Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA.
Clin Orthop Relat Res. 2012 Jan;470(1):284-90. doi: 10.1007/s11999-011-1982-z. Epub 2011 Jul 22.
The incidence of patients with lower extremity injuries presenting to emergency departments in the United States with respect to specific anatomic regions and disease categories is unknown. Such information might be used for injury prevention, resource allocation, and training priorities.
QUESTIONS/PURPOSES: We determined the anatomic regions, disease categories, and circumstances that account for the highest incidence of leg problems among patients presenting to emergency departments in the United States.
We used the National Electronic Injury Surveillance System (NEISS) to obtain a probability sample of all lower extremity injuries treated at emergency departments during 2009. A total of 119,815 patients who presented to emergency departments with lower extremity injuries in 2009 were entered in the NEISS database. Patient and injury characteristics were analyzed. Incidence rates for various regions, disease categories, injuries, and age groups were calculated using US census data.
We identified 112 unique combinations of disease categories and anatomic regions. Strains and sprains accounted for 36% of all lower extremity injuries. The injury with the greatest incidence was an ankle sprain (206 per 100,000; 95% confidence interval, 181-230). Younger patients were more likely to have ankle sprains, foot contusions/abrasions, and foot strains/sprains. Older patients were more likely to have lower trunk fractures and lower trunk contusions/abrasions. The most common incidence for injury was at home (45%).
Given relatively low-acuity leg problems such as strains and sprains account for a substantial number of emergency department visits pertaining to leg problems, use of telephone triage, scheduled same or next-day urgent care appointments, and other alternatives to the traditional emergency room might result in better use of emergency healthcare resources.
在美国，由于特定解剖区域和疾病类别，下肢损伤患者到急诊就诊的发生率尚不清楚。这些信息可能用于损伤预防、资源分配和培训重点。
问题/目的：我们确定了导致美国急诊就诊患者下肢问题发生率最高的解剖区域、疾病类别和情况。
我们使用国家电子伤害监测系统（NEISS）获取了 2009 年所有在急诊治疗的下肢损伤的概率样本。共有 119815 名在 2009 年因下肢损伤就诊于急诊的患者被纳入 NEISS 数据库。分析了患者和损伤特征。使用美国人口普查数据计算了各种区域、疾病类别、损伤和年龄组的发生率。
我们确定了 112 种独特的疾病类别和解剖区域组合。拉伤和扭伤占所有下肢损伤的 36%。发病率最高的损伤是踝关节扭伤（206/100000；95%置信区间，181-230）。年轻患者更易发生踝关节扭伤、足部挫伤/擦伤和足部拉伤/扭伤。老年患者更易发生下肢躯干骨折和下肢躯干挫伤/擦伤。受伤最常见的地点是家中（45%）。
鉴于相对低危的腿部问题（如拉伤和扭伤）占腿部问题急诊就诊的相当大比例，使用电话分诊、预约次日紧急护理以及其他替代传统急诊的方式，可能会更好地利用急诊医疗资源。
