Gordon Adam M, Malik Azeem Tariq, Goyal Kanu S
Department of Orthopaedic Surgery, The Ohio State University Wexner Medical Center, USA.
Department of Orthopaedic Surgery, The Ohio State University Wexner Medical Center, USA.
Am J Emerg Med. 2021 Dec;50:466-471. doi: 10.1016/j.ajem.2021.08.059. Epub 2021 Aug 26.
The purpose was to observe current incidence and trends of hand and wrist injuries presenting to U.S. emergency departments (EDs) over a decade.
The National Electronic Injury Surveillance System (NEISS) was queried for hand and wrist injuries from January 2009-December 2018. Descriptive analyses were used to report injury types to the hand and wrist. Incidence, age, gender, race, injury location, and type of injury were recorded. Linear regression analyses were used to assess changes in trends over time. A p value <0.05 was statistically significant.
In total, 649,131 cases of hand and wrist injuries were identified in the NEISS from 2009 to 2018, correlating to 25,666,596 patients nationally. Incidence rates for finger, hand, and wrist were 450, 264, and 182 per 100,000 people. The estimated number of patients per year declined by 8.6% from 2009 to 2018. Male adults (aged 18-39) were the most frequent demographic. Total national estimates of hand (-8.2%; p = 0.001), wrist (-6.1%; p = 0.007), and finger (-9.9%; p < 0.001) injuries declined over the study period. The most common injuries were lacerations (36.5%), fractures (19.9%), strains/sprains (12.3%), and contusions/abrasions (12.1%) which significantly declined over the study period. The overall admission rate was 1.8%.
The estimated annual number of hand/wrist injuries presenting to US EDs was 2.6 million with gradual decline over the decade. Hand injury registries could assist in quality improvement measures targeted toward increased efficiency and resource allocation and education.
目的是观察十年来美国急诊科手部和腕部损伤的当前发病率及趋势。
查询国家电子伤害监测系统（NEISS）2009年1月至2018年12月期间的手部和腕部损伤情况。采用描述性分析报告手部和腕部的损伤类型。记录发病率、年龄、性别、种族、损伤部位和损伤类型。使用线性回归分析评估随时间变化的趋势。p值<0.05具有统计学意义。
2009年至2018年，NEISS共识别出649,131例手部和腕部损伤病例，全国范围内涉及25,666,596名患者。手指、手部和腕部的发病率分别为每10万人450例、264例和182例。从2009年到2018年，每年估计的患者数量下降了8.6%。成年男性（18 - 39岁）是最常见的人群。在研究期间，全国手部损伤（-8.2%；p = 0.001）、腕部损伤（-6.1%；p = 0.007）和手指损伤（-9.9%；p < 0.001）的总数均有所下降。最常见的损伤是撕裂伤（36.5%）、骨折（19.9%）、拉伤/扭伤（12.3%）和挫伤/擦伤（12.1%），在研究期间均显著下降。总体住院率为1.8%。
美国急诊科每年估计有260万例手部/腕部损伤，且在这十年间逐渐下降。手部损伤登记可有助于采取旨在提高效率、资源分配和教育水平的质量改进措施。
