Teleale F Gebeyehu, Eric R Mong, Sara Thalheimer, Alexander R Vaccaro, James Harrop
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The mean admission rate per year was 678 (range, 378-758). For the elderly versus the younger cohort, the incidence of falls decreased by 5% versus 3.3%, vehicle accidents increased by 3% versus 14%, high tetraplegia increased by 14.7% versus 22.5%, and low tetraplegia decreased by 12% versus 5.7%. In the elderly, ASIA grades A, B, and C decreased significantly, whereas ASIA grade D increased by 23.8%. In the younger cohort, ASIA grade A and B injuries decreased, whereas grades C and D increased, all <5%. Overall, 32.1% of those with ASIA grade A and 68% with ASIA grade B injuries improved within 1-2 years after injury. In-hospital and 1-year mortality decreased by 14.5% and 35.4%, respectively, in the elderly.</p><p><strong>Conclusions: </strong>The incidence of SCI increased. High cervical and incomplete injuries increased, whereas complete SCIs declined. In-hospital and 1-year mortality decreased. 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引用次数: 0
摘要
背景:随着时间的推移,脊髓损伤人群的人口统计学一直在发生变化,尤其是随着年龄的增长。本研究调查了过去十年美国按年龄划分的脊髓损伤入院模式:评估了国家脊髓损伤模型系统记录的数据(2010-21 年)。根据年龄对患者进行比较:共审查了 8,137 名患者,他们的平均年龄为 42.6 岁(15-88 岁不等)。每年的平均入院率为 678 例(范围为 378 -758)。老年人与年轻人相比,跌倒的发生率分别下降了5%和3.3%,车祸的发生率分别上升了3%和14%,高度四肢瘫痪的发生率分别上升了14.7%和22.5%,低度四肢瘫痪的发生率分别下降了12%和5.7%。在老年人中,ASIA A级、B级和C级明显减少,而ASIA D级增加了23.8%。在年轻人群中,ASIA A 级和 B 级损伤有所增加,而 C 级和 D 级损伤有所增加:SCI 发生率增加。高位颈椎损伤和不完全损伤有所增加,而完全脊髓损伤有所减少。住院死亡率和 1 年死亡率有所下降。部分完全性脊髓损伤病例在 1 年内得以康复。
Epidemiology of Spinal Cord Injury and Associated Mortality, Past and Present. Is There a Difference?
Background: The demographics of the population with spinal cord injury (SCI) have been dynamic over time, especially as a result of aging. This study investigated the patterns of SCI admissions by age in the United States over the past decade.
Methods: Data were evaluated (2010-2021), from the National Spinal Cord Injury Model Systems records. Patients were compared based on age (<70 and ≥70 years), analysis of mortality, neurologic level of injury, neurologic improvement, mortality by American Spinal Injury Association (ASIA) grade, and neurologic level of injury. Patients older than 70 years were defined as elderly.
Results: The mean age of the 8137 patients reviewed was 42.6 years (range, 15-88 years). The mean admission rate per year was 678 (range, 378-758). For the elderly versus the younger cohort, the incidence of falls decreased by 5% versus 3.3%, vehicle accidents increased by 3% versus 14%, high tetraplegia increased by 14.7% versus 22.5%, and low tetraplegia decreased by 12% versus 5.7%. In the elderly, ASIA grades A, B, and C decreased significantly, whereas ASIA grade D increased by 23.8%. In the younger cohort, ASIA grade A and B injuries decreased, whereas grades C and D increased, all <5%. Overall, 32.1% of those with ASIA grade A and 68% with ASIA grade B injuries improved within 1-2 years after injury. In-hospital and 1-year mortality decreased by 14.5% and 35.4%, respectively, in the elderly.
Conclusions: The incidence of SCI increased. High cervical and incomplete injuries increased, whereas complete SCIs declined. In-hospital and 1-year mortality decreased. There was recovery in select cases of complete SCIs within 1 year.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS