Garwe Tabitha, Mallonee Sue, Stewart Kenneth, Hays-Moore Pat
Oklahoma State Department of Health, Injury Prevention Service, Oklahoma City 73117-1299, USA.
J Okla State Med Assoc. 2004 Feb;97(2):70-4.
Injuries are the third leading cause of death in Oklahoma and the leading cause of death and disability among persons 1-44 years. In 2001, participation in the Oklahoma trauma system became mandatory, and all licensed acute care hospitals were required to submit data to the Oklahoma Trauma Registry (OTR). The objective of this study was to describe the magnitude of major trauma occurring in Oklahoma from 2001-2002.
Data were collected from all licensed acute care hospitals in Oklahoma. Only patients meeting the major trauma criteria were included in the study. Mortality was used as the main outcome measure.
A total of 5760 major trauma patients were reported. The mean age was 38 years (range: 5 days-100 years). Over two-thirds of major trauma cases were male. Blacks had the highest rate of injury (89.5/100,000 population). The leading cause of injury was motor vehicle crashes among persons < 65 years and falls among persons 65 years or older. Overall mortality was 16%; after controlling for age, males were significantly more likely to die than females (O.R 1.3; CI 1.1-1.5). Persons injured by firearms were nearly 5 times more likely to die (CFR=42%) than persons injured by all other causes (CFR=14%) (Odds Ratio 4.5; CI 3.6, 5.5). Excluding deaths in the emergency department (ED), patients were hospitalized an average of 9 days (median: 5 days; range 1-204 days). Over two-thirds (69%) of survivors were discharged home and 14% were discharged to a rehabilitation facility.
There are noted demographic and etiological differences in the burden of major trauma. Understanding these differences may be useful in enhancing existing prevention practices in Oklahoma and for generating new research to lower this burden. The OTR is relatively new and still maturing; hence, further studies will be required to increase understanding of other factors that influence the incidence and outcome of trauma.
伤害是俄克拉荷马州第三大死因，也是1至44岁人群死亡和残疾的主要原因。2001年，参与俄克拉荷马创伤系统成为强制性要求，所有持牌急症护理医院都必须向俄克拉荷马创伤登记处（OTR）提交数据。本研究的目的是描述2001年至2002年俄克拉荷马州发生的重大创伤的规模。
从俄克拉荷马州所有持牌急症护理医院收集数据。只有符合重大创伤标准的患者才被纳入研究。死亡率用作主要结局指标。
共报告了5760例重大创伤患者。平均年龄为38岁（范围：5天至100岁）。超过三分之二的重大创伤病例为男性。黑人的受伤率最高（89.5/100,000人口）。65岁以下人群受伤的主要原因是机动车碰撞，65岁及以上人群受伤的主要原因是跌倒。总体死亡率为16%；在控制年龄后，男性死亡的可能性明显高于女性（比值比1.3；可信区间1.1-1.5）。受枪支伤害的人死亡的可能性几乎是所有其他原因受伤者的5倍（病死率=42%），而所有其他原因受伤者的病死率为14%（比值比4.5；可信区间3.6,5.5）。排除急诊科死亡病例后，患者平均住院9天（中位数：5天；范围1-204天）。超过三分之二（69%）的幸存者出院回家，14%出院到康复机构。
重大创伤负担存在明显的人口统计学和病因学差异。了解这些差异可能有助于加强俄克拉荷马州现有的预防措施，并开展新的研究以减轻这一负担。OTR相对较新且仍在不断完善；因此，需要进一步研究以加深对影响创伤发生率和结局的其他因素的理解。
