Orces Carlos H, Orces Jacques
Rheumatology, Laredo Medical Center, Laredo, USA.
Emergency Department, Nicklaus Children's Hospital, Miami, USA.
Cureus. 2020 Nov 22;12(11):e11629. doi: 10.7759/cureus.11629.
Objective The study's objective is to examine national trends in emergency department visits for unintentional fall-related fractures among children aged 0 to 19 years between 2001 and 2015. Methods The National Electronic Injury Surveillance System - All Injury Program was used to generate national estimates of fall-related fractures treated in emergency departments. Subsequently, according to demographic characteristics, body parts, and sport activities, age-adjusted fracture rates were calculated using the 2000 U.S. population as the standard. The joinpoint regression program was used to examine the average annual percent change in fracture rates during the study period. Results An estimated 7.9 million emergency department visits for fall-related fractures among U.S. children occurred between 2001 and 2015. Overall, upper extremity fractures accounted for 70% of the cases. Trend analyses demonstrated that fracture rates markedly decreased among children aged 10 to 15 years by -2.5% (95% C: -3.4% to -1.6%) per year. After adjusting for age, boys' fracture rates decreased annually by -1.9% (95% CI: -3.1% to -0.6%), whereas the average decrease in girls was less accentuated by -1.4% (95% CI: -1.8% to -1.0%) per year. Notably, forearm/wrist fracture rates decreased annually by -2.4% (95% CI: -2.9% to -1.9%) from 2004 onwards. In contrast, head and neck fracture rates significantly increased on average by 2.6% (95% CI: 1.3% to 3.9%) per year. Conclusion Childhood emergency department visits for fall-related fractures significantly decreased in the U.S. between 2001 and 2015. However, further research is needed to determine factors related to upward trends in head/neck fractures seen during the study period.
目的 本研究的目的是调查2001年至2015年间0至19岁儿童因意外跌倒相关骨折而到急诊科就诊的全国趋势。方法 利用国家电子伤害监测系统-全伤害项目来生成在急诊科治疗的跌倒相关骨折的全国估计数。随后，根据人口统计学特征、身体部位和体育活动，以2000年美国人口为标准计算年龄调整后的骨折率。使用连接点回归程序来检查研究期间骨折率的年均变化百分比。结果 2001年至2015年间，估计有790万美国儿童因跌倒相关骨折到急诊科就诊。总体而言，上肢骨折占病例的70%。趋势分析表明，10至15岁儿童的骨折率每年显著下降2.5%（95%置信区间：-3.4%至-1.6%）。调整年龄后，男孩的骨折率每年下降1.9%（95%置信区间：-3.1%至-0.6%），而女孩的平均下降幅度较小，为每年1.4%（95%置信区间：-1.8%至-1.0%）。值得注意的是，从2004年起，前臂/腕部骨折率每年下降2.4%（95%置信区间：-2.9%至-1.9%）。相比之下，头部和颈部骨折率平均每年显著增加2.6%（95%置信区间：1.3%至3.9%）。结论 2001年至2015年间，美国儿童因跌倒相关骨折到急诊科就诊的情况显著减少。然而，需要进一步研究以确定与研究期间头部/颈部骨折上升趋势相关的因素。
