Lu-Ping Zhao, Rodriguez-Llanes Jose Manuel, Qi Wu, van den Oever Barbara, Westman Lina, Albela Manuel, Liang Pan, Gao Chen, De-Sheng Zhang, Hughes Melany, von Schreeb Johan, Guha-Sapir Debarati
Crit Care. 2012 May 17;16(3):R87. doi: 10.1186/cc11349.
Multiple injuries have been highlighted as an important clinical dimension of the injury profile following earthquakes, but studies are scarce. We investigated the pattern and combination of injuries among patients with two injuries following the 2008 Wenchuan earthquake. We also described the general injury profile, causes of injury and socio-demographic characteristics of the injured patients.
A retrospective hospital-based analysis of 1,871 earthquake injured patients, totaling 3,177 injuries, admitted between 12 and 31 May 2008 to the People's Hospital of Deyang city (PHDC). An electronic, webserver-based database with International Classification of Diseases (ICD)-10-based classification of earthquake-related injury diagnoses (IDs), anatomical sites and additional background variables of the inpatients was used. We analyzed this dataset for injury profile and number of injuries per patient. We then included all patients (856) with two injuries for more in-depth analysis. Possible spatial anatomical associations were determined a priori. Cross-tabulation and more complex frequency matrices for combination analyses were used to investigate the injury profile.
Out of the 1,871 injured patients, 810 (43.3%) presented with a single injury. The rest had multiple injuries; 856 (45.8%) had two, 169 (9.0%) patients had three, 32 (1.7%) presented with four injuries, while only 4 (0.2%) were diagnosed with five injuries. The injury diagnoses of patients presenting with two-injuries showed important anatomical intra-site or neighboring clustering, which explained 49.1% of the combinations. For fractures, the result was even more marked as spatial clustering explained 57.9% of the association pattern. The most frequent combination of IDs was a double-fracture, affecting 20.7% of the two-injury patients (n = 177). Another 108 patients (12.6%) presented with fractures associated with crush injury and organ-soft tissue injury. Of the 3,177 injuries, 1,476 (46.5%) were fractures. Most injuries were located in the head (22.9%) and lower extremities (30.8%).
Multiple injuries are put forward as an important component of the injury profile after this earthquake. A pattern of injury combinations and spatial aggregation of injuries was also found. Clinical diagnosis and treatment should be adapted to care of these patients. More studies are needed to generalize these findings.
多处损伤已被视为地震后受伤情况的一个重要临床维度，但相关研究较少。我们调查了2008年汶川地震后两处受伤患者的损伤模式及合并情况。我们还描述了受伤患者的总体损伤情况、受伤原因及社会人口学特征。
对2008年5月12日至31日期间收治入德阳市人民医院（PHDC）的1871例地震伤患者进行回顾性医院分析，这些患者共有3177处损伤。使用一个基于网络服务器的电子数据库，该数据库按照国际疾病分类（ICD）-10对与地震相关的损伤诊断（ID）、解剖部位及住院患者的其他背景变量进行分类。我们分析了该数据集的损伤情况及每位患者的损伤数量。然后纳入所有有两处损伤的患者（856例）进行更深入分析。预先确定可能的空间解剖关联。使用交叉表及更复杂的频率矩阵进行合并分析以研究损伤情况。
在1871例受伤患者中，810例（43.3%）为单处损伤。其余为多处损伤；856例（45.8%）有两处损伤，169例（9.0%）患者有三处损伤，32例（1.7%）有四处损伤，而仅有4例（0.2%）被诊断为五处损伤。有两处损伤患者的损伤诊断显示出重要的解剖部位内或相邻部位的聚集，这解释了49.1%的合并情况。对于骨折，结果更为明显，因为空间聚集解释了57.9%的关联模式。最常见的ID组合是双骨折，占两处损伤患者的20.7%（n = 177）。另外108例患者（12.6%）表现为骨折合并挤压伤及器官软组织损伤。在3177处损伤中，1476处（46.5%）为骨折。大多数损伤位于头部（22.9%）和下肢（30.8%）。
多处损伤被认为是此次地震后受伤情况的一个重要组成部分。还发现了损伤合并模式及损伤的空间聚集情况。临床诊断和治疗应适应这些患者的护理需求。需要更多研究来推广这些发现。
