Falls and peripheral nerve injuries: an age-dependent relationship

Abstract

obJect Despite the growing epidemic of falls, the true incidence of peripheral nerve injuries (PNIs) in this patient population remains largely unknown. methods The authors performed a retrospective cohort study of 839,210 fall-injured patients who were registered in the National Trauma Data Bank (NTDB) between 2009 and 2011 and fulfilled the inclusion criteria. Regression techniques were used to investigate the association of demographic and socioeconomic factors with the rate of PNIs in this patient population. The association of age with the incidence of PNIs was also investigated. results Overall, 3151 fall-injured patients (mean age 39.1 years, 33.3% females) sustained a PNI (0.4% of all falls). The respective incidence of PNIs was 2.7 per 1000 patients for ground-level falls, 4.9 per 1000 patients for multilevel falls, and 4.5 per 1000 patients for falls involving force. This demonstrated a rapid increase in the first 2 decades of life, with a maximum rate of 1.1% of all falls in the 3rd decade, followed by a slower decline and eventual plateau in the 7th decade. In a multivariable analysis, the association of PNIs with age followed a similar pattern with patients 20-29 years of age, demonstrating the highest association (OR 2.34 [95% CI 2.0-2.74] in comparison with the first decade of life). Falls involving force (OR 1.25 [95% CI 1.14-1.37] in comparison with multilevel falls) were associated with a higher incidence of PNIs. On the contrary, female sex ) and ground-level falls ) were associated with a lower rate of PNIs. coNclusioNs Utilizing a comprehensive national database, the authors demonstrated that PNIs are more common than previously described in fall-injured patients and identified their age distribution. These injuries are associated with young adults and falls of high kinetic energy.

Nerve Guidance by a Decellularized Fibroblast Extracellular Matrix

“…Peripheral nerve and spinal cord injuries are a critical problem in the United States, leading to devastating functional disability, impacting long term quality of life, and causing significant social and economic burden for thousands of individuals each year [1]. In general, all central nervous system (CNS) injuries and most peripheral nervous system (PNS) injuries over approximately 3 cm lead to poor prognoses for recovery of neurologic function.…”

Restoration of Neurological Function Following Peripheral Nerve Trauma

“…These injuries can be severely debilitating and have a significantly negative impact on the individual's lifestyle, function, and work [3,4]. The majority of those who suffer traumatic nerve injuries are young, with an average age of 39 [5]. Less than 50% of such individuals undergo nerve repair surgery, and of those who do, only 40-50% recover good function [6].…”

Stem cell therapy for nerve injury

“…In 1%-3% of patients with a traumatic accident, a PNI will almost always be involved[ 3 , 4 ]. It has been recognized in children suffering falls[ 5 , 6 ], as a consequence of medical procedures such as surgeries, chemotherapy, radiation[ 7 - 9 ] and sometimes it has been brought about some chronic conditions like diabetes and cancers[ 10 , 11 ]. It can also occur as an iatrogenic injury[ 12 ].…”