Abolfotouh Mostafa A, Hussein Mohamed A, Abolfotouh Sameh M, Al-Marzoug Alanoud, Al-Teriqi Suliman, Al-Suwailem Abeer, Hijazi Ra'ed A
Research Training and Development Section, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,
Biostatistics and Bioinformatics Department King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Open Access Emerg Med. 2018 Jul 31;10:89-99. doi: 10.2147/OAEM.S166026. eCollection 2018.
The aim of this study was to describe the pattern of traumatic injuries and determine the predictors of inhospital mortality in patients admitted to the emergency department.
This is a retrospective cohort study of 3,786 patients with traumat injuries admitted to the emergency department of King Abdulaziz Medical City, Riyadh, Saudi Arabia, between January 2012 and December 2014. Data on patient characteristics, trauma characteristics and outcomes were extracted from medical records. A negative binomial regression model was utilized to identify significant predictors of inhospital mortality.
Of all injured patients, 77.5% were male, 29.8% were aged 15-25 years and 25.7% were aged 26-45 years. Blunt trauma was the main mechanism of injury, including motor vehicle crashes (MVCs) in 52.0% and falls in 25.8% of patients. Most patients had injuries to the extremities (61.3%), followed by the head (32.2%), chest (16.9%) and abdomen (8.9%). Injuries were mild in 49.7% of patients, moderate in 30.2% and severe in 20.1%. The sex of the patients was significantly associated with the mechanism of injury (<0.001), severity (<0.001), anatomical site of injury (<0.001), admission to the intensive care unit (<0.001), need for trauma team activation (<0.001) and type of transportation to hospital (<0.001). The predictors of inhospital mortality were age (rate ratio [RR] for each 10-year increase=1.174; <0.001), falls and burns (RR=2.337 and 1.728; <0.001) and moderate and severe injuries (RR=6.438 and 181.780; <0.001).
Our results suggest different patterns of trauma injuries according to patient age and sex. MVCs were the leading cause of injuries, but falls and burns had the highest inhospital mortality. This suggests the need for a comprehensive national education and prevention programs that address all causes of injuries.
本研究旨在描述创伤性损伤的模式，并确定急诊科收治患者的院内死亡预测因素。
这是一项回顾性队列研究，研究对象为2012年1月至2014年12月期间在沙特阿拉伯利雅得阿卜杜勒阿齐兹国王医疗城急诊科收治的3786例创伤患者。从病历中提取患者特征、创伤特征及结局的数据。采用负二项回归模型确定院内死亡的显著预测因素。
在所有受伤患者中，77.5%为男性，29.8%年龄在15 - 25岁之间，25.7%年龄在26 - 45岁之间。钝性创伤是主要的损伤机制，其中52.0%的患者因机动车碰撞（MVC）受伤，25.8%的患者因跌倒受伤。大多数患者四肢受伤（61.3%），其次是头部（32.2%）、胸部（16.9%）和腹部（8.9%）。49.7%的患者损伤为轻度，30.2%为中度，20.1%为重度。患者性别与损伤机制（<0.001）、严重程度（<0.001）、损伤解剖部位（<0.001）、入住重症监护病房（<0.001）、是否需要启动创伤团队（<0.001）及住院交通方式（<0.001）显著相关。院内死亡的预测因素为年龄（每增加10岁的率比[RR]=1.174；<0.001）、跌倒和烧伤（RR=2.337和1.728；<0.001）以及中度和重度损伤（RR=6.438和181.780；<0.001）。
我们的结果表明，根据患者年龄和性别，创伤性损伤模式有所不同。机动车碰撞是受伤的主要原因，但跌倒和烧伤的院内死亡率最高。这表明需要开展全面的国家教育和预防计划，以应对所有损伤原因。
