Chen Yuying, Tang Ying, Vogel Lawrence C, Devivo Michael J
Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham , Birmingham, Alabama.
Top Spinal Cord Inj Rehabil. 2013 Winter;19(1):1-8. doi: 10.1310/sci1901-1.
Knowledge of the causes of spinal cord injury (SCI) and associated factors is critical in the development of successful prevention programs.
This study analyzed data from the National SCI Database (NSCID) and National Shriners SCI Database (NSSCID) in the United States to examine specific etiologies of SCI by age, sex, race, ethnicity, day and month of injury, and neurologic outcomes.
NSCID and NSSCID participants who had a traumatic SCI from 2005 to 2011 with known etiology were included in the analyses (N=7,834). Thirty-seven causes of injury documented in the databases were stratified by personal characteristics using descriptive analysis.
The most common causes of SCI were automobile crashes (31.5%) and falls (25.3%), followed by gunshot wounds (10.4%), motorcycle crashes (6.8%), diving incidents (4.7%), and medical/surgical complications (4.3%), which collectively accounted for 83.1% of total SCIs since 2005. Automobile crashes were the leading cause of SCI until age 45 years, whereas falls were the leading cause after age 45 years. Gunshot wounds, motorcycle crashes, and diving caused more SCIs in males than females. The major difference among race/ethnicity was in the proportion of gunshot wounds. More SCIs occurred during the weekends and warmer months, which seemed to parallel the increase of motorcycle- and diving-related SCIs. Level and completeness of injury are also associated with etiology of injury.
The present findings suggest that prevention strategies should be tailored to the targeted population and major causes to have a meaningful impact on reducing the incidence of SCI.
了解脊髓损伤(SCI)的病因及相关因素对于成功制定预防方案至关重要。
本研究分析了美国国家脊髓损伤数据库(NSCID)和国家施莱宁脊髓损伤数据库(NSSCID)的数据,以按年龄、性别、种族、民族、损伤日期和月份以及神经学结果来研究脊髓损伤的具体病因。
纳入2005年至2011年有已知病因的创伤性脊髓损伤的NSCID和NSSCID参与者进行分析(N = 7834)。使用描述性分析按个人特征对数据库中记录的37种损伤原因进行分层。
脊髓损伤最常见的原因是汽车碰撞(31.5%)和跌倒(25.3%),其次是枪伤(10.4%)、摩托车碰撞(6.8%)、潜水事故(4.7%)以及医疗/手术并发症(4.3%),自2005年以来这些原因合计占脊髓损伤总数的83.1%。45岁之前,汽车碰撞是脊髓损伤的主要原因,而45岁之后跌倒则是主要原因。枪伤、摩托车碰撞和潜水导致男性脊髓损伤多于女性。种族/民族之间的主要差异在于枪伤的比例。更多的脊髓损伤发生在周末和较温暖的月份,这似乎与摩托车和潜水相关的脊髓损伤增加情况相平行。损伤水平和完整性也与损伤病因相关。
目前的研究结果表明,预防策略应针对目标人群和主要病因进行调整,以便对降低脊髓损伤发生率产生有意义的影响。