Haas Barbara, Doumouras Aristithes G, Gomez David, de Mestral Charles, Boyes Donald M, Morrison Laurie, Nathens Avery B
From the Interdepartmental Division of Critical Care (B.H.), Division of General Surgery, Department of Surgery (D.G., C.D.M., A.B.N.), Department of Geography and Planning (D.M.B.), and Division of Emergency Medicine, Department of Medicine (L.M.), University of Toronto; Sunnybrook Research Institute (B.H. D.G., C.D.M., A.B.N.); Li Ka Shing Knowledge Institute of St Michael's Hospital(L.M.), Toronto; and Division of General Surgery, Department of Surgery (A.G.D.), McMaster University, Hamilton, Ontario, Canada.
J Trauma Acute Care Surg. 2015 Apr;78(4):860-5. doi: 10.1097/TA.0000000000000595.
Injury surveillance is critical in identifying the need for targeted prevention initiatives. Understanding the geographic distribution of injuries facilitates matching prevention programs with the population most likely to benefit. At the population level, however, the geographic site of injury is rarely known, leading to the use of location of residence as a surrogate. To determine the accuracy of this approach, we evaluated the relationship between the site of injury and of residence over a large geographic area.
Data were derived from a population-based, prehospital registry of persons meeting triage criteria for major trauma. Patients dying at the scene or transported to the hospital were included. Distance between locations of residence and of injury was calculated using geographic information system network analysis.
Among 3,280 patients (2005-2010), 88% were injured within 10 miles of home (median, 0.2 miles). There were significant differences in distance between residence and location of injury based on mechanism of injury, age, and hospital disposition. The large majority of injuries involving children, the elderly, pedestrians, cyclists, falls, and assaults occurred less than 10 miles from the patient's residence. Only 77% of motor vehicle collision occurred within 10 miles of the patient's residence.
Although the majority of patients are injured less than 10 miles from their residence, the probability of injury occurring "close to home" depends on patient and injury characteristics.
Epidemiologic study, level III.
伤害监测对于确定针对性预防措施的必要性至关重要。了解伤害的地理分布有助于使预防计划与最可能受益的人群相匹配。然而,在人群层面,伤害发生的地理位置很少为人所知,因此导致使用居住地点作为替代。为了确定这种方法的准确性,我们在一个大的地理区域内评估了伤害地点与居住地点之间的关系。
数据来源于一个基于人群的、对符合重大创伤分诊标准的人员的院前登记系统。纳入在现场死亡或被送往医院的患者。使用地理信息系统网络分析计算居住地点与伤害地点之间的距离。
在3280例患者(2005 - 2010年)中,88%在离家10英里范围内受伤(中位数为0.2英里)。根据伤害机制、年龄和医院处置情况,居住地点与伤害地点之间的距离存在显著差异。涉及儿童、老年人、行人、骑自行车者、跌倒和袭击的绝大多数伤害发生在距患者居住地点不到10英里的范围内。只有77%的机动车碰撞发生在距患者居住地点10英里范围内。
虽然大多数患者在离家不到10英里的范围内受伤,但伤害发生在“家附近”的概率取决于患者和伤害特征。
流行病学研究,III级。