Simon Tamara D, Bublitz Caroline, Hambidge Simon J
Department of Pediatrics, University of Colorado at Denver, USA.
Pediatr Emerg Care. 2006 May;22(5):309-15. doi: 10.1097/01.pec.0000215139.29039.5c.
(1) To characterize the demographics and external causes of pediatric sports injury-related visits (SIRVs) to emergency departments (EDs). (2) To analyze the effect of race/ethnicity and insurance on SIRVs to EDs.
A stratified random-sample cross-sectional survey of EDs in the National Hospital Ambulatory Medical Care Survey was conducted from 1997-2001; for patients younger than 19 years, we used all visits [n = 33,654; injury-related visits (IRVs) = 13,496, SIRVs = 2990]. We examined both the external cause codes and the actual verbatim text of all IRVs. National estimates of pediatric IRVs were obtained using the assigned patient visit weights in the National Hospital Ambulatory Medical Care Survey databases and SUDAAN 9.1 software (SAS Institute, Inc., Cary, NC).
Sports injuries resulted in 2.5 million visits annually, or 23% of ED IRVs. Male sex, older age (6-18 years), and white race/ethnicity are associated with higher rates of SIRVs. Cycling, basketball, playground injuries, and football resulted in the largest numbers of ED SIRVs. Leading diagnoses for SIRVs included fractures and dislocations, sprains and strains, open wounds, and contusions. Hispanic race/ethnicity was associated with lower rates of SIRVs across all insurance types. After controlling for demographic factors and insurance, Hispanic children were less likely to have an SIRV than white children (odds ratio, 0.7; 95% confidence interval, 0.6-0.9).
Sports and recreation are the leading causes of pediatric ED IRVs. Hispanic children, regardless of insurance status, had lower rates of SIRVs than white children, which helps explain the lower rate of nonfatal IRVs to EDs among Hispanic youth.
（1）描述儿科运动损伤相关急诊就诊（SIRV）的人口统计学特征及外部原因。（2）分析种族/民族和保险对儿科急诊SIRV的影响。
1997年至2001年对国家医院门诊医疗调查中的急诊进行分层随机抽样横断面调查；针对19岁以下患者，我们使用了所有就诊病例[n = 33,654；损伤相关就诊（IRV）= 13,496，SIRV = 2990]。我们检查了所有IRV的外部原因编码和实际逐字文本。使用国家医院门诊医疗调查数据库中的指定患者就诊权重和SUDAAN 9.1软件（SAS Institute，Inc.，卡里，北卡罗来纳州）获得儿科IRV的全国估计值。
运动损伤每年导致250万次就诊，占急诊IRV的23%。男性、年龄较大（6 - 18岁）以及白人种族/民族与较高的SIRV发生率相关。骑自行车、篮球、游乐场受伤和足球导致的急诊SIRV数量最多。SIRV的主要诊断包括骨折和脱位、扭伤和拉伤、开放性伤口以及挫伤。在所有保险类型中，西班牙裔种族/民族的SIRV发生率较低。在控制了人口统计学因素和保险因素后，西班牙裔儿童发生SIRV的可能性低于白人儿童（比值比，0.7；95%置信区间，0.6 - 0.9）。
运动和娱乐是儿科急诊IRV的主要原因。无论保险状况如何，西班牙裔儿童的SIRV发生率低于白人儿童，这有助于解释西班牙裔青少年非致命性急诊IRV发生率较低的原因。
