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比较非致命摩托车事故中年轻骑手与年长骑手的骨折模式。

Comparing fracture patterns of younger versus older riders involved in nonfatal motorcycle accidents.

作者信息

Ashie Aubrey, Wilhelm Andrew, Carney Daniel, DiPasquale Thomas, Bush Chelsea

机构信息

a Department of Orthopedics , WellSpan York Hospital , York , Pennsylvania.

b Department of Trauma Services , WellSpan York Hospital , York , Pennsylvania.

出版信息

Traffic Inj Prev. 2018;19(7):761-765. doi: 10.1080/15389588.2018.1494384. Epub 2018 Oct 23.

Abstract

OBJECTIVE

The motorcyclist demographic is shifting to a larger proportion of riders over the age of 40. We sought to identify differences in orthopedic injury distribution and severity between 3 age cohorts and identify independent factors that contribute to fractures following a motorcycle collision (MCC).

METHODS

A trauma registry at a level 1 trauma center was queried for motorcycle-related orthopedic injuries between January 1, 2008, and December 31, 2014. Subjects were stratified into 3 age groups: Young (<40 years), middle-aged (40-59 years), and elderly (≥60 years). Age groups were compared with respect to gender, weight, mechanism of collision, helmet use, Glascow Coma Scale (GCS), fracture type and location, Injury Severity Score (ISS), and hospital length of stay (LOS). A logistic regression model was constructed to identify independent factors that contribute to fractures following MCCs.

RESULTS

Five hundred sixty-seven patients received care for motorcycle-related injuries (219 young, 264 middle-aged, and 84 elderly). Patients were predominantly male (88.7%), were wearing a helmet at the time of collision (58.0%), and sustained a mean of 1.48 fractures per patient. The primary mechanism of collision was noncollision transport accidents (41.4%). Elderly riders weighed significantly more than middle-aged and young riders (P < .0001). There was a significant difference in mean GCS between age groups (P = .02), with elderly patients demonstrating the highest mean GCS (14.0 ± 3.3). Young patients sustained no fractures most frequently when compared with middle-aged and elderly riders (P = .002). There was a significant difference in the percentage of patients sustaining right-sided, lower body fractures between age groups (P = .02) for elderly, middle-aged, and young patients, respectively. There was also a significant difference between age groups in the percentage of riders sustaining fractures other than those of the extremities, pelvis, or spine (P = .0005). Only age was identified as an independent predictor of sustaining a fracture (P = .008).

CONCLUSIONS

Elderly patients sustained fractures more frequently. There was no difference between age groups with respect to injury severity. Mechanism of collision may have more influence than age with respect to fracture type and location. Further research is warranted to develop a more widely generalizable characterization of motorcycle collision injury patterns, risk factors, and patient characteristics.

摘要

目的

骑乘摩托车人群的年龄结构正逐渐向40岁以上骑手比例更高的方向转变。我们试图确定三个年龄组在骨科损伤分布和严重程度上的差异,并找出导致摩托车碰撞(MCC)后骨折的独立因素。

方法

查询了一家一级创伤中心2008年1月1日至2014年12月31日期间与摩托车相关的骨科损伤的创伤登记资料。将受试者分为三个年龄组:青年(<40岁)、中年(40 - 59岁)和老年(≥60岁)。比较各年龄组在性别、体重、碰撞机制、头盔使用情况、格拉斯哥昏迷量表(GCS)、骨折类型和部位、损伤严重程度评分(ISS)以及住院时间(LOS)等方面的差异。构建逻辑回归模型以确定导致MCC后骨折的独立因素。

结果

567例患者因摩托车相关损伤接受治疗(219例青年患者、264例中年患者和84例老年患者)。患者以男性为主(88.7%),碰撞时佩戴头盔的比例为58.0%,每位患者平均骨折1.48处。碰撞的主要机制是非碰撞性交通事故(41.4%)。老年骑手的体重显著高于中年和青年骑手(P < 0.0001)。各年龄组的平均GCS存在显著差异(P = 0.02),老年患者的平均GCS最高(14.0 ± 3.3)。与中年和老年骑手相比,青年患者最常未发生骨折(P = 0.002)。老年、中年和青年患者在右侧下半身骨折患者百分比方面存在显著差异(P = 0.02)。各年龄组在发生四肢、骨盆或脊柱以外骨折的骑手百分比方面也存在显著差异(P = 0.0005)。仅年龄被确定为发生骨折的独立预测因素(P = 0.008)。

结论

老年患者骨折更为常见。各年龄组在损伤严重程度方面无差异。就骨折类型和部位而言,碰撞机制可能比年龄的影响更大。有必要进一步开展研究,以更广泛地概括摩托车碰撞损伤模式、危险因素和患者特征。

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