脊髓损伤：全球疾病负担研究 2019 年的全球发病率、患病率和残疾情况。
Spinal Cord Injury: The Global Incidence, Prevalence, and Disability From the Global Burden of Disease Study 2019.
机构信息
Department of orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
出版信息
Spine (Phila Pa 1976). 2022 Nov 1;47(21):1532-1540. doi: 10.1097/BRS.0000000000004417. Epub 2022 Jun 30.
STUDY DESIGN
A retrospective cohort study.
OBJECTIVE
The authors aimed to estimate the incidence, prevalence and years lived with disability (YLDs) of spinal cord injury (SCI) by location, sex, age, injury site and socio-demographic index (SDI) based on the data of the Global Burden of Disease Study (GBD) 2019.
SUMMARY OF BACKGROUND DATA
GBD 2019 estimates the burden of 369 diseases and injuries worldwide in 2019 and the temporal trends in the past 30 years. SCI is estimated as a result of injury from various causes.
METHODS
A Bayesian meta-regression tool, DisMod-MR2.1, was used to produce the estimates. Estimated annual percentage change (EAPC) was calculated based on a linear regression mode of the age standardized rates and the calendar year to represent the temporal trends of the age standardized rates. Spearman rank order correlation was used to determine the correlation between SDI and the incidence and burden of SCI.
RESULTS
Globally, there were 0.9 [95% uncertainty interval (UI), 0.7 to 1.2] million incident cases, 20.6 (95% UI, 18.9-23.6) million prevalent cases and 6.2 (95% UI, 4.5-8.2) million YLDs of total SCI in 2019. The ASPR increased (EAPC, 0.1; 95% confidence interval, -0.01 to 0.2), while the age standardized incidence rate (ASIR) (EAPC, -0.08; 95% UI, -0.24 to 0.09) and age standardized YLD rate (ASYR) (EAPC, -0.08; 95% confidence interval, -0.24 to 0.09) decreased. Males had higher ASIR and ASYR, and the rate of incidence, prevalence and YLD increased with age. Spinal injuries at neck level caused higher ASYR than injuries below neck level. A positive correlation existed between SDI and ASIR (ρ=0.1626, P <0.05), while a negative correlation was observed between SDI and EAPC of ASYR (ρ=-0.2421, P <0.01).
CONCLUSION
Conclusively, the incidence and burden of SCI has increased over the last 30 years. Males and the elderly were affected to a greater degree than females and younger individuals.
LEVEL OF EVIDENCE
Level III.
研究设计
回顾性队列研究。
目的
作者旨在根据 2019 年全球疾病负担研究（GBD）的数据，按位置、性别、年龄、损伤部位和社会人口指数（SDI）估算脊髓损伤（SCI）的发病率、患病率和伤残损失寿命年（YLDs）。
背景资料概要
GBD 2019 估算了 2019 年全球 369 种疾病和伤害的负担以及过去 30 年的时间趋势。SCI 是由各种原因造成的损伤造成的。
方法
使用贝叶斯荟萃回归工具 DisMod-MR2.1 生成估计值。根据年龄标准化率的线性回归模型和日历年计算估计的年平均变化率（EAPC），以代表年龄标准化率的时间趋势。Spearman 秩相关用于确定 SDI 与 SCI 的发病率和负担之间的相关性。
结果
2019 年，全球有 0.9 [95%置信区间（UI），0.7 至 1.2]百万例新发病例、20.6 [95% UI，18.9 至 23.6]百万例现患病例和 6.2 [95% UI，4.5 至 8.2]百万例总 SCI YLDs。ASPR 增加（EAPC，0.1；95%置信区间，-0.01 至 0.2），而年龄标准化发病率（ASIR）（EAPC，-0.08；95% UI，-0.24 至 0.09）和年龄标准化 YLD 率（ASYR）（EAPC，-0.08；95%置信区间，-0.24 至 0.09）下降。男性的 ASIR 和 ASYR 更高，发病率、患病率和 YLD 随年龄增长而增加。颈部水平的脊柱损伤导致的 ASYR 高于颈部以下水平的损伤。SDI 与 ASIR 之间存在正相关（ρ=0.1626，P<0.05），而 SDI 与 ASYR 的 EAPC 之间存在负相关（ρ=-0.2421，P<0.01）。
结论
综上所述，过去 30 年来，SCI 的发病率和负担有所增加。男性和老年人比女性和年轻人受到的影响更大。
证据水平
III 级。
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