Prevalence of associated injuries of spinal trauma and their effect on medical utilization among hospitalized adult subjects--a nationwide data-based study.
Prevalence of associated injuries of spinal trauma and their effect on medical utilization among hospitalized adult subjects--a nationwide data-based study.
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DOI：
10.1186/1472-6963-9-137
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发表时间：
2009-08-03
影响因子：
2.8
通讯作者：
Yang NP
中科院分区：
文献类型：
--
作者：
Chu D;Lee YH;Lin CH;Chou P;Yang NP
摘要本研究旨在探讨台湾地区20岁及以上急性脊柱外伤住院患者中伴发损伤的发生率及其对医疗利用的影响。本研究使用2000年至2003年台湾全民健康保险（NHI）数据库的全国住院病人数据集。选择急性脊髓损伤住院病例的主要纳入标准是基于三个诊断性国际疾病分类，第9版（ICD-9）代码项目：(1)脊柱骨折，未提及脊髓损伤；(2)脊柱骨折合并脊髓损伤；(3)脊髓病变，无脊髓骨损伤迹象。为了调查符合条件的受试者的伴随损伤，对伴随的ICD-9诊断代码进行评估，并将其分为6类共伤：(1)头部创伤；(2)胸部外伤；(3)腹部外伤；(4)盆腔外伤；(5)上肢外伤；(6)下肢外伤。研究了51641个病例；27.6%的受试者患有神经功能障碍，但只有17.3%的受试者接受了脊柱损伤的手术治疗。其中伴发损伤的发生率为：头部外伤，占17.2%；胸部损伤，2.9%；腹部创伤，1.5%；骨盆损伤或骨折，2.5%；上肢骨折，4.4%；下肢骨折，5.9%。发现急性脊髓损伤的三个主要部位（颈椎、胸椎或腰椎）与相关损伤的不均匀分布相结合。通过逐步多元线性回归分析，性别、年龄、脊髓损伤部位、神经功能缺损、手术干预和6种复合损伤是影响两种医疗利用、住院时间（LOS）和直接医疗费用的显著因素。急性脊柱创伤合并下肢损伤、骨盆损伤、胸部损伤、腹部损伤和上肢损伤导致医疗资源利用率最高，估计额外的LOS在4.3至1.2天之间，计算出的额外医疗费用在1 230至320美元之间。台湾地区急性脊柱外伤住院患者中伴发性损伤的发生率较高，且对患者的医疗利用有明显影响。
This study was wanted to investigate the prevalence of concomitant injuries among hospitalized acute spinal trauma patients aged 20 and over and the effects of those injuries on medical utilization in Taiwan. Nationwide inpatient datasets of Taiwan's National Health Insurance (NHI) database from between 2000 and 2003 were used. The major inclusion criteria used to select cases admitted due to acute spinal trauma were based on three diagnostic International Classification of Disease, 9th Version (ICD-9) codes items: (1) fracture of vertebral column without mention of spinal cord injury; (2) fracture of vertebral column with spinal cord injury; or (3) spinal cord lesion without evidence of spinal bone injury. To investigate the associated injuries among the eligible subjects, the concomitant ICD-9 diagnosis codes were evaluated and classified into six co-injury categories: (1) head trauma; (2) chest trauma; (3) abdominal trauma; (4) pelvic trauma; (5) upper extremities trauma; (6) lower extremities trauma. There were 51,641 cases studied; 27.6% of these subjects suffered from neurological deficit, but only 17.3% underwent a surgical procedure for spinal injury. Among them, the prevalence of associated injuries were as follows: head trauma, 17.2%; chest injury, 2.9%; abdominal trauma, 1.5%; pelvic injury or fracture, 2.5%; upper limb fracture, 4.4%; lower limb fracture, 5.9%. The three major locations of acute spinal injury (cervical, thoracic, or lumbar spine) were found to be combined with unequal distributions of associated injuries. By stepwise multiple linear regression, gender, age, location of spinal injury, neurological deficit, surgical intervention and the six combined injuries were identified significantly as associated factors of the two kinds of medical utilization, length of stay (LOS) and direct medical cost. The combinations of acute spinal trauma with lower extremity injury, pelvic injury, chest injury, abdominal injury and upper extremity injury resulted in of the highest utilization of medical resources, the estimated additional LOS being between 4.3 and 1.2 days, and the extra medical cost calculated as being between $1,230 and $320. The occurrence of associated Injuries among hospitalized acute spinal trauma patients in Taiwan is not uncommon, and results in an obvious effect on medical utilization.
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影响因子：
4.7
作者：
Yang NP;Lee YH;Lin CH;Chung YC;Chen WJ;Chou P
通讯作者：
Chou P
影响因子：
3
作者：
Hu, R;Mustard, CA;Burns, C
通讯作者：
Burns, C
DOI：
10.1097/00005373-200207000-00002
发表时间：
2002-07-01
影响因子：
--
作者：
Robertson, A;Giannoudis, PV;Smith, RM
通讯作者：
Smith, RM
影响因子：
3.7
作者：
van der Roer, N;de Bruyne, MC;Boers, M
通讯作者：
Boers, M
影响因子：
--
作者：
Vives, Michael J.;Kishan, Shyam;Livingston, David
通讯作者：
Livingston, David