Objective

To examine relationships between age and spinal cord injury (SCI) and cause of SCI and how this depends on economic development.

Design

Cross-sectional survey.

Setting

Community, 22 countries representing all stages of economic development.

Participants

A total of 12,591 adults with SCI (N=12,591).

Interventions

Not applicable.

Main Outcome Measures

Interactions between age at injury and gross domestic product per capita based on purchasing power parity (GDP PPP) quartiles calculated with the application of logistic regression with the Maximum Likelihood estimator. Independence between SCI cause and age was assessed with the Wald test.

Results

In persons with traumatic SCI, younger age was associated with a higher likelihood of injury in motor vehicle collisions, whereas older individuals had a greater chance of SCI due to falls. Associations between increased likelihood of high-energy traumatic SCI and younger age, low-energy traumatic SCI with older age, nontraumatic SCI with older age in persons injured in adulthood, and a higher prevalence of incomplete SCI lesions in individuals injured at an older age were revealed. Higher GDP PPP influenced positively the likelihood of low-energy SCI in older individuals and was negatively associated with the chance of sustaining SCI in motor vehicle collisions and the likelihood of having nontraumatic SCI at an older age.

Conclusions

SCI in older age is predominantly because of falls and nontraumatic injuries. Higher country income is associated with an increased proportion of SCI sustained later in life because of low-energy trauma involving cervical injury and a lower chance of being because of motor vehicle collisions. An increased prevalence of nontraumatic SCI in older individuals associated with lower country income may reflect a higher exposure to socially preventable conditions and lower access to or efficacy of health care. Future studies on etiology of SCI should make the distinction between low and high falls and overcome underrepresentation of older persons.

中文翻译：

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脊髓损伤经济发展水平、年龄和病因的关系：来自22个国家的横断面调查

客观的

研究年龄与脊髓损伤 (SCI) 和 SCI 原因之间的关系，以及这如何取决于经济发展。

设计

横断面调查。

环境

共同体，代表经济发展各个阶段的 22 个国家。

参与者

共有 12,591 名成人 SCI (N=12,591)。

干预措施

不适用。

主要观察指标

基于购买力平价 (GDP PPP) 四分位数的受伤年龄与人均国内生产总值之间的相互作用，使用逻辑回归和最大似然估计量计算。使用 Wald 检验评估 SCI 原因和年龄之间的独立性。

结果

在创伤性 SCI 患者中，年龄较小的人在机动车辆碰撞中受伤的可能性较高，而老年人因跌倒而发生 SCI 的可能性较大。高能量创伤性 SCI 的可能性增加与年龄较小、年龄较大的低能量创伤性 SCI、成年后受伤者年龄较大的非创伤性 SCI 以及老年受伤者中不完全 SCI 病变的患病率较高之间的关联是透露。较高的 GDP 购买力平价对老年人发生低能量 SCI 的可能性产生积极影响，并与在机动车碰撞中维持 SCI 的机会以及在老年人中发生非创伤性 SCI 的可能性呈负相关。

结论

老年人的 SCI 主要是由于跌倒和非创伤性损伤。较高的国家收入与晚年 SCI 的比例增加有关，因为涉及颈椎损伤的低能量创伤和较低的机动车辆碰撞几率。与较低国家收入相关的老年人非创伤性 SCI 患病率的增加可能反映了更多地暴露于社会可预防的条件以及较低的医疗保健机会或有效性。未来对 SCI 病因学的研究应区分低位和高位跌倒，并克服老年人代表性不足的问题。