Nosaka Nobuyuki, Fujita Yuki, Morisada Sunao, Ugawa Toyomu, Ujike Yoshihito
Advanced Emergency and Critical Care Medical Center Okayama University Hospital Okayama Japan.
Acute Med Surg. 2014 Mar 5;1(3):145-149. doi: 10.1002/ams2.26. eCollection 2014 Jul.
This study was designed to identify the incidence, injury patterns, and financial burden of ditch-related injuries to provide a reference for establishing guidelines on the prevention of such injuries.
A retrospective chart review in a tertiary care hospital in Okayama city, Japan, focused on patients injured following a ditch-related fall and requiring intensive care between April 2012 and August 2013. Analysis was carried out to describe the epidemiology of ditch-related injuries.
Thirteen patients (median age, 60 years) met the inclusion criteria. The median time lag between the fall and rescue was approximately 1.5 h. Ten patients were injured in residential areas, and three were injured in rural areas. Eight patients were riding a bicycle at the time of the accident. Head and spine injuries predominated, although there were two cases of drowning, of which one died. The injury severity score ranged from 1 to 50 (mean, 17.8 ± 13). At the time of discharge from the intensive care unit, 6, 4, and 1 patients were classified into cerebral performance categories 1, 3, and 4, respectively. There were two in-hospital deaths, resulting in a case fatality rate of 15.3%. The total cost during the review period was ¥27,572,630, with a mean cost of ¥2,120,971 per patient.
Ditch-related injuries are associated with a high rate of poor neurological outcome and pose a financial burden on the health insurance system. Injury prevention efforts directed at decreasing the risk of ditch-related falls are required to minimize these outcomes.
本研究旨在确定沟渠相关损伤的发生率、损伤模式和经济负担,为制定此类损伤的预防指南提供参考。
对日本冈山市一家三级护理医院进行回顾性病历审查,重点关注2012年4月至2013年8月期间因沟渠相关跌倒受伤并需要重症监护的患者。进行分析以描述沟渠相关损伤的流行病学情况。
13名患者(中位年龄60岁)符合纳入标准。跌倒与救援之间的中位时间间隔约为1.5小时。10名患者在居民区受伤,3名在农村地区受伤。8名患者在事故发生时骑自行车。头部和脊柱损伤占主导,不过有2例溺水病例,其中1例死亡。损伤严重程度评分范围为1至50分(平均17.8±13)。在重症监护病房出院时,分别有6、4和1名患者被归类为脑功能类别1、3和4。有2例院内死亡,病死率为15.3%。审查期间的总费用为27,572,630日元,每位患者的平均费用为2,120,971日元。
沟渠相关损伤与神经功能不良的高发生率相关,并给医疗保险系统带来经济负担。需要开展预防损伤的工作,以降低沟渠相关跌倒的风险,从而将这些后果降至最低。