School of Medicine, Stanford University, Stanford, CA, USA.
Division of General Surgery, Department of Surgery, Stanford University, Stanford, CA, USA.
Am Surg. 2023 Jun;89(6):2492-2498. doi: 10.1177/00031348221102609. Epub 2022 May 15.
A prior single-site study from the Midwest exploring seasonality of traumatic rib fractures found injuries are more common during summer months and lower in winter months. There have been no modern studies evaluating seasonality of these common injuries nationally. Our aim was to describe temporal and spatial distribution of rib fractures in the United States. We hypothesized presentations for traumatic rib fractures follow a seasonal pattern, with greater frequency of rib fractures in the summer and lower levels in the winter.
We obtained hospital emergency department (ED) encounter data from Nationwide Emergency Department Sample (NEDS) from January 1, 2018 to December 31, 2018. We used ICD-10 codes to identify all patients with diagnostic codes specific to rib fractures. To examine seasonal patterns, we constructed negative binomial regression models using seasons as covariates to predict incidence of rib fracture encounters across regions.
Of 15,439,004 trauma-related ED encounters in 2018, 384 431 (2%) encounters included a diagnosis of rib fracture(s). The percentage of ED trauma encounters with rib fractures was similar across the 4 regions. Rib fractures were more common in the summer in the Midwest, South, and West as compared to winter [22% (95% CI = 10-34%, = .007), 12% (95% CI = 5-20%, = 0.02), and 11% (95% CI = 5-17%, = .008), respectively].
Our hypothesis was generally supported by our evaluation of NEDS. However, while seasonal variation in rib fractures does appear to exist in the Midwest, South, and West, this variation is not ubiquitous across the United States.
先前在中西部进行的一项单站点研究探索了外伤性肋骨骨折的季节性，发现夏季月份的损伤更为常见，冬季月份则较少。目前还没有关于这些常见损伤在全国范围内季节性的现代研究。我们的目的是描述美国肋骨骨折的时间和空间分布。我们假设外伤性肋骨骨折的表现遵循季节性模式，夏季肋骨骨折的频率更高，冬季频率较低。
我们从全国急诊部样本（NEDS）获得了 2018 年 1 月 1 日至 12 月 31 日期间的医院急诊部（ED）就诊数据。我们使用 ICD-10 代码识别所有具有特定于肋骨骨折诊断代码的患者。为了检查季节性模式，我们使用季节作为协变量构建负二项回归模型，以预测各个地区肋骨骨折就诊的发生率。
在 2018 年的 15439004 例与创伤相关的 ED 就诊中，有 384431 例（2%）就诊包含肋骨骨折的诊断。四个地区的 ED 创伤就诊中，肋骨骨折的比例相似。与冬季相比，中西部、南部和西部夏季 ED 创伤就诊中肋骨骨折更为常见[22%（95%CI=10-34%，=0.007）、12%（95%CI=5-20%，=0.02）和 11%（95%CI=5-17%，=0.008）]。
我们的假设得到了我们对 NEDS 的评估的支持。然而，虽然在中西部、南部和西部似乎存在肋骨骨折的季节性变化，但这种变化并不是美国各地普遍存在的。
