal fracture (n=823, 48.8%), followed by the thoracic (n=724, 43.0%) and the cervical (n=138, 8.2%) regions. Lumbar spinal fractures and thoracic spinal fractures were more commonly seen as a result of accidental falls from low heights and osteoporotic spinal fractures respectively. Thirty-five (3.5%) patients exhibited a complete motor and sensory deficit and 151 (15.2%) an incomplete neurological deficit. The greatest number of complete motor and sensory neurological deficits was associated with cervical spinal fractures and accidental falls. A total of 87 (8.7%) patients had associated non-spinal injuries, of whom 26 (29.9%) sustained a head and neck injury, 28 (32.2%) patients suffered a thoracic injury and 19 (21.8%) patients suffered a fracture of a lower extremity.

CONCLUSION

Spinal fractures usually occur outdoors causing by accidental falls from low heights, most frequently happen on the road. The number of fall-induced injuries and sports injury increased steadily with age, may indicate that there is growing concern for the consequences of falls and sports in the elderly.

摘要

目的

阐述脊柱骨折的流行病学,包括外伤性脊柱骨折和无特定原因的骨质疏松性脊柱骨折、肿瘤和结核引起的脊柱骨折以及老年人的脊柱骨折。

设计

我们回顾性分析了 2001 年 1 月至 2011 年 5 月期间在两所大学附属医院就诊的年龄在 60 岁及以上的所有脊柱骨折患者的住院记录(n=996)。评估的变量包括年龄、性别、住院入院率、脊柱骨折机制、解剖分布、神经缺损、治疗方法、住院时间和住院费用。

地点

2001 年 1 月至 2011 年 5 月期间的两所大学附属医院。

结果

共发现 996 例脊柱骨折患者,其中 34.8%为男性。2001 年,老年人脊柱骨折的年发病率为每 10 万人中有 24 例,随后逐渐增加到 2010 年的每 10 万人中有 130 例。脊柱骨折的原因包括外伤性脊柱骨折(n=714,71.7%)、无特定原因的骨质疏松性骨折(n=264,26.5%)和肿瘤和结核引起的脊柱骨折(n=18,1.8%)。腰椎区是脊柱骨折最常见的部位(n=823,48.8%),其次是胸椎区(n=724,43.0%)和颈椎区(n=138,8.2%)。腰椎脊柱骨折和胸椎脊柱骨折分别更多地由意外从低处坠落和骨质疏松性脊柱骨折引起。35 例(3.5%)患者表现出完全的运动和感觉缺陷,151 例(15.2%)患者表现出不完全的神经缺陷。完全运动和感觉神经缺陷最多见于颈椎骨折和意外坠落。共有 87 例(8.7%)患者合并非脊柱损伤,其中 26 例(29.9%)患者发生头颈部损伤,28 例(32.2%)患者发生胸部损伤,19 例(21.8%)患者发生下肢骨折。

结论

脊柱骨折通常发生在户外,由意外从低处坠落引起,最常发生在路上。跌倒引起的损伤和运动损伤的数量随着年龄的增长而稳步增加,这可能表明老年人对跌倒和运动的后果越来越关注。

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