Pepe P E, Mattox K L, Fischer R P, Matsumoto C M
Department of Surgery, Baylor College of Medicine, Houston, TX.
J Trauma. 1990 Sep;30(9):1125-31; discussion 1131-2. doi: 10.1097/00005373-199009000-00008.
The purpose of this study was to investigate the distribution of various mechanisms of injury and the relative severity of such injury cases throughout the different geographic zones of a large urban area using a computerized emergency medical services (EMS) dispatch/patient record database. The study city (population, 2 million residents) was divided into 156 geographic grids (each 4.5 by 3 miles) and the incidence and relative severity of various injury mechanisms were determined for each zone.
In one year (1988), there were more than 115,000 separate EMS incidents involving more than 150,000 patients, 26,000 of whom were transported for injuries incurred in 10,064 motor vehicle accidents, 4,587 falls, 4,015 lacerations/stabwounds, 1,796 beatings, 1,270 gunshots, and 952 auto-pedestrian accidents. Analysis of the 156 zones showed a disproportionate number of EMS responses in the city center with two centralmost grids accounting for about 25% of all responses. Call volume then progressively diminished toward the periphery of the city. However, with some very minor exceptions, the relative incidence and severity of the various injury mechanisms remained proportionally uniform within each zone, regardless of geographic location. Therefore, contrary to popular notoriety, the incidence and associated severity of any given injury type generally was not necessarily predicted by any particular neighborhood predilection for it, but rather by the overall demand for EMS in that zone of the city.
本研究的目的是利用计算机化的紧急医疗服务（EMS）调度/患者记录数据库，调查一个大城市不同地理区域各类损伤机制的分布情况以及此类损伤病例的相对严重程度。研究城市（人口200万居民）被划分为156个地理网格（每个网格4.5英里×3英里），并确定每个区域各种损伤机制的发生率和相对严重程度。
在一年（1988年）内，有超过115,000起单独的EMS事件，涉及超过150,000名患者，其中26,000人因10,064起机动车事故、4,587起跌倒、4,015起撕裂伤/刺伤、1,796起殴打、1,270起枪击和952起汽车与行人事故所受的伤而被转运。对156个区域的分析显示，市中心的EMS响应数量不成比例，最中心的两个网格占所有响应的约25%。呼叫量随后向城市周边逐渐减少。然而，除了一些非常小的例外情况，每个区域内各种损伤机制的相对发生率和严重程度在比例上保持一致，无论地理位置如何。因此，与普遍的恶名相反，任何特定损伤类型的发生率和相关严重程度通常不一定由任何特定社区对此的偏好来预测，而是由城市该区域对EMS的总体需求来预测。
