Epidemiology of traumatic spinal fractures: experience from medical university–affiliated hospitals in Chongqing, China, 2001–2010

Abstract

<jats:sec> <jats:title>Object</jats:title> <jats:p>The main objective of this study was to analyze the epidemiological data obtained from patients with traumatic spinal fracture at 2 university-affiliated hospitals in Chongqing, China.</jats:p></jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>The authors retrospectively reviewed the hospital records of all patients who suffered traumatic spinal fracture and were treated at Xinqiao Hospital and Southwest Hospital (both affiliated with The Third Military Medical University) between January 2001 and December 2010. The demographic characteristics, injury characteristics, and clinical outcomes of patients over this 10-year period were compared.</jats:p></jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 3142 patients (mean age 45.7 years, range 1–92 years) with traumatic spinal fractures were identified; 65.5% of the patients were male. The peak frequency of these injuries occurred in the 31- to 40-year-old age group. Accidental falls and traffic accidents were the most common causes of spinal fractures (58.9% and 20.9%, respectively). Traffic accidents tended to occur in younger patients, whereas accidental falls tended to occur in older patients. The most common area of fracture was the thoracolumbar spine (54.9%). Cervical spinal fractures were significantly more common in patients injured in traffic accidents, while lumbar spinal fractures were more common in accidental fall patients. Using the American Spinal Injury Association (ASIA) classification, 479 (15.3%) patients were classified as having ASIA A injuries; 913 (29.1%), ASIA B, ASIA C, or ASIA D; and 1750 (55.7%), ASIA E. ASIA A injuries were more common in patients who suffered thoracic spinal fractures (15.09%) than in those with fractures in other areas of the spine. A total of 954 (30.4%) patients had associated nonspinal injuries. Of these patients, 389 (40.78%) suffered a thoracic injury, and 191 (20.02%) sustained a head and neck injury. The length of hospitalization differed significantly between the accidental falls from high heights and falls from low heights, as did the mean cost of hospitalization (p &lt; 0.05), but no significant difference was found between accidental falls from high heights and traffic accidents (p &gt; 0.05). The length of hospitalization differed significantly among the 3 groups according to the ASIA classification, as did the mean cost of hospitalization (p &lt; 0.05). Of patients with incomplete lesions, 39.3% improved 1 or more grades in ASIA classification during hospitalization.</jats:p></jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Accidental falls emerged as the leading cause of traumatic spinal fracture in this study, and the numbers of fall-induced and sports-related injuries increased steadily with age. These results indicate that there should be increased concern for the consequences of fall- and sports-related injuries among the elderly.</jats:p></jats:sec>

Epidemiological Profile of Patients With Traumatic Spinal Fracture

“…4,5,7 This range practically coincides with the peak of the economically active population (EAP) in Brazil, which is from 25 to 49 years of age (60.9% of the EAP in 2015). 15 Thus, spinal fractures have a great economic impact, since the group with the highest incidence is exactly that of young economically active individuals.…”

“…In addition, they are mainly associated with traffic accidents and falls from heights. 4,5 The same epidemiological pattern is maintained in patients with spinal cord injuries, with an annual incidence of approximately 19.4 patients per million inhabitants in France, 10.7 in Germany, 38.4 in the USA, and 21.0 in Brazil. [6][7][8] There is dearth of epidemiological studies about spinal fractures in Brazil.…”

Evaluation of Vertebral Fractures in Patients Presenting to Emergency Department with Trauma

“…Osteoporotic vertebral fractures may occur without trauma; nonetheless, our results suggest traumatic vertebral fractures are also remarkably frequent in elderly population. Previous studies have reported that vertebral fractures were observed 1.9-3.3-fold more frequent in men than in women 2,4,10,12,13 . Contrary to these results, we found male-to-female ratio as 1.5.…”

“…Most commonly, compression and burst fractures are observed after falls, whereas fracturedislocations are most frequently observed after motor vehicle accidents 4,15 . Among all causes of fractures, the incidence rates of falls have been reported to range between 54, and 62% in various studies 2,3,10,13,16 . The fall from a height was observedly the most common cause of trauma at a much higher rate of 79% among patients aged over 65 years who were admitted to the emergency department 17 .…”

“…Although vertebral fractures are observed in only a minority of patients presenting with trauma, they are serious injuries in terms of mortality and morbidity 1,2 . Apart from the osteoporotic fractures seen in the elderly people, vertebral fractures generally occur as a result of high energy traumas 3 .…”