Adler Cameron R, Hopp Alix, Hrelic Dawn, Patrie Jim T, Fox Michael G
Mayo Clinic Arizona, 5777 E. Mayo Blvd., Phoenix, AZ, 85054, USA.
Medical Center Radiologists, 5544 Greenwich Rd., Suite 200, Virginia Beach, VA, 23462, USA.
Emerg Radiol. 2019 Dec;26(6):639-645. doi: 10.1007/s10140-019-01718-8. Epub 2019 Aug 21.
Report the incidence, pattern, and severity of equestrian-related injuries presenting to a rural level 1 trauma center and detail the total radiation dose, imaging, and hospital charges related to those injuries.
An IRB-approved retrospective review of patients presenting to our facility following equine-related trauma was conducted. Demographics, mechanism of injury, types and number of imaging exams, approximate radiation dose administered, imaging findings, Injury Severity Score (ISS), rate/length of hospitalization, and approximate cost of care were recorded.
A total of 222 patients (161 F:61 M; mean age 38.5 years (range 4-79)) presented to our emergency department following horse-related injury. Mechanisms of injury included the following: fall (n = 186), kick (n = 18), stepped on (n = 9), and other (n = 9). Body part injured included extremity (26.1%), torso (26.6%), spine (25.7%), and head/neck (18.5%). Longer hospital admission, higher expenditure, increased CT/MR imaging, higher ISS, and radiation dose were noted in older patients and those injured by a fall or kick. Head injuries were more frequent following a horse kick (p = 0.006). Spinal and torso injuries were more common in patients older than 54 years (p = < 0.001) and those with falls (p < 0.04). Extremity injuries were more common in older patients (p < 0.001).
Patient age greater than 54 years and mechanism of injury are strong predictors of the ISS, injury localization, healthcare expenditure, and mean hospital stay. With the exception of obvious minor wounds, full trauma work-ups (CT chest/abdomen/pelvis and cervical spine) are encouraged for equestrian-related injuries in older patients and those injured by a fall.
报告在一家农村一级创伤中心就诊的与马术相关损伤的发生率、模式和严重程度，并详细说明与这些损伤相关的总辐射剂量、影像学检查及住院费用。
对因马相关创伤前来我院就诊的患者进行一项经机构审查委员会批准的回顾性研究。记录人口统计学资料、损伤机制、影像学检查的类型和数量、给予的大致辐射剂量、影像学检查结果、损伤严重程度评分（ISS）、住院率/住院时长及大致护理费用。
共有222例患者（161例女性：61例男性；平均年龄38.5岁（范围4 - 79岁））因马相关损伤前来我院急诊科就诊。损伤机制包括以下几种：摔倒（n = 186）、踢伤（n = 18）、踩踏伤（n = 9）及其他（n = 9）。受伤的身体部位包括四肢（26.1%）、躯干（26.6%）、脊柱（25.7%）及头/颈部（18.5%）。老年患者以及因摔倒或踢伤而受伤的患者住院时间更长、费用更高、CT/磁共振成像检查增多、ISS更高且辐射剂量更大。被马踢伤后头部受伤更为常见（p = 0.006）。脊柱和躯干损伤在54岁以上患者（p = < 0.001）及摔倒患者中更为常见（p < 0.04）。四肢损伤在老年患者中更为常见（p < 0.001）。
年龄大于54岁的患者及损伤机制是ISS、损伤部位、医疗费用及平均住院时间的有力预测因素。除明显的轻伤外，对于老年患者及因摔倒而受伤的患者，鼓励对与马术相关的损伤进行全面的创伤检查（胸部/腹部/骨盆CT及颈椎检查）。
