Department of Physical Medicine & Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA.
Shirley Ryan AbilityLab, Chicago, Illinois, USA.
J Spinal Cord Med. 2023 Jan;46(1):68-74. doi: 10.1080/10790268.2021.1943250. Epub 2021 Jul 7.
To describe the adult functional, participation, education, employment, and quality of life outcomes of children who incurred spinal cord injury (SCI) as the result of gun injuries vs. non-violent etiologies, as well as their utilization of health services.
Retrospective-cohort study. Eligibility criteria were current age at least 18 years, at least 5 years after SCI, and injury prior to 19 years of age. After enrolling the gun injury group, we matched individuals with non-violent etiologies from the Midwest Regional SCI Model System database to the gun injury group's demographic characteristics. Adult outcomes included education level, employment, income, involvement with the criminal justice system, quality of life indicators using PROMIS and SCI-QOL item banks, and utilization of health services.
Twenty-six participants with gun injury SCI matched with 19 participants with non-violent etiologies.
Average age at injury was 15 years and current age was 44 years for both cohorts. Individuals from racial minority groups were over-represented in the gun injury cohort. The gun-injury cohort had lower educational attainment. Though employment rates were similar, the gun injury group had a lower income level. Both groups endorsed high average levels of function and quality of life on the PROMIS and SCI-QOL short forms.
SCI etiology reflects racial characteristics of the sample and is associated with subsequent educational attainment and income. Rehabilitation planning should consider gun injury etiology in children not as a characteristic that determines a poor outcome, but as a risk factor for reduced educational attainment and lifetime income.
描述因枪支伤害和非暴力病因导致脊髓损伤（SCI）的成年患者的功能、参与度、教育、就业和生活质量结局，以及他们对卫生服务的利用情况。
回顾性队列研究。入选标准为当前年龄至少 18 岁，SCI 后至少 5 年，且年龄在 19 岁以下。在纳入枪支伤害组后，我们从中西部地区脊髓损伤模型系统数据库中匹配非暴力病因的个体与枪支伤害组的人口统计学特征相匹配。成人结局包括教育程度、就业、收入、与刑事司法系统的关系、使用 PROMIS 和 SCI-QOL 项目库的生活质量指标，以及卫生服务的利用情况。
26 名因枪支伤害导致 SCI 的参与者与 19 名因非暴力病因导致 SCI 的参与者相匹配。
两组平均损伤年龄均为 15 岁，当前年龄均为 44 岁。枪支伤害组中少数民族群体的比例过高。枪支伤害组的教育程度较低。尽管就业率相似，但枪支伤害组的收入水平较低。两组在 PROMIS 和 SCI-QOL 简短形式上的功能和生活质量评分均较高。
SCI 的病因反映了样本的种族特征，与随后的教育程度和收入相关。康复规划应考虑儿童的枪支伤害病因，不应将其视为预后不良的特征，而应将其视为教育程度降低和终身收入减少的风险因素。
