Keays Glenn, Swaine Bonnie, Ehrmann-Feldman Debbie
School of Public Health and Faculty of Medicine, Physiotherapy Program, University of Montreal, Quebec.
Arch Pediatr Adolesc Med. 2006 Aug;160(8):812-6. doi: 10.1001/archpedi.160.8.812.
To describe the frequency of subsequent injuries in children who were seen at an emergency department (ED) for a musculoskeletal injury and to explore factors associated with sustaining a subsequent injury within a year.
This was a prospective cohort study of children aged 1 through 17 years who sought care at an ED for an injury. Subsequent injuries were assessed through telephone interviews.
Subjects were recruited from a national database of childhood injury after they presented to a hospital ED at 1 of the 2 pediatric trauma centers in Montreal, Quebec. PATIENTS/ PARTICIPANTS: A consecutive sample of 7640 children aged 1 through 17 years who sought care for a fracture or a soft-tissue injury to an arm or a leg; 6182 completed both telephone interviews (80.9% response rate). Main Exposure Having a more severe injury was defined in 2 ways: (1) fracture of a limb or (2) injury that required follow-up or admission. Main Outcome Measure Having a subsequent injury during 12-month follow-up.
Subjects with an index fracture were at lower risk of subsequent injury than were those with a soft-tissue injury (13.5% compared with 17.7%; adjusted odds ratio, 0.74; 95% confidence interval, 0.63-0.87). Subjects whose injury needed a follow-up were also at lower risk of subsequent injury than those whose injury was treated only in the ED (17.7% compared with 14.3%; adjusted odds ratio, 0.79; 95% confidence interval, 0.67-0.93) as were those who were admitted (17.7% compared with 8.7%; adjusted odds ratio, 0.51; 95% confidence interval, 0.26-0.99).
Having had a severe musculoskeletal injury may be associated with a decreased risk of subsequent injury in children and adolescents. A possible explanation could be reduced exposure to risk.
描述因肌肉骨骼损伤在急诊科就诊的儿童后续受伤的频率，并探讨与一年内再次受伤相关的因素。
这是一项对1至17岁因伤在急诊科就诊的儿童进行的前瞻性队列研究。通过电话访谈评估后续受伤情况。
研究对象从魁北克省蒙特利尔市两家儿科创伤中心之一的医院急诊科就诊后纳入全国儿童伤害数据库。
患者/参与者：连续抽取7640名1至17岁因手臂或腿部骨折或软组织损伤前来就诊的儿童；6182名完成了两次电话访谈（应答率为80.9%）。主要暴露因素 严重损伤以两种方式定义：（1）肢体骨折或（2）需要随访或住院的损伤。主要结局指标 在12个月随访期间再次受伤。
初次骨折的受试者后续受伤风险低于软组织损伤的受试者（分别为13.5%和17.7%；调整后的优势比为0.74；95%置信区间为0.63 - 0.87）。受伤需要随访的受试者后续受伤风险也低于仅在急诊科接受治疗的受试者（分别为17.7%和14.3%；调整后的优势比为0.79；95%置信区间为0.67 - 0.93），住院患者也是如此（分别为17.7%和8.7%；调整后的优势比为0.51；95%置信区间为0.26 - 0.99）。
患有严重的肌肉骨骼损伤可能与儿童和青少年后续受伤风险降低有关。一种可能的解释是风险暴露减少。
