Pascual-Marrero Annette, Ramos-Meléndez Ediel O, García-Rodríguez Omar, Morales-Quiñones José E, Rodríguez-Ortiz Pablo
a Department of Surgery , Medical Sciences Campus , University of Puerto Rico , San Juan , Puerto Rico.
b Puerto Rico Trauma Hospital , San Juan , Puerto Rico.
Int J Inj Contr Saf Promot. 2018 Mar;25(1):14-22. doi: 10.1080/17457300.2017.1310738. Epub 2017 Apr 18.
This study aimed to describe the distribution of injury mechanisms and to assess the impact of those mechanisms on the morbidity and mortality of trauma. All patients admitted to Puerto Rico Trauma Hospital (2002-2011) for road-traffic collisions (RTCs, 5,371), gunshot wounds (GSWs, 2,946), falls (2,319), pedestrian accidents (1,652), and stab wounds (SWs, 1,073) were selected. Gunshot victims were 1.19 (95%CI: 1.07-1.33) times as likely as road-traffic victims to have an ISS ≥25. Pedestrians were 1.76 (95%CI: 1.49-2.09) times more likely to have a GCS ≤8 than road-traffic victims were. The risk of dying was 2.64 (95%CI: 2.20-3.16) times higher for gunshot victims and 1.51 (95%CI: 1.23-1.86) times higher for pedestrians compared to patients who had had RTCs. Gunshot victims and pedestrians had the worst clinical outcomes. Accordingly, these patients should receive the most aggressive clinical management. Furthermore, it is imperative to develop public health campaigns on trauma prevention.
本研究旨在描述损伤机制的分布情况，并评估这些机制对创伤发病率和死亡率的影响。选取了波多黎各创伤医院（2002 - 2011年）收治的所有因道路交通事故（RTCs，5371例）、枪伤（GSWs，2946例）、跌倒（2319例）、行人事故（1652例）和刺伤（SWs，1073例）的患者。枪伤受害者的损伤严重程度评分（ISS）≥25的可能性是道路交通事故受害者的1.19倍（95%置信区间：1.07 - 1.33）。行人的格拉斯哥昏迷量表（GCS）≤8的可能性比道路交通事故受害者高1.76倍（95%置信区间：1.49 - 2.09）。与道路交通事故患者相比，枪伤受害者的死亡风险高2.64倍（95%置信区间：2.20 - 3.16），行人的死亡风险高1.51倍（95%置信区间：1.23 - 1.86）。枪伤受害者和行人的临床结局最差。因此，这些患者应接受最积极的临床治疗。此外，开展创伤预防的公共卫生运动势在必行。
