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哥伦比亚外伤性脊髓损伤的流行病学。

Epidemiology of traumatic spinal cord injuries in Colombia.

机构信息

Departamento de Medicina Física y Rehabilitación, Grupo de Investigación en Rehabilitación de la Universidad del Valle (GIRUV), Escuela de Medicina, Facultad de Salud, Universidad del Valle, Cali, Colombia.

The University of Western Australia, Perth, WA, Australia.

出版信息

Spinal Cord Ser Cases. 2021 May 25;7(1):42. doi: 10.1038/s41394-021-00408-3.

Abstract

STUDY DESIGN

Retrospective cohort study.

OBJECTIVES

To determine the incidence and characteristics of newly injured individuals admitted to a traumatic spinal cord injury (TSCI) referral center during a 4-year period.

SETTING

University Hospital of Valle, Cali, Colombia.

METHODS

Individuals were identified, and their data was recorded based on the International Spinal Cord Injury Core Data Set. The outcome of interest was the American Spinal Injury Association Impairment Scale (AIS) grade at the last follow-up.

RESULTS

There were 491 individuals admitted in the 4-year period. The mean annual incidence of TSCI was 56.27 per million inhabitants. Considering TSCI in individuals exclusively from Cali, the mean annual incidence was 27.78 per million. The leading cause of TSCI was interpersonal violence (47.25%) and falls (33.60%). There was a strong correlation between AIS grade at admission and last follow-up. The most common AIS grade at the last follow-up was E (34.01%) caused mostly by falls (57.48%), followed by A (31.16%) caused mostly by interpersonal violence (76.27%). The reported employment rate dropped from 75.56% to 18.94% before and after TSCI (p < 0.05). AIS grade A was associated with more post-injury complications (p < 0.05).

CONCLUSIONS

This is the first cohort study in Colombia describing the incidence and AIS grades of individuals with TSCI from a trauma referral center. Interpersonal violence was overrepresented in this population. Future research should include the evaluation of prevention strategies, as well as research on interventions towards quality improvement in patient care and post-discharge services especially for individuals with AIS grade A.

摘要

研究设计

回顾性队列研究。

目的

确定在四年期间,创伤性脊髓损伤(TSCI)转诊中心新收治的损伤患者的发生率和特征。

地点

哥伦比亚卡利市 Valle 大学医院。

方法

根据国际脊髓损伤核心数据集确定患者并记录其数据。研究结果为最后一次随访时的美国脊髓损伤协会损伤分级(AIS)。

结果

在四年期间,共收治了 491 名患者。TSCI 的年平均发病率为每百万居民 56.27 例。考虑到仅来自卡利的 TSCI 患者,年平均发病率为 27.78 例。TSCI 的主要原因是人际暴力(47.25%)和跌倒(33.60%)。入院时的 AIS 分级与最后一次随访时具有很强的相关性。最后一次随访时最常见的 AIS 分级是 E(34.01%),主要由跌倒引起(57.48%),其次是 A(31.16%),主要由人际暴力引起(76.27%)。TSCI 前后的就业率从 75.56%降至 18.94%(p<0.05)。AIS 分级 A 与更多的损伤后并发症相关(p<0.05)。

结论

这是哥伦比亚第一份描述创伤转诊中心 TSCI 患者发病率和 AIS 分级的队列研究。该人群中人际暴力占比过高。未来的研究应包括预防策略的评估,以及针对患者护理和出院后服务质量改进的干预措施的研究,特别是针对 AIS 分级 A 的患者。

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