Gevitz Kathryn, Madera Robbie, Newbern Claire, Lojo José, Johnson Caroline C
1 Division of Disease Control, Philadelphia Department of Public Health, Philadelphia, PA, USA.
Public Health Rep. 2017 Jul/Aug;132(1_suppl):53S-58S. doi: 10.1177/0033354917706968.
Following a surge in fall-related visits to local hospital emergency departments (EDs) after a severe ice storm, the Philadelphia Department of Public Health examined the association between inclement winter weather events and fall-related ED visits during a 5-year period.
Using a standardized set of keywords, we identified fall-related injuries in ED chief complaint logs submitted as part of Philadelphia Department of Public Health's syndromic surveillance from December 2006 through March 2011. We compared days when falls exceeded the winter fall threshold (ie, "high-fall days") with control days within the same winter season. We then conducted matched case-control analysis to identify weather and patient characteristics related to increased fall-related ED visits.
Fifteen high-fall days occurred during winter months in the 5-year period. In multivariable analysis, 18- to 64-year-olds were twice as likely to receive ED care for fall-related injuries on high-fall days than on control days. The crude odds of ED visits occurring from 7:00 am to 10:59 am were 70% higher on high-fall days vs control days. Snow was a predictor of a high-fall day: the adjusted odds of snow before a high-fall day as compared with snow before a control day was 13.4.
The association between the number of fall-related ED visits and weather-related fall injuries, age, and timing suggests that many events occurred en route to work in the morning. Promoting work closures or delaying openings after severe winter weather would allow time for better snow or ice removal, and including "fall risk" in winter weather advisories might effectively warn morning commuters. Both strategies could help reduce the number of weather-related fall injuries.
在一场严重的冰暴过后,当地医院急诊科与跌倒相关的就诊人数激增,费城公共卫生部对5年期间恶劣冬季天气事件与急诊科跌倒相关就诊之间的关联进行了调查。
我们使用一组标准化关键词,在2006年12月至2011年3月期间费城公共卫生部综合征监测提交的急诊科主诉日志中识别与跌倒相关的损伤。我们将跌倒人数超过冬季跌倒阈值的日子(即“高跌倒日”)与同一冬季的对照日进行比较。然后,我们进行了匹配病例对照分析,以确定与急诊科跌倒相关就诊增加有关的天气和患者特征。
在这5年期间的冬季月份出现了15个高跌倒日。在多变量分析中,18至64岁的人在高跌倒日因跌倒相关损伤接受急诊治疗的可能性是对照日的两倍。与对照日相比,高跌倒日上午7:00至10:59进行急诊就诊的粗略几率高70%。降雪是高跌倒日的一个预测因素:与对照日前降雪相比,高跌倒日前降雪的调整后几率为13.4。
急诊科跌倒相关就诊次数与天气相关跌倒损伤、年龄和时间之间的关联表明,许多事件发生在早上上班途中。在严重冬季天气后推动工作场所关闭或推迟开工,将有时间更好地清除积雪或结冰,并且在冬季天气警报中纳入“跌倒风险”可能会有效警告早上通勤者。这两种策略都有助于减少与天气相关的跌倒损伤数量。