KITE, Toronto Rehabilitation Institute, University Health Network, 550 University Avenue, Toronto, Ontario, M5G 2A2, Canada.
Toronto General Hospital, University Health Network, Toronto, Canada.
Can J Public Health. 2020 Aug;111(4):492-501. doi: 10.17269/s41997-019-00286-1. Epub 2020 Feb 11.
Assault by strangulation has the potential for severe brain injury or death. The objectives of this study were to describe the profile of individuals who had strangulation-related emergency department (ED) or acute care visits, and to explore 1-year readmission outcomes among survivors.
A population-based retrospective cohort study was conducted using health administrative data in Ontario, Canada. Adults aged 15 years and older who were seen in the ED or acute care with assault by strangulation between fiscal years 2002/2003 and 2016/2017 were included in the study. Bivariate analyses were conducted to compare the patient profile and subsequent readmissions within 1 year of discharge, stratified by sex.
A total of 586 patients were included in the study. The majority of these patients were seen in the ED (93%), predominantly female (70%), aged ≤ 39 years (68%), and of lower income quintiles of ≤ 3 (73%). Of the 579 patients who survived the initial admission, 52% had subsequent ED readmission and 21% had acute care readmission within 1 year. In sex-stratified analyses, a higher proportion of females were between 20 to 39 years (58.7% vs. 44.1%, p = 0.001), discharged home (88% vs. 81%, p < 0.001), and had ED readmission within 1 year of discharge (56% vs. 17%, p = 0.002). Males had comparatively higher 1-year acute care readmissions.
The study shows high readmissions with sex differences among individuals with an assault by strangulation, suggesting sex-specific approach to health care practices to support the needs of this vulnerable population, thus reducing health system inefficiencies.
扼颈攻击可能导致严重的脑损伤或死亡。本研究的目的是描述与扼颈相关的急诊（ED）或急症就诊的个体特征，并探讨幸存者的 1 年再入院结局。
本研究采用加拿大安大略省的健康管理数据进行了一项基于人群的回顾性队列研究。研究纳入了在 2002/2003 财年至 2016/2017 财年期间因扼颈攻击在 ED 或急症就诊的 15 岁及以上成年人。通过双变量分析比较了患者特征，并按性别分层比较了出院后 1 年内的再次入院情况。
共纳入 586 例患者。这些患者多数在 ED 就诊（93%），主要为女性（70%），年龄≤39 岁（68%），收入五分位数处于较低的 1-3 档（73%）。在 579 例存活至初次入院出院的患者中，52%在出院后 1 年内再次因 ED 入院，21%因急性护理再次入院。在性别分层分析中，女性中 20 至 39 岁的比例更高（58.7%比 44.1%，p=0.001），出院回家的比例更高（88%比 81%，p<0.001），出院后 1 年内因 ED 再次入院的比例更高（56%比 17%，p=0.002）。男性的 1 年急性护理再入院率相对较高。
研究表明，因扼颈攻击而就诊的个体存在较高的再入院率，且存在性别差异，这提示需要针对这一弱势群体采用性别特异性的医疗保健方法，以满足其需求，从而减少医疗系统效率低下的问题。
