Hackam D J, Kreller M, Pearl R H
Department of Surgery, The Hospital of Sick Children and University of Toronto, Ontario, Canada.
J Pediatr Surg. 1999 Jan;34(1):65-8; discussion 69. doi: 10.1016/s0022-3468(99)90230-0.
The aim of this study was to investigate the causes, clinical course, and financial impact of snow-related sport injuries in children.
Reports of snow-related injuries (skiing, toboganning, snowboarding) occurring in 147 consecutive children (< or =16 years of age) admitted from 1991 through 1997 were collected prospectively and assessed retrospectively. During the last year of the study, outpatients treated and released from the emergency department (1996 through 1997) were examined in parallel (n = 101). Total financial impact was determined from the aggregate hospital, rehabilitation, and societal costs.
One hundred thirty-seven patients (M:F, 2:1; mean age, 13 yrs) were admitted (toboggan [n = 74], ski [n = 59], snowboard [n = 16]), of which 66% occurred at licensed resorts, and 33% at parks or private property. There was one death. Although the pattern of injury was similar in all groups (head greater than long bone greater than intraabdominal injuries), mean injury severity scores (ISS) were significantly higher for snowboard injuries. Seventy-five percent of patients required at least one operation. Postdischarge, 15% of patients required institutional care. Of the 101 ambulatory patients (ski [n = 48], toboggan [n = 35], snowboard [n = 18]), 65% were injured at licensed resorts, and 56% required outpatient rehabilitation or home care. The per-patient costs were: hospital treatment, $27,936; outpatient services, $15,243; lost parental income, $1,500.
Snow sport injuries, particularly snowboarding, cause severe childhood morbidity. Helmet usage, training requirements, and regulation of licensed resorts may reduce the morbidity and staggering costs.
本研究旨在调查儿童雪上运动损伤的原因、临床过程及经济影响。
前瞻性收集并回顾性评估1991年至1997年间连续收治的147名（年龄≤16岁）雪上运动损伤（滑雪、雪橇、单板滑雪）患儿的报告。在研究的最后一年，对急诊科诊治并出院的门诊患者（1996年至1997年）进行了平行检查（n = 101）。通过综合医院、康复及社会成本确定总经济影响。
137例患者（男:女 = 2:1；平均年龄13岁）入院（雪橇 [n = 74]，滑雪 [n = 59]，单板滑雪 [n = 16]），其中66%发生在有执照的滑雪场，33%发生在公园或私人场地。有1例死亡。尽管所有组的损伤模式相似（头部损伤＞长骨损伤＞腹部损伤），但单板滑雪损伤的平均损伤严重程度评分（ISS）显著更高。75%的患者至少需要进行一次手术。出院后，15%的患者需要机构护理。在101例门诊患者中（滑雪 [n = 48]，雪橇 [n = 35]，单板滑雪 [n = 18]），65%在有执照的滑雪场受伤，56%需要门诊康复或家庭护理。每位患者的费用为：住院治疗27,936美元；门诊服务15,243美元；父母收入损失1,500美元。
雪上运动损伤，尤其是单板滑雪损伤，会导致严重的儿童发病情况。使用头盔、培训要求及对有执照滑雪场的监管可能会降低发病率及惊人的成本。
