Forrester Joseph D, Tran Kenneth, Tennakoon Lakshika, Staudenmayer Kristan
Divisions of General Surgery (Drs Forrester and Staudenmayer, and Ms. Tennakoon).
Vascular Surgery (Dr Tran), Department of Surgery, Stanford University, Stanford, CA.
Wilderness Environ Med. 2018 Dec;29(4):425-430. doi: 10.1016/j.wem.2018.05.006. Epub 2018 Sep 18.
Rock climbing and mountaineering are popular outdoor recreational activities. More recently, indoor climbing has become popular, which has increased the number of persons at risk for climbing-related injuries. The purpose of this study was to assess the morbidity, mortality, and healthcare cost due to climbing-related injury among persons presenting to US emergency departments (ED).
We performed a retrospective analysis of the 2010 to 2014 National Emergency Department Sample database, a nationally representative sample of all visits to US EDs. Rock climbing, mountain climbing, and wall climbing injuries were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes (E004.0). Outcomes evaluated included morbidity, mortality, inpatient admission, and costs. Adjusted analyses accounting for survey methodology were performed.
A weighted-estimate 15,116 adult ED visits were associated with climbing-related injury. Patient age was 32.8±14.7 (mean±SD) (95% CI: 32.1-33.5) y, and 62% of patients were male. The majority of the injuries occurred in the Western census region (9593; 63%). Less than 1% of all climbing-related visits resulted in death. Only of injury severity score >15 was associated with death (P = 0.005). A total of 1610 (11%) of patients were admitted as inpatients. Accounting for ED and inpatient costs, climbing-related injuries cost the US healthcare system approximately $102 (95% CI: $75-130) million USD for the 5-y period, averaging $20±9.5 million USD per y.
Most persons with climbing-related injuries presenting to EDs do not require inpatient admission. Although death is rare among patients with climbing-related injuries, the costs of injuries in survivors remain high.
攀岩和登山是广受欢迎的户外休闲活动。近年来,室内攀岩也开始流行起来,这使得与攀岩相关受伤的风险人群数量有所增加。本研究的目的是评估前往美国急诊科就诊的患者中与攀岩相关损伤的发病率、死亡率及医疗费用。
我们对2010年至2014年国家急诊科样本数据库进行了回顾性分析,该数据库是对所有前往美国急诊科就诊情况的全国代表性样本。使用国际疾病分类第九版临床修订本编码(E004.0)来识别攀岩、登山和壁爬损伤。评估的结果包括发病率、死亡率、住院情况及费用。进行了考虑调查方法的校正分析。
加权估计有15116例成年患者因与攀岩相关的损伤前往急诊科就诊。患者年龄为32.8±14.7(均值±标准差)(95%置信区间:32.1 - 33.5)岁,62%的患者为男性。大多数损伤发生在西部普查地区(9593例;63%)。所有与攀岩相关就诊中不到1%导致死亡。仅损伤严重程度评分>15与死亡相关(P = 0.005)。共有1610例(占11%)患者住院治疗。考虑急诊科和住院费用,5年期间与攀岩相关的损伤使美国医疗系统花费约1.02亿美元(95%置信区间:7500万 - 1.30亿美元),平均每年2000万美元±950万美元。
大多数因与攀岩相关损伤前往急诊科就诊的患者不需要住院治疗。虽然与攀岩相关损伤患者中死亡情况罕见,但幸存者的损伤费用仍然很高。