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冰岛的穿透性刺伤:一项全国性研究,调查因穿透性刺伤而住院患者的发病率和结局。

Penetrating stab injuries in Iceland: a whole-nation study on incidence and outcome in patients hospitalized for penetrating stab injuries.

机构信息

Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland.

Department of Anesthesiology and Critical Care, Yale New Haven Hospital, New Haven, CT, USA.

出版信息

Scand J Trauma Resusc Emerg Med. 2019 Jan 23;27(1):7. doi: 10.1186/s13049-018-0582-2.

Abstract

BACKGROUND

Studies on penetrating injuries in Europe are scarce and often represent data from single institutions. The aim of this study was to describe the incidence and demographic features of patients hospitalized for stab injury in a whole nation.

MATERIALS AND METHODS

This was a retrospective nationwide population-based study on all consecutive adult patients who were hospitalized in Iceland following knife and machete-related injuries, 2000-2015. Age-standardized incidence was calculated and Injury Severity Score (ISS) was used to assess severity of injury.

RESULTS

Altogether, 73 patients (mean age 32.6 years, 90.4% males) were admitted during the 16-year study period, giving an age-standardized incidence of 1.54/100,000 inhabitants. The incidence did not vary significantly during the study period (P = 0.826). Most cases were assaults (95.9%) occurring at home or in public streets, and involved the chest (n = 32), abdomen (n = 26), upper limbs (n = 26), head/neck/face (n = 21), lower limbs (n = 10), and the back (n = 6). Median ISS was 9, with 14 patients (19.2%) having severe injuries (defined as ISS > 15). The median length of hospital stay was 2 days (range 0-53). Forty-seven patients (64.4%) underwent surgery and 26 of them (35.6%) required admission to an intensive care unit (ICU), all with ISS scores above 15. Three patients did not survive for 30 days (4.1%); all of them had severe injuries (ISS 17, 25, and 75).

CONCLUSION

Stab injuries that require hospital admission are rare in Iceland, and their incidence has remained relatively stable. One in every five patients sustained severe injuries, two-thirds of whom were treated with surgical interventions, and roughly one-third required ICU care. Although some patients were severely injured with high injury scores, their 30-day mortality was still low in comparison to other studies.

摘要

背景

欧洲关于穿透性损伤的研究很少,而且通常代表单个机构的数据。本研究的目的是描述在一个国家中因刀刺伤而住院的患者的发病率和人口统计学特征。

材料和方法

这是一项回顾性的全国性基于人群的研究,研究对象为 2000 年至 2015 年间在冰岛因与刀和大砍刀相关的伤害而住院的所有连续成年患者。计算了年龄标准化发病率,并使用损伤严重程度评分(ISS)来评估损伤的严重程度。

结果

在 16 年的研究期间,共有 73 名患者(平均年龄 32.6 岁,90.4%为男性)入院,年龄标准化发病率为 1.54/100,000 居民。在此期间,发病率没有明显变化(P=0.826)。大多数病例是袭击(95.9%)发生在家里或公共街道上,涉及胸部(n=32)、腹部(n=26)、上肢(n=26)、头/颈/面(n=21)、下肢(n=10)和背部(n=6)。ISS 中位数为 9,14 名患者(19.2%)有严重损伤(定义为 ISS > 15)。中位住院时间为 2 天(范围 0-53)。47 名患者(64.4%)接受了手术,其中 26 名(35.6%)需要入住重症监护病房(ICU),所有患者的 ISS 评分均高于 15。有 3 名患者在 30 天内未存活(4.1%);他们都有严重损伤(ISS 分别为 17、25 和 75)。

结论

在冰岛,需要住院治疗的刺伤很少见,其发病率相对稳定。每五名患者中就有一名患者受重伤,其中三分之二接受了手术干预,大约三分之一需要重症监护。尽管一些患者受伤严重,分数较高,但与其他研究相比,他们的 30 天死亡率仍然较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cf4/6343331/788cd274c74b/13049_2018_582_Fig1_HTML.jpg

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