Strotmeyer Stephen, Koff Abigail, Honeyman Joshua N, Gaines Barbara A
1UPMC Children's Hospital of Pittsburgh, 4401 Penn Avenue, Faculty Pavilion, 07-63, Pittsburgh, PA 15224 USA.
2Department of Pediatrics, University of Washington Affiliated Hospitals, Seattle, WA 98195 USA.
Inj Epidemiol. 2019 Dec 17;6:49. doi: 10.1186/s40621-019-0223-x. eCollection 2019.
The purpose of this study was to examine the injury risk patterns among Amish children, many of whom may be exposed to uncommon injuries and limited access to care due to their agrarian lifestyle and remote communities.
Retrospective Chart Review.
With IRB approval, we performed a retrospective review of Amish patients age ≤ 12 years presenting to a level I pediatric trauma center between January 1, 2005, and December 31, 2015. Data abstracted from the institutional trauma registry and electronic medical record were analyzed using descriptive statistics and univariate/multivariate analysis.
One hundred eighty-three Amish children were admitted, and 2 died from injuries. Patients were 72.1% male; the median age was 5 (IQR 3-8); median injury severity score (ISS) was 9 (IQR 4-14), Most injuries were the result of blunt force trauma (91.8%). The most frequent mechanisms were falls (42.6%), followed by animal-related (15.3%), and buggy (12.5%). Most injuries occurred at home (44.4%) or on a farm (33.9%). Hay hole falls were a unique source of injury with a high ISS (12; IQR 6-17). The overall median length of stay (LOS) was 2 days (IQR 1-3), with animal-related injuries associated with the longest LOS (3 days; IQR 1-4.75).
The majority of injuries among Amish children are due to falls. Hay hole falls and animal-related injuries result in the highest ISS and longest LOS. These findings identify the farm as a potential target for culturally appropriate interventions for risk modification.
本研究旨在调查阿米什儿童的受伤风险模式，由于他们的农耕生活方式和地处偏远社区，许多阿米什儿童可能面临不常见的伤害且获得医疗服务的机会有限。
回顾性病历审查。
经机构审查委员会批准，我们对2005年1月1日至2015年12月31日期间到一级儿科创伤中心就诊的12岁及以下阿米什患者进行了回顾性研究。从机构创伤登记处和电子病历中提取的数据采用描述性统计和单变量/多变量分析。
183名阿米什儿童入院，2人因伤死亡。患者中72.1%为男性；中位年龄为5岁（四分位间距3 - 8岁）；中位损伤严重程度评分（ISS）为9分（四分位间距4 - 14分）。大多数损伤是钝器伤（91.8%）所致。最常见的致伤机制是跌倒（42.6%），其次是与动物相关的伤害（15.3%）和马车事故（12.5%）。大多数损伤发生在家中（44.4%）或农场（33.9%）。干草洞坠落是一种独特的致伤原因，ISS较高（12分；四分位间距6 - 17分）。总体中位住院时间（LOS）为2天（四分位间距1 - 3天），与动物相关的伤害住院时间最长（3天；四分位间距1 - 4.75天）。
阿米什儿童的大多数损伤是由跌倒所致。干草洞坠落和与动物相关的伤害导致最高的ISS和最长的住院时间。这些发现表明农场是进行符合文化特点的风险修正干预的潜在目标。
