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小儿犬咬伤预防:我们是找错方向了还是只是叫得不够大声?

Pediatric Dog Bite Prevention: Are We Barking Up the Wrong Tree or Just Not Barking Loud Enough?

作者信息

Bykowski Michael R, Shakir Sameer, Naran Sanjay, Smith Darren M, Goldstein Jesse A, Grunwaldt Lorelei, Saladino Richard A, Losee Joseph E

机构信息

From the Department of Pediatric Plastic Surgery.

Department of Pediatric Emergency Medicine, Children's Hospital of Pittsburgh, of University of Pittsburgh Medical Center, Pittsburgh, PA.

出版信息

Pediatr Emerg Care. 2019 Sep;35(9):618-623. doi: 10.1097/PEC.0000000000001132.

Abstract

OBJECTIVES

The objectives of this study were (1) to evaluate dog bite-related injuries and associated medical documentation and (2) to compare these results with a study of dog bites from the same institution 10 years prior.

METHODS

Data were retrospectively collected from a pediatric emergency department from July 2007 to July 2011 for patients treated for dog bites. These data were then compared with data from the same institution from 10 years prior.

RESULTS

A total of 1017 bite injuries were treated (average, 254.25 bites/year), which represents a 25% increase compared with 10 years prior. Comparing the 1997 and 2007 to 2011 cohorts, patient demographics, bite rate among children less than 5 years old, rate of dog breed documentation, and setting of injury were similar. Dog breed was reported in 47% (95% confidence interval [CI], 40.2-53.9) and 41% (95% CI, 38.0-44.0) of cases, respectively, in the 2 cohorts. Bites to the craniofacial region were most common (face only reported for 1997: 43.2%; 95% CI, 36.4-50 versus 2007-2011: 66.1%; 95% CI, 63.2-69.0). In both cohorts, the child's home was the most frequent setting, accounting for 43% of bites (1997: 95% CI, 30.2-55.9 and 2007-2011: 95% CI, 39.3-46.7).

CONCLUSIONS

Pediatric dog bites continue to occur frequently, and the associated factors did not change over the 10-year period: young age of child, bites to the craniofacial region, and dogs familiar to the child. Although accurate medical documentation of dog bites is a prerequisite to develop effective prevention strategies, current medical documentation of dog bites may be misguided.

摘要

目的

本研究的目的是:(1)评估与狗咬伤相关的损伤及相关医疗记录;(2)将这些结果与10年前同一机构关于狗咬伤的一项研究进行比较。

方法

回顾性收集2007年7月至2011年7月在一家儿科急诊科接受狗咬伤治疗的患者的数据。然后将这些数据与10年前同一机构的数据进行比较。

结果

共治疗了1017例咬伤(平均每年254.25例),与10年前相比增加了25%。比较1997年和2007年至2011年的队列,患者人口统计学特征、5岁以下儿童的咬伤率、犬种记录率和受伤环境相似。在这两个队列中,分别有47%(95%置信区间[CI],40.2 - 53.9)和41%(95%CI,38.0 - 44.0)的病例报告了犬种。头面部区域咬伤最为常见(仅面部在1997年报告为43.2%;95%CI,36.4 - 50,而2007 - 2011年为66.1%;95%CI,63.2 - 69.0)。在两个队列中,孩子家中是最常见的受伤环境,占咬伤的43%(1997年:95%CI,30.2 - 55.9;2007 - 2011年:95%CI,39.3 - 46.7)。

结论

儿童狗咬伤仍频繁发生,且相关因素在10年期间未发生变化:儿童年龄小、头面部咬伤以及孩子熟悉的狗。尽管准确记录狗咬伤的医疗情况是制定有效预防策略的前提条件,但目前关于狗咬伤的医疗记录可能存在误导。

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