Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
Eur J Neurol. 2013 Feb;20(2):293-9. doi: 10.1111/j.1468-1331.2012.03845.x. Epub 2012 Aug 14.
The aim of the study was to compare the incidence, causes, severity and mortality of traumatic spinal cord injury (TSCI) in Western Norway and Estonia from 1997 to 2001.
The patients were identified from hospital records. All patients were followed until death or 14 October 2011. Analysed data included demographic data, causes of injury, neurological level, American Spinal Injury Association Impairment Scale and mortality.
A total of 71 patients in Western Norway and 244 in Estonia were included. The standardized incidence rate per million was 24.9 (CI 95%, 19.4-31.7) for Western Norway and 37.4 (CI 95%, 32.8-42.5) for Estonia. Falls was the most frequent cause of TSCI in both countries. The incidence of TSCI was highest among men in their 20s in Estonia and men in their 70s in Western Norway. The median survival time among the deceased was 4.0 (95% CI, 1.50-6.50) years in Norway and 2.8 (95% CI, 1.54-4.04) in Estonia. The mean standardized mortality ratio (SMR) was 5.00 (95% CI, 4.00-6.20) in Estonia and 1.89 (95% CI, 1.23-2.77) in Western Norway.
Although the two cohorts had similar demographic, injury and clinical characteristics, the age profile of the victims was different. The incidence rate was 1.5 times higher and SMR was 2.7 times higher in Estonia. Probable explanations for the different outcomes of the two European countries are socioeconomic differences, lower physical activity level, lower life expectancy and insufficient injury prevention programmes in Estonia.
本研究旨在比较 1997 年至 2001 年期间挪威西部和爱沙尼亚创伤性脊髓损伤（TSCI）的发病率、病因、严重程度和死亡率。
从医院病历中确定患者。所有患者均随访至死亡或 2011 年 10 月 14 日。分析数据包括人口统计学数据、损伤原因、神经损伤水平、美国脊髓损伤协会损伤量表和死亡率。
挪威西部共纳入 71 例患者，爱沙尼亚共纳入 244 例患者。挪威西部每百万人口的标准化发病率为 24.9（95%CI，19.4-31.7），爱沙尼亚为 37.4（95%CI，32.8-42.5）。在这两个国家，跌倒都是 TSCI 最常见的病因。在爱沙尼亚，TSCI 的发病率在 20 多岁的男性中最高，在挪威西部，70 多岁的男性中发病率最高。在死亡患者中，中位生存时间挪威为 4.0（95%CI，1.50-6.50）年，爱沙尼亚为 2.8（95%CI，1.54-4.04）年。爱沙尼亚的平均标准化死亡率比（SMR）为 5.00（95%CI，4.00-6.20），挪威西部为 1.89（95%CI，1.23-2.77）。
尽管这两个队列具有相似的人口统计学、损伤和临床特征，但受害者的年龄分布不同。爱沙尼亚的发病率是挪威西部的 1.5 倍，SMR 是挪威西部的 2.7 倍。这两个欧洲国家的结果不同，可能的解释是社会经济差异、较低的身体活动水平、较低的预期寿命和爱沙尼亚缺乏充分的损伤预防计划。
