中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (5): 1126-1132.

• 原著:脊髓损伤修复保护与再生 • 上一篇    下一篇

中国创伤性脊髓损伤的流行病学和临床特征、治疗状况和经济负担: 基于医院的回顾性研究

  


  • 出版日期:2024-05-15 发布日期:2023-11-01

Epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China: a hospital-based retrospective study

Hengxing Zhou1, 2, #, Yongfu Lou1, 3, #, Lingxiao Chen2, 4, #, Yi Kang3, Lu Liu5, Zhiwei Cai6, David B. Anderson7, 8, Wei Wang2, Chi Zhang2, Jinghua Wang9, Guangzhi Ning3, Yanzheng Gao10, Baorong He5, Wenyuan Ding11, Yisheng Wang12, Wei Mei13, Yueming Song14, Yue Zhou15, Maosheng Xia16, Huan Wang17, Jie Zhao18, Guoyong Yin19, Tao Zhang20, Feng Jing21, Rusen Zhu22, Bin Meng23, Li Duan24, Zhongmin Zhang25, Desheng Wu26, Zhengdong Cai27, Lin Huang28, Zhanhai Yin29, Kainan Li30, Shibao Lu31, Shiqing Feng1, 2, 3, *   

  1. 1Department of Orthopedics, The Second Hospital, Cheeloo College of Medicine, Shandong University, Shandong, China; 2Department of Orthopedics, Shandong University Center for Orthopedics, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Shandong, China; 3Department of Orthopedics, Tianjin Medical University General Hospital, International Science and Technology Cooperation Base of Spinal Cord Injury, Tianjin Key Laboratory of Spine and Spinal Cord, Tianjin, China; 4Faculty of Medicine and Health, The Back Pain Research Team, Sydney Musculoskeletal Health, The Kolling Institute, University of Sydney, Sydney, NSW, Australia; 5Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an, Shaanxi Province, China; 6Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China; 7Faculty of Medicine and Health, School of Health Sciences, University of Sydney, NSW, Australia; 8Sydney Spine Institute, Burwood, Sydney, NSW, Australia; 9Laboratory of Epidemiology, Tianjin Neurological Institute, Department of Neurology, Tianjin Medical University General Hospital & Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China; 10Department of Orthopedics, Henan Provincial People’s Hospital, Zhengzhou, Henan Province, China; 11...
  • Online:2024-05-15 Published:2023-11-01
  • Contact: Shiqing Feng, MD, sqfeng@tmu.edu.cn.
  • Supported by:
    This study was supported by the National Key Research and Development Project, No. 2019YFA0112100 (to SF).

PDF

47

摘要：

中国以往关于创伤性脊髓损伤的研究主要来自区域性地区，但关于流行病学和临床特征的全国性研究很少，特别是关于治疗状况和经济负担的国家级研究还没有开展。为揭示2013-2018年发生在中国的创伤性脊髓损伤的流行病学和临床特征、治疗状况和经济负担。这项国家级、基于医院的回顾性研究于2013年1月至2018年12月从代表中国地理分区的11个省/直辖市的30家医院招募了13,465例患者，记录了患者的流行病学和临床特征、治疗状况、总费用和日常费用。使用Joinpoint回归程序，通过年度百分比变化评估了住院患者中创伤性脊髓损伤的比例、通过骨科住院患者中创伤性脊髓损伤的比例以及费用的趋势。住院患者中创伤性脊髓损伤的百分比和通过骨科住院患者中创伤性脊髓损伤的百分比总体上没有明显变化（APC=-0.5%，95%CI：-3.8至2.9和2.1%，-4.1至8.6，分别）。共有10,053例（74.7%）患者在创伤性脊髓损伤后接受了手术。然而，只有2.8%的接受手术的患者在伤后不到24h接受了手术。共有2005例（14.9%）患者接受了大剂量（≥500mg）的甲基强的松龙琥珀酸钠/甲基强的松龙（MPSS/MP）治疗，615例（4.6%）患者在8h内接受治疗。急性创伤性脊髓损伤的总费用有所下降（-4.7%，-6.3至-3.1），而每日费用没有明显变化（1.0%，-1.4至3.5）。上述结果表明，医院需要提高完成早期手术的能力，因为24h内手术与改善感觉运动恢复有关；提高临床指南的知晓率，以提高治疗效果。

https://orcid.org/0000-0001-9437-7674 (Shiqing Feng)

Abstract: Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death. China has the largest population of patients with traumatic spinal cord injury. Previous studies of traumatic spinal cord injury in China have mostly been regional in scope; national-level studies have been rare. To the best of our knowledge, no national-level study of treatment status and economic burden has been performed. This retrospective study aimed to examine the epidemiological and clinical features, treatment status, and economic burden of traumatic spinal cord injury in China at the national level. We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China. Patient epidemiological and clinical features, treatment status, and total and daily costs were recorded. Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program. The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall (annual percentage change, –0.5% and 2.1%, respectively). A total of 10,053 (74.7%) patients underwent surgery. Only 2.8% of patients who underwent surgery did so within 24 hours of injury. A total of 2005 (14.9%) patients were treated with high-dose (≥ 500 mg) methylprednisolone sodium succinate/methylprednisolone (MPSS/MP); 615 (4.6%) received it within 8 hours. The total cost for acute traumatic spinal cord injury decreased over the study period (–4.7%), while daily cost did not significantly change (1.0% increase). Our findings indicate that public health initiatives should aim at improving hospitals’ ability to complete early surgery within 24 hours, which is associated with improved sensorimotor recovery, increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.  

Key words: China, clinical features, costs, epidemiology, methylprednisolone sodium succinate, methylprednisolone, retrospective study, traumatic spinal cord injury, treatment