Price C, Makintubee S, Herndon W, Istre G R
Oklahoma State Department of Health, Injury Prevention Service, Oklahoma City 73117-1299.
Am J Epidemiol. 1994 Jan 1;139(1):37-47. doi: 10.1093/oxfordjournals.aje.a116933.
Few injuries result in more profound and long-term disability than traumatic spinal cord injury. This study describes the demographic and epidemiologic characteristics of traumatic spinal cord injury among Oklahoma residents reported to the statewide, population-based surveillance system in 1988-1990; initial acute hospital and rehabilitation charges for 1989 are also included. There was a reported incidence rate of 40 per million population. Based on a reporting sensitivity of 77%, the "true" incidence of spinal cord injury was estimated to be 51 per million population. Motor vehicle crashes accounted for 48% of injuries. Males aged 15-29 years and blacks were at highest risk of injury. Among blacks, the injury rate due to violence was seven times that for whites or Native Americans. Alcohol/drug use was a contributing factor in 39% of injuries and was highest among males aged 20-29 years (58%), Native Americans (57%), and victims of motor vehicle crashes (48%) or violence (51%). The combined initial charges for persons receiving both acute and rehabilitative care ranged from $9,790 to $666,510, with a median of $53,410 per patient; for complete quadriplegia, the combined median charge was $88,585. Despite its low incidence, hospitalization and rehabilitation charges for spinal cord injury in 1989 caused an economic burden of an estimated $8.4 million. While the charges presented were only a small portion of the total costs of spinal cord injury, they further substantiate the need for prevention efforts targeting these debilitating, often permanent injuries. These efforts should target young males and blacks, and should focus on preventing injuries associated with motor vehicle crashes, violence, and alcohol/drug use.
很少有损伤会比创伤性脊髓损伤导致更严重、更长期的残疾。本研究描述了1988 - 1990年向俄克拉荷马州基于人群的全州监测系统报告的该州居民创伤性脊髓损伤的人口统计学和流行病学特征；还包括了1989年最初的急性医院治疗和康复费用。报告的发病率为每百万人口40例。基于77%的报告敏感度，估计脊髓损伤的“真实”发病率为每百万人口51例。机动车碰撞占损伤的48%。15 - 29岁的男性和黑人受伤风险最高。在黑人中，暴力导致的受伤率是白人或美洲原住民的7倍。酒精/药物使用是39%的损伤的一个促成因素，在20 - 29岁的男性（58%）、美洲原住民（57%）以及机动车碰撞受害者（48%）或暴力受害者（51%）中最高。接受急性和康复护理的患者的初始费用总计从9790美元到666510美元不等，每位患者的中位数为53410美元；对于完全四肢瘫痪患者，合并的中位数费用为88585美元。尽管发病率较低，但1989年脊髓损伤的住院和康复费用造成了估计840万美元的经济负担。虽然所呈现的费用只是脊髓损伤总成本的一小部分，但它们进一步证实了针对这些使人衰弱且往往是永久性损伤的预防工作的必要性。这些工作应针对年轻男性和黑人，并应侧重于预防与机动车碰撞、暴力以及酒精/药物使用相关的损伤。
