Association between spinal curvature disorders and injury: a nationwide population-based retrospective cohort study

• Published in: BMJ open 2019-01, Vol.9 (1), p.e023604-e023604
• Main Authors: Kuo, Yen-Liang, Chung, Chi-Hsiang, Huang, Tsai-Wang, Tsao, Chang-Huei, Chang, Shan-Yueh, Peng, Chung-Kan, Cheng, Wei-Erh, Chien, Wu-Chien, Shen, Chih-Hao
• Format: Article
• Language: English
• Subjects: Activities of daily living; Adult; Age; Aged; Case-Control Studies; Cohort analysis; Cross-Sectional Studies; Databases, Factual; Exercise; Female; Fractures; Health insurance; Humans; Incidence; Injuries; Male; Middle Aged; Older people; Osteoporosis; Patients; Physical fitness; Population; Population-based studies; Posture; Proportional Hazards Models; Public Health; Retrospective Studies; Risk Factors; Scoliosis; Spinal Curvatures - epidemiology; Taiwan - epidemiology; Teenagers; Wounds and Injuries - epidemiology; Young Adult
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2018-023604

ObjectivesInjury is an important issue in public health. Spinal curvature disorders are deformities characterised by excessive curves of the spine. The prevalence of spinal curvature disorders is not low, but its relationship with injury has not been studied. The aim of this study is to investigate whether spinal curvature disorders increase the risk of injury.DesignPopulation-based retrospective cohort study.SettingUsing data from the Taiwan National Health Insurance Research Database from 2000 to 2010.Participants and exposurePatients with spinal curvature disorders were selected using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. A cohort without spinal curvature was randomly frequency-matched to the spinal curvature disorders cohort at a ratio of 2:1 according to age, sex and index year.Primary outcome measuresThe risk of injury was analysed using Cox’s proportional hazards regression models adjusting for age, sex, comorbidities, urbanisation level and socioeconomic status.ResultsA total of 20 566 patients with spinal curvature disorders and 41 132 controls were enrolled in this study. The risk of injury was 2.209 times higher (95% CI 2.118 to 2.303) in patients with spinal curvature disorders than in the control group. The spinal curvature disorders cohort exhibited higher risk of developing injury compared with the control group, regardless of age, sex, comorbidities, urbanisation level and subgroup of spinal curvature disorders. Based on the subgroup analysis, the spinal curvature disorders cohort had higher risks of unintentional injury and injury diagnoses such as fracture, dislocation, open wound, superficial injury/contusion, crushing and injury to nerves and spinal cord compared with the control cohort.ConclusionsPatients with spinal curvature disorders have a significantly higher risk of developing injury than patients without spinal curvature disorders. Aggressive detection and management of spinal curvature disorders may be beneficial for injury prevention.