Department of Orthopaedics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Department of Orthopaedic Surgery, St Luke's University Health Network, Bethlehem, PA, USA.
Pediatr Int. 2021 Oct;63(10):1230-1235. doi: 10.1111/ped.14652. Epub 2021 Sep 22.
The aim of this work was to estimate the difference in severity between musculoskeletal trampoline park injuries (TPIs) and home trampoline injuries (HTI) and identify the factors that might mediate or modify that effect.
The National Electronic Injury Surveillance System database was used to identify musculoskeletal home trampoline injuries and TPIs in pediatric patients occurring in the 2009-2017 period. Injury mechanism and body region were inductively coded. The effect of TPI on risk of admission was estimated using a doubly robust logistic regression model for confounding adjustment. Adjustments were made for date, age, gender, injury mechanism, and body region. The comparative importance of injury mechanism and location and the effect modification of patient characteristics was explored using likelihood ratio tests.
Trampoline park injuries were more likely to result in admission even in the model adjusted for injury mechanism and body region (odds ratio (OR) = 2.12 [1.30, 3.45]). Injuries sustained from falling off the trampoline were associated with significantly fewer hospitalizations (OR = 0.119 [0.029, 0.495]) than injuries from falling while on the trampoline. Patient age significantly modified the effect of setting on risk of admission (P = 0.042). Adolescents demonstrated an increased risk at trampoline parks (15 years old OR = 3.23 [1.38, 7.56]), whereas younger children demonstrated a marginally lower risk (5 years old OR = 0.77 [0.44, 1.35]).
Trampoline park musculoskeletal injuries demonstrate an increased risk of admission even after rigorous adjustment for confounding. Injuries to the proximal limbs were associated with a much higher risk of admission than distal injuries. Adolescents face an increased risk of admission after TPI, underscoring the importance of public health interventions that target this age group.
本研究旨在评估儿童在蹦床公园和家庭蹦床发生的肌肉骨骼损伤的严重程度差异，并确定可能影响或调节这种差异的因素。
使用国家电子伤害监测系统数据库，确定 2009 年至 2017 年期间发生的儿童肌肉骨骼家庭蹦床损伤和蹦床公园损伤。采用诱导编码法对损伤机制和身体部位进行编码。使用双稳健逻辑回归模型对混杂因素进行调整，估计 TPI 对入院风险的影响。调整因素包括日期、年龄、性别、损伤机制和身体部位。采用似然比检验探索损伤机制和位置的相对重要性以及患者特征的效应修饰作用。
即使在调整了损伤机制和身体部位的模型中，蹦床公园损伤仍更有可能导致入院（比值比（OR）=2.12[1.30，3.45]）。与在蹦床上受伤相比，从蹦床上摔下来导致的损伤与显著较少的住院治疗相关（OR=0.119[0.029，0.495]）。患者年龄显著改变了环境对入院风险的影响（P=0.042）。青少年在蹦床公园的风险增加（15 岁 OR=3.23[1.38，7.56]），而年幼的儿童风险略有降低（5 岁 OR=0.77[0.44，1.35]）。
即使经过严格的混杂因素调整，蹦床公园肌肉骨骼损伤的入院风险仍显著增加。四肢近端损伤与更高的入院风险相关，而四肢远端损伤则风险较低。青少年在 TPI 后入院风险增加，突显了针对该年龄组的公共卫生干预措施的重要性。
