TY - JOUR
T1 - Age, sex, and socio-economic status affect the incidence of pediatric spinal cord injury
T2 - An eleven-year national cohort study
AU - Chien, Li Chien
AU - Wu, Jau Ching
AU - Chen, Yu Chun
AU - Liu, Laura
AU - Huang, Wen Cheng
AU - Chen, Tzeng-Ji
AU - Thien, Peck Foong
AU - Lo, Su-Shun
AU - Cheng, Henrich
PY - 2012/6/22
Y1 - 2012/6/22
N2 - Background: Few studies focus on pediatric spinal cord injury (SCI) and there is little information regarding the cause, anatomic level, and high risk population of SCI in children. This study aims to investigate the incidence and risk factors of pediatric SCI. Methods: A nationwide cohort of 8.7 million children aged<18 years in an 11-year period was analyzed for causes, age at injury, anatomic sites, disability, and familial socio-economic factors. Incidence rates and Cox regression analysis were conducted. Results: A total of 4949 SCI patients were analyzed. The incidence rates of cervical, thoracic, lumbar, and other SCI were 4.06, 0.34, 0.75, and 0.85 per 100,000 person-years, respectively. The proportional composition of gender, age, and socio-economic status of SCI patients were significantly different than those of non-SCI patients (all p<0.001). Male children were significantly more likely to have SCI than females in both the cervical and the other SCI groups [Incidence rate ratio (IRR) = 2.03 and 1.52; both p<0.001]. Young adults and teenagers were also significantly more likely to have SCI than pre-school age children in the cervical SCI (IRR = 28.55 and 10.50, both p<0.001) and other SCI groups (IRR = 18.8 and 7.47, both p<0.001). Children in families of lower socio-economic status were also significantly more likely to have SCI (p<0.05). Conclusions: In the pediatric population, the overall SCI incidence rate is 5.99 per 100,000 person-years, with traumatic cervical SCI accounting for the majority. The incidence rate increases abruptly in male teenagers. Gender, age, and socio-economic status are independent risk factors that should be considered.
AB - Background: Few studies focus on pediatric spinal cord injury (SCI) and there is little information regarding the cause, anatomic level, and high risk population of SCI in children. This study aims to investigate the incidence and risk factors of pediatric SCI. Methods: A nationwide cohort of 8.7 million children aged<18 years in an 11-year period was analyzed for causes, age at injury, anatomic sites, disability, and familial socio-economic factors. Incidence rates and Cox regression analysis were conducted. Results: A total of 4949 SCI patients were analyzed. The incidence rates of cervical, thoracic, lumbar, and other SCI were 4.06, 0.34, 0.75, and 0.85 per 100,000 person-years, respectively. The proportional composition of gender, age, and socio-economic status of SCI patients were significantly different than those of non-SCI patients (all p<0.001). Male children were significantly more likely to have SCI than females in both the cervical and the other SCI groups [Incidence rate ratio (IRR) = 2.03 and 1.52; both p<0.001]. Young adults and teenagers were also significantly more likely to have SCI than pre-school age children in the cervical SCI (IRR = 28.55 and 10.50, both p<0.001) and other SCI groups (IRR = 18.8 and 7.47, both p<0.001). Children in families of lower socio-economic status were also significantly more likely to have SCI (p<0.05). Conclusions: In the pediatric population, the overall SCI incidence rate is 5.99 per 100,000 person-years, with traumatic cervical SCI accounting for the majority. The incidence rate increases abruptly in male teenagers. Gender, age, and socio-economic status are independent risk factors that should be considered.
UR - http://www.scopus.com/inward/record.url?scp=84862652358&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0039264
DO - 10.1371/journal.pone.0039264
M3 - Article
C2 - 22761749
AN - SCOPUS:84862652358
SN - 1932-6203
VL - 7
JO - PLoS ONE
JF - PLoS ONE
IS - 6
M1 - e39264
ER -