Rhea Sarah K, Weber David J, Poole Charles, Waller Anna E, Ising Amy I, Williams Carl
Department of Epidemiology, Gillings School of Global Public Health, School of Medicine, University of North Carolina, Chapel Hill, NC 27599., Department of Emergency Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27599.
J Am Vet Med Assoc. 2014 Mar 1;244(5):597-603. doi: 10.2460/javma.244.5.597.
OBJECTIVE--To determine incidence of animal bite injuries among humans in North Carolina by use of statewide emergency department visit data; to evaluate incidence rates on the basis of age, sex, urbanicity, biting species, and month for selected species; and to characterize bite-related emergency department visits. DESIGN--Retrospective cohort and cross-sectional study. SAMPLE--Records of 38,971 incident animal bite-related emergency department visits in North Carolina from 2008 to 2010. PROCEDURES--Emergency department visits were selected for inclusion by means of external-cause-of-injury codes assigned with an international coding system and keyword searches of chief complaint and triage notes. Rates were calculated with denominators obtained from census data. Cross-sectional analysis of incident emergency department visits was performed. RESULTS--By the age of 10, a child in North Carolina had a 1 in 50 risk of dog bite injury requiring an emergency department visit. Incidence rates for dog bites were highest for children ≤ 14 years of age, whereas the incidence rate for cat bites and scratches was highest among individuals > 79 years of age. Lifetime risk of cat bite or scratch injury requiring an emergency department visit was 1 in 60 for the population studied. Rabies postexposure prophylaxis was administered during 1,664 of 38,971 (4.3%) incident visits. CONCLUSIONS AND CLINICAL RELEVANCE--Emergency department visit surveillance data were used to monitor species-specific bite incidence statewide and in various subpopulations. Emergency department surveillance data may be particularly useful to public health veterinarians. Results may inform and renew interest in targeted animal bite prevention efforts.
目的——利用全州急诊就诊数据确定北卡罗来纳州人类动物咬伤伤害的发生率；根据年龄、性别、城市化程度、致伤物种以及选定物种的月份评估发生率；并描述与咬伤相关的急诊就诊情况。设计——回顾性队列研究和横断面研究。样本——2008年至2010年北卡罗来纳州38971例与动物咬伤相关的急诊就诊记录。程序——通过国际编码系统分配的外部伤害原因代码以及对主诉和分诊记录进行关键词搜索来选择纳入的急诊就诊病例。发生率通过人口普查数据获得的分母进行计算。对急诊就诊病例进行横断面分析。结果——到10岁时，北卡罗来纳州的儿童中有1/50的风险因狗咬伤而需要急诊就诊。狗咬伤的发生率在≤14岁的儿童中最高，而猫咬伤和抓伤的发生率在>79岁的人群中最高。在所研究的人群中，因猫咬伤或抓伤而需要急诊就诊的终生风险为1/60。在38971例（4.3%）急诊就诊病例中，有1664例进行了狂犬病暴露后预防。结论及临床意义——急诊就诊监测数据用于监测全州及不同亚人群中特定物种的咬伤发生率。急诊就诊监测数据对公共卫生兽医可能特别有用。结果可能为有针对性的动物咬伤预防工作提供信息并重新激发人们的兴趣。
