Jager T E, Weiss H B, Coben J H, Pepe P E
Department of Emergency Medicine, Allegheny General Hospital, Allegheny University of the Health Sciences, Pittsburgh, PA, USA.
Acad Emerg Med. 2000 Feb;7(2):134-40. doi: 10.1111/j.1553-2712.2000.tb00515.x.
To describe the incidence and patient characteristics of traumatic brain injuries (TBIs) treated in U.S. emergency departments (EDs).
A secondary analysis was performed on data from the National Hospital Ambulatory Medical Care Survey administered from 1992 to 1994. An ED visit was determined to represent a case of TBI if the case record contained ICD-9-CM codes of 800.0-801.9, 803.0-804.9, or 850.0-854.1.
The average annual estimate of new TBI treated in U.S. EDs was 1,144,807, equaling 444 per 100,000 persons (95% CI = 390 to 498), which represents approximately 3,136 new cases of TBI per day and accounts for 1.3% of all ED visits. Males were 1.6 times as likely as females to suffer TBI until the age of 65 years, when the female rate exceeded the male. The rate for blacks was 35% higher than that for whites. The highest overall incidence rate of TBI occurred in the less-than-5-year age group (1,091 per 100,000), closely followed by the more-than-85-year age group (1,026 per 100,000). Falls represented the most common mechanism of TBI injury, followed by motor vehicle-related trauma.
This study underscores the ongoing need for effective surveillance of all types of TBI and evaluation of prevention strategies targeting high-risk individuals. It serves as a clinically grounded and ED-based corroboration of prior survey research, providing a basis for comparison of incidence rates over time and a tool with which to measure the efficacy of future interventions.
描述在美国急诊科（ED）接受治疗的创伤性脑损伤（TBI）的发病率及患者特征。
对1992年至1994年进行的国家医院门诊医疗调查数据进行二次分析。如果病例记录包含国际疾病分类第九版临床修订本（ICD-9-CM）编码800.0 - 801.9、803.0 - 804.9或850.0 - 854.1，则确定一次急诊就诊代表一例TBI病例。
美国急诊科每年新治疗的TBI平均估计数为1,144,807例，相当于每10万人中有444例（95%可信区间 = 390至498），这意味着每天约有3,136例新的TBI病例，占所有急诊就诊病例的1.3%。在65岁之前，男性发生TBI的可能性是女性的1.6倍，65岁之后女性发病率超过男性。黑人的发病率比白人高35%。TBI总体发病率最高的是年龄小于5岁的组（每10万人中有1,091例），紧随其后的是年龄大于85岁的组（每10万人中有1,026例）。跌倒为TBI损伤最常见的机制，其次是机动车相关创伤。
本研究强调持续需要对所有类型的TBI进行有效监测，并评估针对高危个体的预防策略。它作为基于临床和急诊科的对先前调查研究的佐证，为随时间比较发病率提供了基础，也为衡量未来干预措施的效果提供了工具。
