Sex, age, role and geographic differences in traumatic spinal fractures caused by motor vehicle collisions: a multicentre retrospective study

Abstract

To investigate the sex, age, role and geographic differences in traumatic spinal fractures (TSFs) caused by motor vehicle collisions (MVCs) in adults (≥ 18 years old). This was a multicentre retrospective observational study. In total, 798 patients with TSFs caused by MVCs admitted to our hospitals from January 2013 to December 2019 were enrolled. The patterns were summarized with respect to different sexes (male and female), age group (18–60 and ≥ 60), role (driver, passenger and pedestrian) and geographic location (Chongqing and Shenyang). Significant differences in distribution related to district (p = 0.018), role (p < 0.01), motorcycle (p = 0.011), battery electric vehicle (p = 0.045), bicycle (p = 0.027), coma after injury (p = 0.002), pelvic fracture (p = 0.021), craniocerebral injury (p = 0.008) and fracture location (p < 0.01) were observed between the male and female groups. Significant differences in distribution related to district (p < 0.01), role (p < 0.01), car (p = 0.013), coma after injury (p = 0.003), lower limb fracture (p = 0.016), fracture location (p = 0.001) and spinal cord injury (p < 0.01) were observed between the young adult and elderly groups. Significant differences in distribution related to sex ratio (p < 0.01), age (p < 0.01), district (p < 0.01), most vehicles involved (P < 0.01), lower limb fracture (p < 0.01), pelvic fracture (p < 0.01), fracture location (p < 0.01), complications (p < 0.01), and spinal cord injury (p < 0.01) were observed between the three different groups of pedestrian, passenger, and driver. Significant differences in distribution related to sex ratio (p = 0.018), age (p < 0.01), role (p < 0.01), most vehicles involved (p < 0.01), coma after injury (p = 0.030), LLF (P = 0.002), pelvic fracture (p < 0.01), craniocerebral injury (p = 0.011), intrathoracic injury (p < 0.01), intra-abdominal injury (p < 0.01), complications (p = 0.033) and spinal cord injury (p < 0.01) were observed between the Chongqing and Shenyang groups. This study demonstrates the age-, gender-, role- and geographic-specific clinical characteristics of TSFs resulting from MVCs and reveals a significant relationship between different ages, sexes, roles, geographic locations and associated injuries, complications and spinal cord injuries.

Examination and Scientific Analysis of Thoracic Vertebral Fractures

“…The available data suggests that in terms of absolute numbers, men tend to have a slightly higher incidence of thoracic spine fractures than women, particularly in younger age groups. This is often attributed to higher rates of trauma-related incidents and participation in activities with a higher risk of injury among younger men [2,3,5,6,[20][21][22]27].…”

“…Statistical analysis was conducted to explore the impact of implicated products, injured body parts, age, gender, and locations of injury incidents. The analysis focused on the top five locations for thoracic vertebral fractures based on previous studies, while excluding unknown locations due to their lack of substantial public health significance [ 6 , 17 ]. Pearson chi-square tests were employed to assess potential significant differences in thoracic vertebral fracture occurrence across different areas (“Home,” “Place of Recreation/Sports,” “Other Public Property,” “Street or Highway,” “School”) and products (“Ladder,” “Floor,” “Bicycles,” “Football,” “Bed”).…”

“…Pearson chi-square tests were employed to assess potential significant differences in thoracic vertebral fracture occurrence across different areas (“Home,” “Place of Recreation/Sports,” “Other Public Property,” “Street or Highway,” “School”) and products (“Ladder,” “Floor,” “Bicycles,” “Football,” “Bed”). Per previous investigations [ 1 , 6 , 17 ], multivariate logistic regression was utilized to assess patterns of both sex and age groups. This involved adjusting for age as a covariate in the regression model examining the relationship with sex.…”

“…Emerging research suggests potential sex-specific predilections for specific spinal fractures, possibly rooted in divergent bone density and hormonal influences. Meanwhile, age, a formidable predictor of fracture incidence, exerts its effect through dynamic alterations in bone quality and strength [5,6].…”

“…Emerging research suggests potential sex-specific predilections for specific spinal fractures, possibly rooted in divergent bone density and hormonal influences. Meanwhile, age, a formidable predictor of fracture incidence, exerts its effect through dynamic alterations in bone quality and strength [ 5 , 6 ]. Exploring sex and age dynamics within the context of thoracic vertebral fractures is pivotal for revealing underlying risk factors and optimizing strategies for fracture prevention [ 1 , 7 , 8 ].…”