Fagenholz Peter J, Sheridan Robert L, Harris N Stuart, Pelletier Andrea J, Camargo Carlos A
Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
J Burn Care Res. 2007 Sep-Oct;28(5):681-90. doi: 10.1097/BCR.0B013E318148C9AC.
No studies have examined U.S. burn epidemiology from the perspective of the Emergency Department. We sought to describe patient characteristics, injury types, and Emergency Department practice patterns. Data were collected from the National Hospital Ambulatory Medical Care Survey between 1993 and 2004. Emergency Department visit rates for burn injury decreased from 1993 to 2004 with a peak of 2.8 (95% confidence interval [CI] 2.1-3.4) per 1000 U.S. population in 1995 and a nadir of 1.6 (95% CI 1.2-2.0) per 1000 in 2004. The Emergency Department visit rate for burn injuries was greater for men than women (2.7 [95% CI 2.4-3.0] vs 1.8 [95% CI 1.6-2.0] per 1000) and for black than white subjects (3.4 [95% CI 2.8-3.9] vs 2.1 [95%CI 1.9-2.3] per 1000), though all these groups showed decreases. Emergency Department visit rates for burns were greatest in the first and third decades (3.3 [95% CI 2.8-3.7] and 3.5 [95% CI 3.0-4.0] per 1000, respectively) and decreased thereafter. The upper extremity was the most commonly burned part of the body (37% of total) and most burns of specified depth were partial thickness (48% of total). Less than half of patients received analgesics (47%) or topical antibiotics (38%). Emergency Department visits for burns are declining, but rates remain high in men, black individuals, and children. Burn-prevention efforts should target these groups. Upper-extremity and partial-thickness injuries are common, and less than half of patients receive analgesics or topical antibiotics. Collaboration between burn specialists and Emergency Department personnel should focus on the care of these types of injuries.
尚无研究从急诊科的角度审视美国烧伤流行病学情况。我们试图描述患者特征、损伤类型以及急诊科的诊疗模式。数据收集自1993年至2004年的《国家医院门诊医疗调查》。1993年至2004年期间,烧伤的急诊科就诊率呈下降趋势,1995年达到峰值,每1000名美国人口中有2.8例(95%置信区间[CI] 2.1 - 3.4),2004年降至最低点,每1000名中有1.6例(95% CI 1.2 - 2.0)。男性的烧伤急诊科就诊率高于女性(每1000名中分别为2.7例[95% CI 2.4 - 3.0]和1.8例[95% CI 1.6 - 2.0]),黑人高于白人(每1000名中分别为3.4例[95% CI 2.8 - 3.9]和2.1例[95% CI 1.9 - 2.3]),尽管所有这些群体的就诊率均呈下降趋势。烧伤的急诊科就诊率在第一个和第三个十年最高(分别为每1000名中有3.3例[95% CI 2.8 - 3.7]和3.5例[95% CI 3.0 - 4.0]),此后下降。上肢是身体最常被烧伤的部位(占总数的37%),特定深度的烧伤大多为浅度烧伤(占总数的48%)。不到一半的患者接受了镇痛药(47%)或外用抗生素(38%)。烧伤的急诊科就诊人数正在下降,但男性、黑人个体和儿童的就诊率仍然很高。烧伤预防工作应针对这些群体。上肢和浅度烧伤很常见,不到一半的患者接受了镇痛药或外用抗生素。烧伤专科医生与急诊科人员之间的合作应侧重于这类损伤的护理。