@article{ref1,
title="Fatal cervical spine injuries: a Finnish nationwide register-based epidemiological study on data from 1987 to 2010",
journal="Spine journal",
year="2015",
author="Thesleff, Tuomo and Niskakangas, Tero and Luoto, Teemu M. and Ohman, Juha and Ronkainen, Antti",
volume="16",
number="8",
pages="918-926",
abstract="BACKGROUND CONTEXT: The number of cervical spine injuries (CSIs) is increasing. CSIs are associated with high morbidity and mortality. Identifying those who are at risk for CSI-related death can help develop national and international interventions and policies to reduce mortality. <br><br>PURPOSE: To determine the trends in the incidence and the characteristics of fatal cervical spine injuries (CSIs) in XXXXX over a 24-year study period from 1987 to 2010. STUDY DESIGN/SETTING: A large nationwide, retrospective, register-based study. PATIENT SAMPLE: The population-based sample was collected from death certificates issued in XXXX between 1987 and 2010. The death certificates were obtained from the official Cause-of-Death Register, coordinated by Statistics XXXX, which covers all deaths occurring in XXXX. OUTCOME MEASURES: Socio-demographics and injury- and death related data. <br><br>METHODS: All death certificates issued in XXXX (1987-2010) containing a CSI as the cause of death were carefully reviewed. <br><br>RESULTS: A total of 2041 fatal CSIs were identified. These constituted 0.17% of all deaths in XXXX within the study period. The average annual incidence of fatal CSIs was 16.5/million (range: 12.5-21.2). The majority of the victims were male (72.9%) and had concurrent spinal cord injury (83.0%). Traffic accidents (40.1%) and falls (45.0%) were the most common injury mechanisms. Almost one third (29.8%) of the deaths were alcohol-related. Among the young victims (<60 years) with upper CSI (C0-C2), the majority (91.8%) died within 24 hours post-injury. One third of elderly victims (≥60 years) CSI-related deaths occurred after one week post-injury and were mostly (74.2%) caused by respiratory- and circulatory system diseases. Within the 24-year period, the incidence of fatal CSIs (+2/million), as well as the average age of sustaining a fatal CSI (+13.5 years), increased markedly. Fall-induced accidents among elderly males were the most prominently increasing subpopulation of fatal CSI victims. <br><br>CONCLUSIONS: In recent decades, fatal CSI incidence (death certificate-based) has increased, being 18.6/million in XXXX in 2010. Victims of fatal CSIs tend to be older than in the past, and for a substantial number of males, low-energy falls lead to cervical trauma and death.<p /> <p>Language: en</p>",
language="en",
issn="1529-9430",
doi="10.1016/j.spinee.2015.11.054",
url="http://dx.doi.org/10.1016/j.spinee.2015.11.054"
}