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胸椎骨折的检查与科学分析

Examination and Scientific Analysis of Thoracic Vertebral Fractures.

作者信息

Singh Gurbinder, Rao Varun, Thamba Aish, Roth Dylan, Zaazoue Mohamed A

机构信息

Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, USA.

Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, USA.

出版信息

Cureus. 2023 Sep 9;15(9):e44938. doi: 10.7759/cureus.44938. eCollection 2023 Sep.

Abstract

Background Thoracic vertebral fractures are clinically important due to their association with the thoracic spinal cord and the potential to cause devastating neurological injury. Using the National Electronic Injury Surveillance System (NEISS) data, this study investigated fracture patterns to understand associated factors to improve prevention strategies. We explored different factors associated with thoracic vertebral fractures to improve our understanding of preventative strategies and patient care standards, focusing on spatial distribution, sex-age dynamics, and location of injury. Methodology This retrospective, cross-sectional study examines thoracic vertebral fractures across diverse age groups from 2013 to 2022, utilizing the NEISS database from the U.S. Consumer Product Safety Commission. Inclusion criteria based on specific terms related to thoracic fractures were employed. Descriptive statistics illustrated fracture distribution by age groups and associated products. Statistical analyses, including chi-square tests and multivariate logistic regressions, were conducted to explore associations between fracture occurrence, locations, products, age, and gender. Results The analysis of thoracic vertebral fractures by location and associated products yielded several statistically significant findings. Notably, the prevalence of fractures at home (39.67%) was significantly higher than in other locations, and these differences in fracture distribution were statistically significant (χ² = 7.34, p < 0.001). Among the associated products, ladders (10.46%) emerged as the most frequent product associated with fractures. Multivariate logistic regression analysis showed that the age groups of 41-50, 51-60, and 61-70 had increased odds of fractures with adjusted odds ratios (AORs) of 1.08 (95% confidence interval (CI) = 1.04-1.42, p < 0.05), 1.21 (95% CI = 1.13-1.56, p < 0.001), and 1.17 (95% CI = 1.08-1.39, p < 0.001), respectively. The likelihood of thoracic vertebral fractures did not significantly differ between males and females (AOR = 1.12, 95% CI = 0.87-1.53, p = 0.262). Fracture distribution by age groups and products indicated increasing ladder-related fractures within the 41-50 age group and 51-60 age group. Football-related fractures peaked within the 21-30 age group. Fracture distribution patterns for bicycles had increased prevalence within the 11-20 and 21-30 age groups, and football-related fractures in younger age groups. Conclusions This study analyzed factors associated with thoracic vertebral fractures, showing the significance of targeted preventative interventions, such as earlier screening, physical therapy, and nutritional status assessment, in the setting of significant location and age-related susceptibilities. The observed patterns of injury provide a foundation for future research to elucidate the underlying mechanisms between different environments and the likelihood of injury to improve preventive strategies.

摘要

背景

胸椎骨折因其与胸段脊髓相关联且有可能导致严重的神经损伤,在临床上具有重要意义。本研究利用国家电子伤害监测系统(NEISS)的数据,调查骨折模式以了解相关因素,从而改进预防策略。我们探讨了与胸椎骨折相关的不同因素,以增进对预防策略和患者护理标准的理解,重点关注空间分布、性别 - 年龄动态以及损伤部位。

方法

这项回顾性横断面研究利用美国消费品安全委员会的NEISS数据库,对2013年至2022年不同年龄组的胸椎骨折情况进行了检查。采用基于与胸椎骨折相关的特定术语的纳入标准。描述性统计说明了按年龄组和相关产品划分的骨折分布情况。进行了包括卡方检验和多因素逻辑回归在内的统计分析,以探讨骨折发生、部位、产品、年龄和性别的关联。

结果

按部位和相关产品对胸椎骨折进行的分析得出了几个具有统计学意义的发现。值得注意的是,在家中发生骨折的比例(39.67%)显著高于其他场所,且这些骨折分布差异具有统计学意义(χ² = 7.34,p < 0.001)。在相关产品中,梯子(10.46%)是与骨折关联最频繁的产品。多因素逻辑回归分析表明,41 - 50岁、51 - 60岁和61 - 70岁年龄组的骨折几率增加,调整后的优势比(AOR)分别为1.08(95%置信区间(CI) = 1.04 - 1.42,p < 0.05)、1.21(95% CI = 1.13 - 1.56,p < 0.001)和1.17(95% CI = 1.08 - 1.39,p < 0.001)。胸椎骨折在男性和女性之间的可能性没有显著差异(AOR = 1.12,95% CI = 0.87 - 1.53,p = 0.262)。按年龄组和产品划分的骨折分布表明,在41 - 50岁年龄组和51 - 60岁年龄组中,与梯子相关的骨折有所增加。与足球相关的骨折在21 - 30岁年龄组达到峰值。自行车相关骨折在11 - 20岁和21 - 30岁年龄组的患病率有所增加,且年轻年龄组中与足球相关的骨折也有所增加。

结论

本研究分析了与胸椎骨折相关的因素,表明在存在显著的部位和年龄相关易感性的情况下,有针对性的预防干预措施,如早期筛查、物理治疗和营养状况评估具有重要意义。观察到的损伤模式为未来研究提供了基础,以阐明不同环境与损伤可能性之间的潜在机制,从而改进预防策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7e03/10492182/52de643e2557/cureus-0015-00000044938-i01.jpg

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