Neck Injury Comorbidity in Concussion-Related Emergency Department Visits: A Population-Based Study of Sex Differences Across the Life Span.
Neck Injury Comorbidity in Concussion-Related Emergency Department Visits: A Population-Based Study of Sex Differences Across the Life Span.
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脑震荡相关急诊科就诊中的颈部损伤合并症：基于人群的生命周期性别差异研究。
DOI：
10.1089/jwh.2018.7282
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Colantonio,Angela
中科院分区：
文献类型：
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作者：
Sutton,Mitchell;Chan,Vincy;Escobar,Michael;Mollayeva,Tatyana;Hu,Zheng;Colantonio,Angela
背景：颈椎区域特别容易在脑震荡中并发损伤，研究表明，由于女性较弱的颈部和解剖结构上的不同，女性可能面临更大的风险。我们研究的主要目的是研究在急诊科(ED)诊断为脑震荡的患者按受伤原因(机动车碰撞[MVC]和运动)在一生中颈部损伤共患病率的性别差异。材料和方法：所有在2002/2003财政年度至2011/2012财年(含)在安大略省首次就诊的脑震荡相关ED患者在基于人口的卫生管理数据中使用加拿大国际疾病和相关健康问题统计分类(ICD-10-CA)代码进行识别。结果：女性脑震荡患者在5-49岁的脑震荡相关急诊室、15-49岁的MVC相关脑震荡急诊室和10-39岁的运动相关脑震荡急诊室的合并颈部损伤的风险显著较高，模型中所有其他协变量保持不变。结论：这些结果支持考虑增加颈部损伤的筛查，特别是女性，以便进行早期干预。此外，与脑震荡相关的急诊室就诊的女性合并颈部损伤的风险增加与年龄有关，性别和年龄之间的相互作用遵循非线性趋势。因此，未来对脑震荡的研究应该考虑性别和年龄的线性和非线性相互作用。
Background:The cervical spine region can be especially vulnerable to concurrent injury in concussion, with research suggesting that females may be at greater risk due to their weaker and anatomically distinct necks. The main objective of our research was to study sex differences in the rate of neck injury comorbidity across the life span among patients with a concussion diagnosis in the emergency department (ED) setting, by cause of injury (motor vehicle collisions [MVC] and sports).Materials and Methods:All patients with a first concussion-related ED visit between fiscal years 2002/2003 and 2011/2012 (inclusive) in Ontario were identified in population-based health administrative data using the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Canada (ICD-10-CA) codes. Age-dependent odds ratios of comorbid neck injury for sex were estimated using polynomial multivariable logistic regression models, adjusting for sociodemographic characteristics.Results:Females with a concussion had significantly higher odds of sustaining a comorbid neck injury between the ages of 5–49 years for all concussion-related ED visits, 15–49 years for MVC-related concussion ED visits, and 10–39 years for sports-related concussion ED visits, holding all other covariates in the model constant.Conclusions:These results support the consideration of increased screening for comorbid neck injuries, particularly for females, to allow for early intervention. Furthermore, the increased risk of comorbid neck injury in females with a concussion-related ED visit was age-dependent, with the interaction between sex and age following a nonlinear trend. As such, future studies on concussions should consider linear and nonlinear sex and age interactions.