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周末和工作日晚间的受伤入院情况与工作日入院情况有差异吗?

Are injury admissions on weekends and weeknights different from weekday admissions?

作者信息

Tiruneh Abebe, Siman-Tov Maya, Radomislensky Irina, Peleg Kobi

机构信息

Israel National Center for Trauma and Emergency Medicine Research, Sheba Medical Center, Gertner Institute for Epidemiology and Public Health Policy Research, Tel-Hashomer, 52621, Ramat Gan, Israel.

Department of Disaster Management, School of Public Health, Tel Aviv University, Tel Aviv, Israel.

出版信息

Eur J Trauma Emerg Surg. 2020 Feb;46(1):197-206. doi: 10.1007/s00068-018-1022-8. Epub 2018 Oct 22.

Abstract

PURPOSE

To examine whether hours of a day and days of a week influence injury pattern, means of evacuation, and hospital resource utilization.

METHODS

A study based on the Israeli National Trauma Registry of patients hospitalized due to injury between 2008 and 2015.

RESULTS

Of 293,077 subjects included; 32.8% were admitted on weekends (weekend-days 16.7% and weekend-nights 16.1%), 20.0% on weeknights and 47.2% on weekdays. Compared with weekday admissions, weekend and weeknight admissions had higher risk of hospitalization from violence and fall-related injuries, but lower risk from road traffic injuries (RTI) except for weekend-day admissions adjusted for age, gender, and ethnicity. Hospitalization due to burn injuries was greater on weekends, particularly on weekend-days. Hospitalization for violence and burn injuries was greater on weekend-nights vs weeknights, while injuries from other unintentional causes were greater on weeknights than weekend-nights. Furthermore, patients admitted on weekends and weeknights were more likely to have severe and critical injuries, greater utilization of intensive care unit and to be referred for rehabilitation, but were less likely to receive prehospital emergency medical service. In stratified analyses, RTI-related hospitalization was greater on weekends among youth and adults aged 15-64 years, males and Arabs, while burn injuries were more likely among weekend admissions for children aged 0-14 years, female and Jews.

CONCLUSIONS

Injury pattern and resource utilization are related to time. Therefore, injury prevention and intervention efforts should account for hours of a day and days of a week, particularly in relation with age, gender, and ethnicity.

摘要

目的

研究一天中的时段和一周中的日期是否会影响损伤模式、疏散方式及医院资源利用情况。

方法

一项基于以色列国家创伤登记处的研究,研究对象为2008年至2015年间因伤住院的患者。

结果

纳入的293,077名受试者中,32.8%在周末入院(周末日为16.7%,周末夜为16.1%),20.0%在工作日夜间入院,47.2%在工作日入院。与工作日入院相比,周末和工作日夜间入院因暴力和跌倒相关损伤而住院的风险更高,但道路交通损伤(RTI)的风险较低,不过周末日入院在调整年龄、性别和种族后除外。烧伤导致的住院在周末更多,尤其是在周末日。暴力和烧伤导致的住院在周末夜间比工作日夜间更多,而其他意外伤害导致的损伤在工作日夜间比周末夜间更多。此外,在周末和工作日夜间入院的患者更有可能受到严重和危急损伤,更多地使用重症监护病房并被转诊进行康复治疗,但接受院前紧急医疗服务的可能性较小。在分层分析中,15 - 64岁的青年和成年人、男性和阿拉伯人在周末因RTI相关住院的情况更多,而0 - 14岁的儿童、女性和犹太人在周末入院时更易发生烧伤。

结论

损伤模式和资源利用与时间有关。因此,伤害预防和干预措施应考虑一天中的时段和一周中的日期,特别是与年龄、性别和种族相关的情况。

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