Randall Zachary D, Navarro Brendan J, Brogan David M, Dy Christopher J
Washington University School of Medicine, St Louis, MO, USA.
Hand (N Y). 2024 Nov 26:15589447241299050. doi: 10.1177/15589447241299050.
Peripheral nerve injuries (PNI) range from mild neurapraxia to severe transection, leading to significant morbidity. Despite their impact, the societal implications of PNI in the United States are not well understood. This study aims to systematically review the literature on PNI epidemiology in the United States. We hypothesize that this review will reveal significant gaps in the understanding of PNI incidence, demographics, and economic impact.
Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we queried the literature for studies on PNI that reported at least one of the following: incidence rates, demographics, affected nerve distribution, injury mechanisms, surgical intervention rates, and associated direct costs. Exclusion criteria included non-English publications, abstracts, conference proceedings, reviews, or editorials, studies published before 2000, non-US studies, or studies focusing solely on digital nerves or plexus injuries.
Fifteen studies met the inclusion criteria. Data indicate a higher incidence of upper extremity nerve injuries compared with lower extremity injuries. The literature lacks comprehensive reporting on surgical intervention rates, with no recent data since 2013. There is a notable absence of nationwide epidemiological data on PNI mechanisms and recent cost data, with most information over a decade old and primarily focused on inpatient costs, neglecting outpatient visits, physical therapy, and medication expenses.
The epidemiological data on PNI are limited and outdated, highlighting the need for further research. Future studies should focus on recent trends in PNI incidence, injury mechanisms, and financial burden, including comprehensive reporting on surgical interventions, to inform strategies aimed at improving patient outcomes and health care resource allocation.
周围神经损伤（PNI）范围从轻度神经失用到严重横断，会导致显著的发病率。尽管其有影响，但美国PNI的社会影响尚未得到充分了解。本研究旨在系统回顾美国关于PNI流行病学的文献。我们假设该综述将揭示在PNI发病率、人口统计学和经济影响的理解方面存在重大差距。
按照系统评价和Meta分析的首选报告项目指南，我们在文献中查询关于PNI的研究，这些研究报告了以下至少一项内容：发病率、人口统计学、受影响神经分布、损伤机制、手术干预率以及相关直接成本。排除标准包括非英文出版物、摘要、会议论文集、综述或社论、2000年以前发表的研究、非美国研究或仅关注指神经或神经丛损伤的研究。
15项研究符合纳入标准。数据表明上肢神经损伤的发病率高于下肢损伤。文献缺乏关于手术干预率的全面报告，自2013年以来没有近期数据。明显缺乏关于PNI机制的全国性流行病学数据和近期成本数据，大多数信息已有十多年历史，且主要关注住院费用，忽略了门诊就诊、物理治疗和药物费用。
关于PNI的流行病学数据有限且过时，凸显了进一步研究的必要性。未来的研究应关注PNI发病率、损伤机制和经济负担的近期趋势，包括对手术干预的全面报告，以为旨在改善患者结局和医疗资源分配的策略提供信息。
