Department of Emergency Medicine, Eastern Virginia Medical School, USA.
Sentara Healthcare Quality Research Institute, USA.
Am J Emerg Med. 2018 Sep;36(9):1645-1649. doi: 10.1016/j.ajem.2018.06.059. Epub 2018 Jun 26.
Shark-related-injuries (SRIs) are not thoroughly evaluated in the medical literature given their rare occurrence. Previous studies involve the utilization of large-independent databases and have demonstrated that shark attacks appear to be increasing, even though mortality of SRIs has decreased from 51% in 1958 to 8.3% in 2001.
We performed a retrospective chart review on patients presenting to 10 emergency departments (ED) in southeastern Virginia from February 22, 2008 through December 31, 2016. We used a free-text search feature to identify patients documented to have the word "shark" in the record. We reported descriptive statistics for patient demographics, disposition, mortality, time of injury, body injury location, activity during injury, injury severity score (ISS), antibiotic use, and if the patient was in the International Shark Attack File(ISAF) or the Global Shark Attack File(GSAF).
We identified 11 patients. Most patients were male (81.8%) and Caucasian (90.9%) with a mean age of 35 years old (SD = 13.4, range17-55). Most patients (72.7%) arrived to the ED by private vehicle. Seventy-eight percent of patients were safely discharged from the ED. There were no deaths. There was a bimodal distribution of the time of injury around noon and early evening. Only 1 of our patients was present in the GSAF and 4 were present in the ISAF.
Most SRIs can be safely evaluated, treated, and discharged from the ED. Utilization of large databases for shark related research may underestimate its prevalence in the US. Further research is needed into the care of SRIs in the ED.
由于鲨鱼相关伤害（SRIs）的罕见发生，其在医学文献中并未得到充分评估。先前的研究涉及使用大型独立数据库，结果表明，尽管鲨鱼袭击导致的死亡率已从 1958 年的 51%降至 2001 年的 8.3%，但鲨鱼袭击似乎仍呈上升趋势。
我们对 2008 年 2 月 22 日至 2016 年 12 月 31 日期间弗吉尼亚州东南部的 10 家急诊部（ED）就诊的患者进行了回顾性图表审查。我们使用自由文本搜索功能来识别记录中提到“鲨鱼”一词的患者。我们报告了患者人口统计学、处置、死亡率、受伤时间、身体受伤部位、受伤期间的活动、损伤严重程度评分（ISS）、抗生素使用情况以及患者是否在国际鲨鱼袭击档案（ISAF）或全球鲨鱼袭击档案（GSAF）中的描述性统计数据。
我们共确定了 11 名患者。大多数患者为男性（81.8%）和白人（90.9%），平均年龄为 35 岁（标准差=13.4，范围 17-55 岁）。大多数患者（72.7%）通过私人交通工具到达 ED。78%的患者从 ED 安全出院。无死亡病例。受伤时间呈中午和傍晚双峰分布。我们的患者中只有 1 人出现在 GSAF 中，4 人出现在 ISAF 中。
大多数 SRIs 可在 ED 中安全评估、治疗和出院。利用大型数据库进行鲨鱼相关研究可能低估了其在美国的流行率。需要进一步研究 ED 中 SRIs 的护理。
