Lumbar spine fractures within a complete American cohort: epidemiology and risk factors among military service members.
*Warfare; Adolescent; Adult; Age Distribution; Aged; Cohort Studies; Comorbidity; Female; Humans; Lumbar Vertebrae/*injuries; Male; Middle Aged; Military Personnel/*statistics & numerical data; Prevalence; Retrospective Studies; Risk Factors; Sex Distribution; Spinal Cord Injuries/*epidemiology; Spinal Fractures/*epidemiology; United States/epidemiology; Young Adult
STUDY DESIGN: Retrospective database review. OBJECTIVE: To describe the incidence of, and risk factors for, lumbar spine fractures within the population of the US military. SUMMARYOF BACKGROUND DATA: Fractures of the lumbar region are an important health concern; however, the epidemiology of this injury has not been extensively studied in the United States. METHODS: International Classification of Diseases, Clinical Modification, Ninth Revision codes for lumbar spine fractures were used in a search of the Defense Medical Epidemiology Database, identifying all individuals who sustained such injuries between 2001 and 2010. The database was also used to obtain the complete number of individuals serving in the Armed Forces over the same time period. Information regarding race, rank, branch of service, sex, and age was obtained for all individuals identified as having lumbar spine fractures as well as for the whole military population. The incidence of lumbar spine fractures was determined for the cohort. Unadjusted incidence rates were derived for risk factors and multivariate Poisson regression analysis, controlling for all other risks, was used to obtain adjusted incidence rate ratios and identify statistically significant risks for lumbar fractures. RESULTS: Between 2001 and 2010, the overall incidence of lumbar fractures was 0.38 per 1000 person-years. Male sex, white race, enlisted ranks, service in the Army and Marines, and age were found to be significant predictors of lumbar spine fracture. Service in the Army demonstrated the highest rate of lumbar fractures (0.48 per 1000 person-years). CONCLUSIONS: This investigation is the first to document the incidence and postulate risk factors for lumbar spine fracture in an American population. In this study, males, whites, enlisted personnel, those serving in the Army and Marines, and individuals aged 20-24 or greater than 40 were found to be at an increased risk of lumbar fracture.
Schoenfeld Andrew J; Romano David; Bader Julia O; Walker John J
Journal of spinal disorders & techniques
2013
2013-06
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1097/BSD.0b013e31823f3237" target="_blank" rel="noreferrer noopener">10.1097/BSD.0b013e31823f3237</a>
Incidence and epidemiology of spinal cord injury within a closed American population: the United States military (2000-2009).
*Military Personnel; Adolescent; Adult; Female; Humans; Incidence; International Classification of Diseases; Male; Middle Aged; Retrospective Studies; Risk Factors; Spinal Cord Injuries/*epidemiology; United States/epidemiology; Young Adult
STUDY DESIGN: Cohort study. OBJECTIVES: The objective of this study was to characterize the incidence of spinal cord injury (SCI) within the population of the United States military from 2000-2009. This investigation also sought to define potential risk factors for the development of SCI. SETTING: The population of the United States military from 2000-2009. METHODS: The Defense Medical Epidemiology Database was queried for the years 2000-2009 using the International Classification of Diseases, Ninth Revision, Clinical Modification codes for SCI (806.0, 806.1, 806.2, 806.3, 806.4, 806.5, 806.8, 806.9, 952.0, 952.1, 952.2, 952.8, 952.9). The raw incidence of SCI was calculated and unadjusted incidence rates were generated for the risk factors of age, sex, race, military rank and branch of service. Adjusted incidence rate ratios were subsequently determined via multivariate Poisson regression analysis that controlled for other factors in the model and identified significant independent risk factors for SCI. RESULTS: Between 2000 and 2009, there were 5928 cases of SCI among a population at-risk of 13,813,333. The raw incidence of SCI within the population was 429 per million person-years. Male sex, white race, enlisted personnel and service in the Army, Navy or Marine Corps were found to be significant independent risk factors for SCI. The age groups 20-24, 25-29 and \textgreater40 were also found to be at significantly greater risk of developing the condition. CONCLUSIONS: This study is one of the few investigations to characterize the incidence, epidemiology and risk factors for SCI within the United States. Results presented here may represent the best-available evidence for risk factors of SCI in a large and diverse American cohort.
Schoenfeld A J; McCriskin B; Hsiao M; Burks R
Spinal Cord
2011
2011-08
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1038/sc.2011.18" target="_blank" rel="noreferrer noopener">10.1038/sc.2011.18</a>