Kimia Amir, Lee Lois, Shannon Michael, Capraro Andrew, Mays Donald, Johnston Patrick, Hummel David, Shuman Margot
Division of Emergency Medicine, Harvard Medical School, Children's Hospital Boston, 300 Longwood Ave, Boston, MA 02115, USA.
Pediatr Emerg Care. 2009 Dec;25(12):819-22. doi: 10.1097/PEC.0b013e3181c33109.
Holiday ornament injuries in children have not been well documented in the medical literature. Our aim was to investigate the patterns of injuries sustained from these ornaments as a first measure toward prevention.
This was a retrospective cohort analysis of all patients examined in an urban pediatric emergency department over a 13-year period ending in March 2008 for holiday ornament-related injuries. Cases were identified using a computer-assisted text query followed by a manual chart review. Data collected from each chart included the child's age, sex, injury characteristics, physical examination findings, radiographic imaging, interventions, and disposition. To analyze injury rates over the years, we used a multiplicative Poisson model allowing varying exposures.
Over the study period, we identified 76 eligible patients. The median age was 2 years (interquartile range, 1.17-3.3 years); 44.7% were female. Forty-three of the 76 cases (53.9%) involved ingestions: 35 were of holiday ornaments, and 8 were of light bulbs. All but one of these ornaments were made of glass. In 28%, there was an associated bleed either from the mouth or as a delayed gastrointestinal bleed. Other patients experienced lacerations (27.6%), eye injuries (5.1%), and minor electrocution injury (2.5%). Imaging was performed in 85%. A subspecialty consult was obtained in 23%, primarily addressing a foreign body ingestion or removal after skin exploration. The incidence rate has not changed over the years.
Holiday ornament-related injuries primarily involve foreign body ingestions and glass-related injuries. Over half of the injuries involved small light bulbs and ornaments made of glass placed at the level a toddler can reach. Pediatricians are advised to discuss these points with families during holiday season.
儿童节日饰品伤害在医学文献中尚未得到充分记载。我们的目的是调查这些饰品造成的伤害模式，作为预防的首要措施。
这是一项回顾性队列分析，研究对象为2008年3月结束的13年期间在城市儿科急诊科接受检查的所有因节日饰品相关伤害就诊的患者。通过计算机辅助文本查询，随后进行人工病历审查来确定病例。从每份病历中收集的数据包括儿童的年龄、性别、损伤特征、体格检查结果、影像学检查、干预措施和处置情况。为了分析多年来的伤害发生率，我们使用了一个允许不同暴露情况的乘性泊松模型。
在研究期间，我们确定了76例符合条件的患者。年龄中位数为2岁（四分位间距为1.17 - 3.3岁）；44.7%为女性。76例病例中有43例（53.9%）涉及吞食：35例吞食的是节日饰品，8例吞食的是灯泡。除了一件饰品外，其他所有饰品均由玻璃制成。其中28%的患者出现口腔出血或延迟性胃肠道出血。其他患者经历了撕裂伤（27.6%）、眼外伤（5.1%）和轻微电击伤（2.5%）。85%的患者进行了影像学检查。23%的患者获得了专科会诊，主要针对异物吞食或皮肤探查后异物取出。多年来发病率未发生变化。
节日饰品相关伤害主要涉及异物吞食和玻璃相关伤害。超过一半的伤害涉及放在幼儿能够够到高度的小电灯泡和玻璃饰品。建议儿科医生在节日期间与家庭讨论这些问题。
