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运动相关性创伤性脑损伤的 ED 利用趋势。

ED utilization trends in sports-related traumatic brain injury.

机构信息

Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 2008 Cincinnati, OH 45229.

出版信息

Pediatrics. 2013 Oct;132(4):e859-64. doi: 10.1542/peds.2013-1704. Epub 2013 Sep 30.

Abstract

BACKGROUND

Emergency department (ED) visits for sports-related traumatic brain injuries (TBIs) have risen. This study evaluated how the number and severity of admissions have changed as ED visits for sports-related TBIs have increased.

METHODS

A retrospective study of children aged 0 to 19 years at a level 1 trauma center was performed. Patients from 2002 to 2011 with a primary or secondary diagnosis of TBI were identified from the hospital's inpatient and outpatient trauma registries. Frequencies were used to characterize the population, χ(2) analysis was performed to determine differences between groups, and regression analysis looked at relationship between year and injury severity score or length of stay.

RESULTS

Sport was responsible for injury in 3878 (15.4%) cases during the study period; 3506 (90.4%) were discharged from the hospital, and 372 (9.6%) were admitted. Seventy-three percent were male patients and 78% Caucasian; mean age was 13 ± 3.5 years. ED visits for sports-related TBIs increased 92% over the study period, yet there was no significant change (χ(2) = 9.8, df = 9, P = .37) in the percentage of children admitted. Mean injury severity score for those admitted decreased from 7.8 to 4.8 (β = -0.46; P = .006); length of stay trended downward (β = -0.05; P = .05).

CONCLUSIONS

The percentage of children being admitted from the ED with sports-related TBI has not changed over the past 10 years. The severity of admitted sports-related TBI is decreasing. Additional research is needed to correlate these trends with other TBI mechanisms.

摘要

背景

因运动相关创伤性脑损伤(TBI)前往急诊科(ED)就诊的人数有所增加。本研究评估了随着因运动相关 TBI 前往 ED 的就诊人数增加,其入院人数和严重程度的变化情况。

方法

对一家一级创伤中心的 0 至 19 岁儿童进行了一项回顾性研究。从医院的住院和门诊创伤登记处确定了 2002 年至 2011 年间有原发性或继发性 TBI 诊断的患者。使用频率来描述人群,通过 χ(2) 分析来确定组间差异,并通过回归分析来研究年份与损伤严重程度评分或住院时间之间的关系。

结果

在研究期间,运动导致 3878 例(15.4%)患者受伤;3506 例(90.4%)患者从医院出院,372 例(9.6%)患者入院。73%为男性患者,78%为白种人;平均年龄为 13 ± 3.5 岁。在研究期间,因运动相关 TBI 前往 ED 的就诊人数增加了 92%,但入院儿童的比例没有显著变化(χ(2) = 9.8,df = 9,P =.37)。入院患者的平均损伤严重程度评分从 7.8 降至 4.8(β = -0.46;P =.006);住院时间呈下降趋势(β = -0.05;P =.05)。

结论

过去 10 年来,因运动相关 TBI 从 ED 入院的儿童比例没有变化。入院的运动相关 TBI 的严重程度正在降低。需要进一步研究以将这些趋势与其他 TBI 机制相关联。

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