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头颈部烧伤:急诊科就诊情况的全国代表性分析。

Burns in the head and neck: A national representative analysis of emergency department visits.

作者信息

Heilbronn Cameron M, Svider Peter F, Folbe Adam J, Shkoukani Mahdi A, Carron Michael A, Eloy Jean Anderson, Zuliani Giancarlo

机构信息

Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.

Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan, U.S.A.

出版信息

Laryngoscope. 2015 Jul;125(7):1573-8. doi: 10.1002/lary.25132. Epub 2015 Jan 30.

Abstract

OBJECTIVES/HYPOTHESIS: Head and neck burns (HNBs) engender serious sequelae including airway edema, speech/swallowing dysfunction, sensory deficits, and scarring/disfigurement, often requiring significant reconstructive surgery. We used a nationally representative resource to estimate the number of visits to emergency departments (EDs), analyze burn types and demographic patterns, and identify specific consumer products involved.

METHODS

The National Electronic Injury Surveillance System was evaluated for the most recent 5-year period available. HNB ED visits were identified, and patient records were evaluated for consumer products facilitating injury, along with other ED visit and patient characteristics.

RESULTS

From 2009 to 2013, 6,326 cases extrapolating to 233,431 ED visits nationally were identified. Males were predominantly impacted (64.1%). Although adults overall comprised the majority of patients (59.7%), children between 1 and 2 years of age had the highest incidence (21,544 ED visits nationally). The most common consumer products facilitating HNB included welding equipment, hot water, gasoline, bleaches, and cookware. Most injuries involved the face (55%), whereas the most common etiologies included thermal (40%), chemical (23%), and scald (22%) burns. Consumer products and injury patterns varied by patient age.

CONCLUSIONS

HNBs significantly impact healthcare delivery, as over 200,000 visits reportedly presented to EDs over the 5-year period studied. Consumer products facilitating visits and associated patient demographics described may guide history, clinical examination, and identification of secondary injuries. In particular, age-specific patterns detailed may be included in consumer education and patient counseling to facilitate injury prevention, as office visits provide an opportunity to counsel patients.

摘要

目的/假设:头颈部烧伤(HNBs)会引发严重的后遗症,包括气道水肿、言语/吞咽功能障碍、感觉缺陷以及瘢痕形成/毁容,通常需要进行重大的重建手术。我们利用具有全国代表性的资源来估计急诊科(EDs)的就诊次数,分析烧伤类型和人口统计学模式,并确定涉及的特定消费品。

方法

对国家电子伤害监测系统进行了为期5年的最新评估。确定了HNB的急诊科就诊情况,并对患者记录进行评估,以确定导致受伤的消费品以及其他急诊科就诊情况和患者特征。

结果

2009年至2013年期间,共识别出6326例病例,推算全国急诊科就诊次数达233,431次。男性受影响最为严重(64.1%)。虽然总体上成年人占患者多数(59.7%),但1至2岁的儿童发病率最高(全国急诊科就诊次数为21,544次)。导致HNB最常见的消费品包括焊接设备、热水、汽油、漂白剂和炊具。大多数损伤涉及面部(55%),而最常见的病因包括热烧伤(40%)、化学烧伤(23%)和烫伤(22%)。消费品和损伤模式因患者年龄而异。

结论

HNB对医疗服务产生了重大影响,据报道,在研究的5年期间,有超过20万次就诊。所描述的导致就诊的消费品及相关患者人口统计学特征可为病史询问、临床检查和继发性损伤的识别提供指导。特别是,详细的年龄特异性模式可纳入消费者教育和患者咨询中,以促进伤害预防,因为门诊就诊为咨询患者提供了机会。

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