Smith Michael Robert, Davis Robert Lee, Phillips Patricia Anne, Shvilkina Tatyana, Kaur Kamalijit, Tabolt Heather Katrina, Krause Matthew, Galdi Vincent
*Department of Surgery, St Barnabas Hospital, Bronx, New York. †Department of Surgery. Lutheran Medical Center, Brooklyn, NY.
Ann Surg. 2017 Feb;265(2):418-423. doi: 10.1097/SLA.0000000000001663.
Although trauma may be considered a random act, geographical patterns of trauma potentially emerge. Our institution is unique in that it rests at an intersection of two of the highest areas of poverty and assault in New York City and has adequate data to analyze these patterns.
We review the incident reports logged by emergency medical services (EMS) technicians arriving with intentionally injured trauma patients from January 1 to December 31, 2013 at a single institution. After acquisition of this data, it was placed into a computer file using an individual identifying numbers for each incident along with latitude and longitude coordinates determined by global positioning software for each event. The data were separated into blunt and penetrating categories. Penetrating trauma was further separated into the type of instrument used: edged weapon or firearm. Kernel density estimate using the Crimestat program was then performed to determine the epicenters with the highest incidents of nonaccidental trauma.
Two hundred eighty-three patients were evaluated for assault-related trauma. Two hundred fifty-four patients were included in the mapping of the data with almost equal blunt and penetrating trauma. Seventy-four percent of trauma occurred from 6 PM to 6 AM, and 41% occurring between midnight and 6 AM. Of patients, 32.7% were found to be assaulted at their home address. Regression analysis demonstrated that each type of trauma had unique epicenters of likelihood for occurrence.
We can only speculate the reasons for many of these results at this time and further research into the sociological, psychological, and environmental factors is required. A high proportion of patients are assaulted at their home addresses. Further study is necessary to improve patient care with additional data provided by emergency medical services, police departments and surrounding hospitals.
尽管创伤可能被视为一种随机事件，但创伤的地理分布模式可能会显现出来。我们的机构具有独特性，它位于纽约市两个贫困和袭击发生率最高的地区的交汇处，并且拥有足够的数据来分析这些模式。
我们回顾了2013年1月1日至12月31日期间，急救医疗服务（EMS）技术人员送来的故意受伤创伤患者的事件报告，这些患者均来自同一机构。获取这些数据后，将其放入计算机文件中，每个事件都使用一个个人识别号码，并通过全球定位软件确定每个事件的纬度和经度坐标。数据被分为钝器伤和穿透伤两类。穿透伤进一步按使用的器械类型分开：锐器或火器。然后使用Crimestat程序进行核密度估计，以确定非意外创伤发生率最高的震中。
对283名与袭击相关的创伤患者进行了评估。254名患者的数据被纳入绘图分析，钝器伤和穿透伤的数量几乎相等。74%的创伤发生在下午6点至上午6点之间，41%发生在午夜至上午6点之间。在患者中，32.7%是在其家庭住址遭受袭击。回归分析表明，每种类型的创伤都有独特的发生可能性震中。
目前我们只能推测这些结果中许多情况的原因，需要对社会学、心理学和环境因素进行进一步研究。很大一部分患者是在其家庭住址遭受袭击。有必要通过急救医疗服务、警察部门和周边医院提供的更多数据进行进一步研究，以改善患者护理。
