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因野生动物袭击而到急诊科就诊的患者的损伤模式:一项回顾性观察研究。

Pattern of injuries due to wild animal attack among patients presenting to the emergency department: A retrospective observational study.

机构信息

Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, 751019, India.

College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, 751019, India.

出版信息

Chin J Traumatol. 2021 Nov;24(6):383-388. doi: 10.1016/j.cjtee.2021.09.004. Epub 2021 Sep 20.

Abstract

PURPOSE

The human-wildlife conflicts (HWCs) causing nuisances and injuries are becoming a growing public health concern over recent years worldwide. We aimed to study the demographic profile, mode of injury, pattern of injury, and outcome of wild animal attack victims presented to the emergency department.

METHODS

This retrospective cross-sectional study was conducted in the emergency department of a tertiary-care hospital in Eastern India. Data were retrieved from the medical records from May 2017 to May 2021. Patients of all ages and genders attacked by wild animals and secondary injuries were included in this study. Patients with incomplete data, injuries due to the attack of stray and domestic animals and trauma due to other causes were excluded. Demographic profile, mode of injury, the pattern of injury, injury severity score (ISS), radiological pattern, and outcome were recorded. Statistical analysis with R (version 3.6.1.) was conducted.

RESULTS

A total of 411 wild animal attack victims were studied, of which 374 (90.9%) were snakebite injuries and 37 (9.1%) were wild mammalian (WM) attack injuries. The mean age of WM attack victims was 46 years, and the male-to-female ratio was 4:1. Elephant attack injury (40.5%) was the most common WM attack injury reported. Most WM attacks (43.2%) occurred between 4:00 a.m. to 8:00 a.m. The median ISS was 18.5 (13-28), where 54.2% of patients had polytrauma (ISS>15). Elephant attack was associated with a higher ISS, but the difference was not significant compared to other animal types (p = 0.2). Blunt trauma was common pattern of injury in the elephant attack injury cases. Lacerations and soft tissue injuries were common patterns in other animal attacks. Among snakebites, neurotoxic was the most common type (55.4%), and lower extremity was the most common site involved.

CONCLUSION

The young male population is the major victim of HWCs; and elephant is the most common animal involved. There is a need to design scientifically sound preventive strategies for HWCs and to strengthen the preparedness in health establishments to manage victims effectively.

摘要

目的

近年来,全球范围内由人类-野生动物冲突(HWCs)引起的滋扰和伤害事件日益成为一个日益严重的公共卫生问题。我们旨在研究到急诊就诊的野生动物袭击受害者的人口统计学特征、损伤方式、损伤模式和结局。

方法

这是一项在印度东部一家三级保健医院急诊部进行的回顾性横断面研究。数据从 2017 年 5 月至 2021 年 5 月从病历中检索。本研究纳入了所有年龄和性别的被野生动物袭击和继发损伤的患者。排除了数据不完整、因流浪和家养动物袭击以及其他原因导致的创伤的患者。记录人口统计学特征、损伤方式、损伤模式、损伤严重程度评分(ISS)、影像学模式和结局。使用 R(版本 3.6.1)进行统计分析。

结果

共研究了 411 例野生动物袭击受害者,其中 374 例(90.9%)为蛇咬伤,37 例(9.1%)为野生哺乳动物(WM)袭击伤。WM 袭击伤患者的平均年龄为 46 岁,男女比例为 4:1。大象袭击伤(40.5%)是报告的最常见 WM 袭击伤。大多数 WM 袭击(43.2%)发生在凌晨 4:00 至 8:00。ISS 的中位数为 18.5(13-28),其中 54.2%的患者为多发伤(ISS>15)。大象袭击与更高的 ISS 相关,但与其他动物类型相比,差异无统计学意义(p=0.2)。在大象袭击损伤病例中,钝性损伤是常见的损伤模式。其他动物袭击中常见的损伤模式是裂伤和软组织损伤。在蛇咬伤中,神经毒性是最常见的类型(55.4%),最常见的受累部位是下肢。

结论

年轻男性是 HWCs 的主要受害者;大象是最常见的涉及动物。需要设计科学合理的 HWCs 预防策略,并加强卫生机构的准备工作,以有效管理受害者。

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