Singer Adam J, Thode Henry C, Hollander Judd E
Department of Emergency Medicine, Stony Brook University, NY 11794-8350, USA.
Am J Emerg Med. 2006 Mar;24(2):183-8. doi: 10.1016/j.ajem.2005.08.021.
National estimates of the number of lacerations are based on the number of wounds cared for in the emergency department (ED). However, this number includes wounds other than lacerations. We estimated the number and characteristics of lacerations treated in the United States between 1992 and 2002.
The design used was secondary analysis of National Hospital Ambulatory Medical Care Survey (a weighted sample of ED encounters). Encounters with a laceration recorded as 1 of the 3 diagnosis codes (870-897) of the International Classification of Diseases, Ninth Revision, Clinical Modification for the visit were included. Data collection included demographics, wound location, insurance status, procedures performed, type of practitioner, and pain severity. For data analysis, the National Hospital Ambulatory Medical Care Survey databases for 1992 to 2002 were downloaded from its Web site and imported into SPSS 12.0 (SPSS, Chicago, Ill) for analysis. National estimates were obtained using assigned patient visit weights. Descriptive statistics were calculated, and group comparisons were performed with chi(2) tests using unweighted data. Rates were calculated using population data from the US census.
There were 300715 patient encounters sampled from nearly 400 EDs resulting in an estimated 1.08 billion ED visits between 1992 and 2002. In the sample, 24755 patients (8.2%) had lacerations resulting in an estimated 90 million lacerations. Although the number of total ED visits increased annually during the study period (from 89.8 to 110.15 million), the number of lacerations declined (from 9.35 to 7.27 million). Lacerations were distributed on the upper extremity (35%), face (28%), trunk (14.5%), lower extremity (12.5%), and head and neck (10%). In 2002, about two thirds of the patients with a laceration were men, one third were children, and more than three fourths were white. Facial lacerations were more common in children (43% vs 20%; P < .01), whereas upper extremity lacerations were more common in adults (48% vs 20%, P < .001). The number of visits for lacerations was greatest on weekends, during the spring and summer, and between noon and 10 pm. Work-related injuries accounted for 11% of lacerations.
Despite an increase in the total number of ED visits over the last decade, the number of lacerations has declined, as is less than previously estimated.
全国范围内对撕裂伤数量的估计是基于急诊科（ED）所处理伤口的数量。然而，这个数字包含了除撕裂伤之外的其他伤口。我们估算了1992年至2002年间美国治疗的撕裂伤的数量及特征。
采用的设计是对国家医院门诊医疗调查（急诊科就诊情况的加权样本）进行二次分析。将就诊时记录为国际疾病分类第九版临床修订本中3个诊断编码（870 - 897）之一的撕裂伤病例纳入。数据收集包括人口统计学信息、伤口位置、保险状况、所实施的操作、从业者类型以及疼痛严重程度。为进行数据分析，从其网站下载了1992年至2002年的国家医院门诊医疗调查数据库，并导入SPSS 12.0（SPSS，伊利诺伊州芝加哥）进行分析。使用指定的患者就诊权重获得全国估计值。计算描述性统计量，并使用未加权数据通过卡方检验进行组间比较。发病率使用美国人口普查的人口数据计算。
从近400个急诊科抽取了300715例患者就诊病例，由此估计1992年至2002年间急诊科就诊人次达10.8亿。在样本中，24755名患者（8.2%）有撕裂伤，由此估计有9000万例撕裂伤。尽管在研究期间急诊科就诊总人次逐年增加（从8980万增至1.1015亿），但撕裂伤数量却有所下降（从935万降至727万）。撕裂伤分布在上肢（35%）、面部（28%）、躯干（14.5%）、下肢（12.5%）以及头颈部（10%）。2002年，约三分之二的撕裂伤患者为男性，三分之一为儿童，超过四分之三为白人。面部撕裂伤在儿童中更为常见（43%对20%；P < 0.01），而上肢撕裂伤在成年人中更为常见（48%对20%，P < 0.001）。撕裂伤就诊人次在周末、春季和夏季以及中午至晚上10点之间最多。工伤导致的撕裂伤占11%。
尽管在过去十年中急诊科就诊总人次有所增加，但撕裂伤数量却有所下降，且低于先前估计。
