Division of Neurosurgery, Department of Surgery, King Khalid University, Abha, Saudi Arabia; College of Medicine, King Khalid University, Abha, Saudi Arabia; Division of Neurosurgery, Department of Surgery, St. Michael's Hospital Injury Prevention Research Office, Li KaShing Knowledge Institute, Keenan Research Centre, Toronto, Canada.
Injury Section, Health Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada.
World Neurosurg. 2021 May;149:e116-e127. doi: 10.1016/j.wneu.2021.02.066. Epub 2021 Feb 23.
No previous large population-based studies of traumatic spinal injury (TSI) rates, trends, and patterns exist. We aimed to fill this knowledge gap on TSI epidemiology using a population-based study of 13 million people.
This is a descriptive cross-sectional cohort study that analyzes a national, mandatory reporting database for all emergency departments and ambulatory care centers in Ontario over 15 years. Demographics of TSI, trends in the TSI rate, etiology, transfer, disposition, comorbidities, and associated traumatic brain injury or spinal cord injury were analyzed.
There were 167,357 TSI-related emergency department visits resulting in 70,684 hospitalizations and 376 deaths. The overall rate of TSI significantly increased from 66.94 to 118.61 per 100,000. Female patients had greater rates of TSI. Older patients had greater rates of TSI, especially related to falls. Fall was found to be the commonest mechanism of TSI, whereas motor vehicle collisions scaled down to the third commonest mechanism of TSI. Sport-related TSI had the greatest percentage of increase in the rate over all mechanisms (221%, P < 0.001). TSI with associated traumatic brain injury comprised 6% of the cohort but had the greatest percentage increase (91%) in the rate compared to all other TSI forms.
The rate of TSI continues to rise in Ontario as the population ages. The rise is primarily attributed to a shift in the epidemiology and etiology of TSI from a younger male population toward an older female population, with falls as the primary injury mechanism. Establishing preventive measures to address this shift is essential.
目前尚无关于创伤性脊髓损伤（TSI）发生率、趋势和模式的大型基于人群的研究。我们旨在通过一项针对 1300 万人的基于人群的研究来填补这一关于 TSI 流行病学的知识空白。
这是一项描述性的横断面队列研究，分析了安大略省 15 年来所有急诊部和门诊护理中心的强制性报告数据库。分析了 TSI 的人口统计学特征、TSI 发生率的趋势、病因、转移、处置、合并症以及与创伤性脑损伤或脊髓损伤相关的情况。
共有 167357 例与 TSI 相关的急诊就诊导致 70684 例住院和 376 例死亡。TSI 的总体发生率从 66.94 升至 118.61/10 万。女性患者 TSI 发生率更高。年龄较大的患者 TSI 发生率更高，尤其是与跌倒有关。跌倒被认为是 TSI 最常见的机制，而机动车碰撞则降至 TSI 的第三常见机制。与运动相关的 TSI 在所有机制中增长率最高（221%，P <0.001）。伴有创伤性脑损伤的 TSI 占队列的 6%，但与所有其他 TSI 形式相比，其发生率增幅最大（91%）。
随着人口老龄化，安大略省的 TSI 发生率继续上升。这种上升主要归因于 TSI 的流行病学和病因学从年轻男性人群向老年女性人群的转变，跌倒成为主要的损伤机制。制定针对这一转变的预防措施至关重要。
