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牛相关创伤:瑞士一家单一三级创伤中心的患者 10 年回顾性队列研究。

Cattle-related trauma: a 10-year retrospective cohort study of patients admitted to a single tertiary trauma centre in Switzerland.

机构信息

Department of Emergency Medicine, Inselspital University of Bern, Switzerland.

出版信息

Swiss Med Wkly. 2022 Jul 11;152:w30201. doi: 10.4414/smw.2022.w30201. eCollection 2022 Jul 4.

Abstract

AIMS OF THE STUDY

Switzerland is traditionally an agricultural country with more than 50,000 farms and 1.5 million registered cows. However, contemporary literature on cattle-related trauma in Switzerland remain limited. The purpose of this study was to examine injury patterns and outcomes of patients who presented to a tertiary trauma centre in Switzerland following cattle-related trauma.

METHODS

Retrospective single-centre study over a 10-year period (2012-2021) including all patients experiencing cattle-related trauma. From retrieved charts demographics, injury data, and outcomes were collected and subsequently analysed.

RESULTS

A total of 94 patients with cattle-related injuries were identified. The median age was 52 years (interquartile range [IQR] 37-63) and 75% were male. Cattle-related injuries were most frequent among farmers (73%) and were most often caused by cows (86%), followed by bulls (10%). Blunt trauma (89%) was the leading mechanism of injury including headbutt (36%), kick (35%), physical contact (20%) and trampling injury (12%). Penetrating injury occurred in 11%, all caused by headbutt. Contusions (82%) and lacerations (45%) were the leading injuries, followed by face fractures (28%), closed head trauma (19%) and chest injuries (17%). Overall, 10% of all patients had a head abbreviated injury scale (AIS) score of ≥3 and 8% had a chest AIS of ≥3. The hospital admission rate was 49% for cow-related injury vs 90% for bull-related injuries, p = 0.023. Overall, in-hospital mortality was 3% and the median length of stay was 4.5 days (IQR 3-8) among patients admitted to the hospital.

CONCLUSIONS

Cattle-related injuries in Switzerland mainly affect farmers and are associated with considerable morbidity, especially when caused by bulls. Facial fractures, head injuries and chest injuries are common, and the latter two in particular can be severe. The results of the present study can be used for the implementation of data-driven prevention measures for the safe handling of cattle in Switzerland.

摘要

研究目的

瑞士传统上是一个农业国家,拥有超过 5 万家农场和 150 万头注册奶牛。然而,瑞士关于与牛相关创伤的当代文献仍然有限。本研究的目的是检查在瑞士一家三级创伤中心就诊的与牛相关创伤患者的损伤模式和结局。

方法

回顾性单中心研究,时间跨度为 10 年(2012-2021 年),包括所有经历过与牛相关创伤的患者。从检索到的图表中收集人口统计学、损伤数据和结局,并随后进行分析。

结果

共确定了 94 例与牛相关的损伤患者。中位年龄为 52 岁(四分位距 [IQR] 37-63),75%为男性。与牛相关的损伤最常见于农民(73%),最常见的原因是奶牛(86%),其次是公牛(10%)。钝性创伤(89%)是主要的损伤机制,包括头撞(36%)、踢(35%)、身体接触(20%)和踩踏伤(12%)。穿透性损伤占 11%,均由头撞引起。挫伤(82%)和撕裂伤(45%)是最常见的损伤,其次是面部骨折(28%)、闭合性颅脑创伤(19%)和胸部损伤(17%)。总体而言,所有患者中有 10%的头部简明损伤评分(AIS)≥3,8%的胸部 AIS≥3。与奶牛相关的损伤住院率为 49%,与公牛相关的损伤住院率为 90%,p=0.023。总体而言,住院患者的死亡率为 3%,中位住院时间为 4.5 天(IQR 3-8)。

结论

瑞士的与牛相关的损伤主要影响农民,且与相当大的发病率相关,尤其是由公牛引起的损伤。面部骨折、头部损伤和胸部损伤很常见,后两者尤其严重。本研究的结果可用于实施瑞士安全处理牛的基于数据的预防措施。

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