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种族和民族差异以及急性创伤性脊髓损伤后流行病学、生存和神经学结局的相似性:使用 NASCIS-1 试验数据的回顾性队列研究。

Racial and Ethnical Discrepancies and Similarities in the Epidemiology, Survival, and Neurological Outcomes After Acute Traumatic Spinal Cord Injury: A Retrospective Cohort Study Using Data from the NASCIS-1 Trial.

机构信息

Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.

KITE Research Institute, University Health Network, Toronto, ON, Canada.

出版信息

Top Spinal Cord Inj Rehabil. 2023 Fall;29(Suppl):88-102. doi: 10.46292/sci23-00055S. Epub 2023 Nov 17.

Abstract

BACKGROUND

Little is known about the impact of race/ethnicity on the clinical and neurological outcomes after acute traumatic spinal cord injury (tSCI).

OBJECTIVES

This study examined the influence of race/ethnicity on the individuals' survival and neurological recovery within the first year after tSCI.

METHODS

The 306 cases enrolled in the First National Acute Spinal Cord Injury Study (NASCIS-1) were grouped as African American individuals ( = 84), non-Hispanic White individuals ( = 159), and other races/ethnicities that included Hispanic individuals ( = 60) and Asian individuals ( = 3). Outcome measures included survival and neurological recovery within the first year after tSCI. Data analyses were adjusted for major potential confounders.

RESULTS

There were 39 females and 267 males with mean age of 31 years who mostly sustained cervical severe tSCI after motor vehicle accidents or falls. The three groups were comparable regarding sex distribution, level and severity of tSCI, level of consciousness at admission, and total received dose of methylprednisolone. African American individuals were significantly older than non-Hispanic White individuals ( = .0238). African American individuals and individuals of other races/ethnicities more often had a tSCI with open wound caused by missile and water-related accidents than non-Hispanic White individuals ( < .0001). Survival rates within the first year after tSCI were comparable among the three groups ( = .3191). Among the survivors, there were no significant differences among the three groups regarding motor and pinprick and light-touch sensory recovery ( > .0500).

CONCLUSIONS

The results of this study suggest that, while there were few differences among the racial/ethnical groups regarding the epidemiology of tSCI, race/ethnicity did not influence survival rate or neurological recovery within the first year post-tSCI.

摘要

背景

种族/民族对急性创伤性脊髓损伤(tSCI)后的临床和神经结局的影响知之甚少。

目的

本研究探讨了种族/民族对 tSCI 后一年内个体生存和神经恢复的影响。

方法

纳入的 306 例患者参加了第一届全国急性脊髓损伤研究(NASCIS-1),分为非裔美国人( = 84)、非西班牙裔白人( = 159)和其他种族/民族(包括西班牙裔( = 60)和亚洲人( = 3))。结果测量包括 tSCI 后一年内的生存和神经恢复。数据分析调整了主要潜在混杂因素。

结果

39 名女性和 267 名男性,平均年龄 31 岁,主要因机动车事故或跌倒导致颈段严重 tSCI。三组在性别分布、tSCI 水平和严重程度、入院时意识水平和甲基强的松龙总剂量方面无差异。非裔美国人明显比非西班牙裔白人年长( =.0238)。非裔美国人和其他种族/民族的个体,tSCI 由枪伤和与水有关的事故导致开放性伤口的比例明显高于非西班牙裔白人( <.0001)。tSCI 后一年内的生存率在三组之间相似( =.3191)。在幸存者中,三组之间在运动和刺痛及轻触觉感觉恢复方面无显著差异( >.0500)。

结论

本研究结果表明,虽然种族/民族在 tSCI 的流行病学方面存在一些差异,但种族/民族并不影响 tSCI 后一年内的生存率或神经恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcab/10759859/570aebb4cac7/i1945-5763-29-suppl-88-f01.jpg

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