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雪地摩托事故导致的骨科损伤:一项关于人口统计学、损伤模式及预后的多中心分析

Orthopaedic injuries from snowmobile accidents: a multi-centre analysis of demographics, injury patterns, and outcomes.

作者信息

Whiting Paul, Rice Christopher, Siy Alexander, Wiseley Benjamin, Simske Natasha, Berg Richard, Lockhart Madeline, Debruin Abbey, Polga David, Doro Christopher, Goodspeed David, Lang Gerald

机构信息

Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, 1685 Highland Avenue, Madison, WI, 53705, USA.

Marshfield Medical Center, 1000 N. Oak Ave, Marshfield, WI, 54449, USA.

出版信息

Eur J Orthop Surg Traumatol. 2019 Dec;29(8):1617-1621. doi: 10.1007/s00590-019-02514-3. Epub 2019 Jul 29.

Abstract

PURPOSE

More than 2 million people in North America use snowmobiles, resulting in an estimated 200 fatalities and 14,000 injuries annually. The purpose of this study is to document the demographics, orthopaedic injury patterns, and short-term outcomes of patients with snowmobile-related injuries.

MATERIALS AND METHODS

A retrospective review was performed at two regional trauma centres in a region where snowmobile use is prevalent. Patients who sustained snowmobile-related injuries over a 12-year period were identified from the hospitals' trauma registries using E-codes (E820-E820.9). Patient demographics were recorded, as were injury characteristics including rates of substance use, open fractures, Injury Severity Score (ISS), Abbreviated Injury Score (AIS) for the extremities, and mortality. Rates of inpatient surgery, as well as hospital and ICU length of stay (LOS), were also recorded.

RESULTS

We identified 528 patients with snowmobile-related injuries. Average age was 37 years, and 418 patients (79%) were male. Eighty-eight per cent of all patients with snowmobile injuries were admitted to the hospital with an average LOS of 5.7 days. Among those admitted to the hospital, average ISS was 12.3, and 28% of these patients had ISS > 15. A total of 261 patients (56%) suffered extremity injuries (including 163 upper and 173 lower extremity fractures) with an average extremity AIS of 2.4. There were 700 total fractures (1.5 per patient), and 9% of all fractures were open. A total of 208 patients (45%) suffered head injuries, and 132 patients (28%) sustained vertebral column fractures. A total of 201 patients (43%) required inpatient surgery, and eight patients (1.7%) sustained fatal injuries.

CONCLUSIONS

We present a detailed multi-centre analysis of orthopaedic injury patterns and outcomes resulting from snowmobile-related injuries. Patients injured while snowmobiling share similar injury patterns with patients injured in motorcycle and other high-energy motor vehicle accidents.

摘要

目的

北美有超过200万人使用雪地摩托,每年估计有200人死亡,14000人受伤。本研究的目的是记录与雪地摩托相关损伤患者的人口统计学特征、骨科损伤模式及短期预后。

材料与方法

在雪地摩托使用盛行地区的两个区域创伤中心进行回顾性研究。使用E编码(E820-E820.9)从医院创伤登记处识别出在12年期间遭受与雪地摩托相关损伤的患者。记录患者的人口统计学特征以及损伤特征,包括药物使用情况、开放性骨折发生率、损伤严重度评分(ISS)、四肢简明损伤评分(AIS)以及死亡率。还记录了住院手术率以及住院和重症监护病房(ICU)的住院时间(LOS)。

结果

我们识别出528例与雪地摩托相关损伤的患者。平均年龄为37岁,418例患者(79%)为男性。所有雪地摩托损伤患者中有88%入院,平均住院时间为5.7天。入院患者中,平均ISS为12.3,其中28%的患者ISS>15。共有261例患者(56%)遭受四肢损伤(包括163例上肢骨折和173例下肢骨折),四肢平均AIS为2.4。总共有700处骨折(每位患者1.5处),所有骨折中有9%为开放性骨折。共有208例患者(45%)头部受伤,132例患者(28%)发生脊柱骨折。共有201例患者(43%)需要住院手术,8例患者(1.7%)死亡。

结论

我们对与雪地摩托相关损伤导致的骨科损伤模式及预后进行了详细的多中心分析。雪地摩托骑行时受伤的患者与摩托车及其他高能机动车事故受伤的患者具有相似的损伤模式。

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