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美国急诊科收治的高空定点跳伞损伤:发病率、急诊科及住院费用评估

BASE Jumping Injuries Presenting to Emergency Departments in the United States: an Assessment of Morbidity, Emergency Department, and Inpatient Costs.

作者信息

Forrester Joseph D, Yelorda Kirbi, Tennakoon Lakshika, Spain David A, Staudenmayer Kristan

机构信息

Department of Surgery, Stanford University, Stanford, CA.

Department of Surgery, Stanford University, Stanford, CA.

出版信息

Wilderness Environ Med. 2019 Jun;30(2):150-154. doi: 10.1016/j.wem.2019.02.002. Epub 2019 Apr 16.

Abstract

BACKGROUND

BASE (building, antenna, span, earth) jumping involves jumping from fixed objects with specialized parachutes. BASE jumping is associated with less aerodynamic control and flight stability than skydiving because of the lower altitude of jumps. Injuries and fatalities are often attributed to bad landings and object collision.

METHODS

We performed a retrospective analysis of the 2010-2014 National Emergency Department Sample database, a nationally representative sample of all visits to US emergency departments (EDs). BASE jumping-associated 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.

RESULTS

After weighting, 1790 BASE-associated ED presentations were identified with 358±28 injuries annually. A total of 1313 patients (73%) were aged 18 to 44 y, and 1277 (71%) were male. Nine hundred seventy-six (55%) multiple body system injuries and 677 (38%) isolated extremity injuries were reported. There were 1588 (89%) patients discharged home from the ED; only 144 (7%) were admitted as inpatients. On multivariate logistic regression, only anatomic site of injury was associated with inpatient admission (odds ratio=0.6, P<0.001, 95% CI 0.5-0.8). Including ED and inpatient costs, BASE injuries cost the US healthcare system approximately $1.7 million annually. No deaths were identified within the limitations of the survey design.

CONCLUSIONS

Although deemed one of the most dangerous extreme sports, many patients with BASE injuries surviving to arrival at definitive medical care do not require inpatient admission.

摘要

背景

定点跳伞(从建筑物、天线、跨度、地面起跳)是指使用特制降落伞从固定物体上跳下。与跳伞相比,定点跳伞由于起跳高度较低,空气动力学控制和飞行稳定性较差。受伤和死亡事故往往归因于着陆不佳和物体碰撞。

方法

我们对2010 - 2014年国家急诊科样本数据库进行了回顾性分析,该数据库是对美国急诊科所有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]识别与定点跳伞相关的损伤。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。

结果

加权后,共识别出1790例与定点跳伞相关的急诊科就诊病例,每年有358±28例损伤。共有1313例患者(73%)年龄在18至44岁之间,1277例(71%)为男性。报告了976例(55%)多系统损伤和677例(38%)孤立的肢体损伤。1588例(89%)患者从急诊科出院回家;仅144例(7%)住院治疗。多因素逻辑回归分析显示,仅损伤的解剖部位与住院治疗相关(比值比 = 0.6,P < 0.001,95%可信区间0.5 - 0.8)。包括急诊科和住院费用,定点跳伞损伤每年使美国医疗系统花费约170万美元。在调查设计的局限性范围内未发现死亡病例。

结论

尽管定点跳伞被认为是最危险的极限运动之一,但许多在接受确定性医疗救治时存活下来的定点跳伞损伤患者并不需要住院治疗。

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