Department of Orthopedics and Traumatology, Paracelsus Medical University Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria.
Campus Virchow, Charité University Medicine Berlin, Augustenburger Platz 1, 13353 Berlin, Germany.
Int J Environ Res Public Health. 2023 Jan 10;20(2):1265. doi: 10.3390/ijerph20021265.
Increasing patient inflow into the emergency department makes it necessary to optimize triage management. The scope of this work was to determine simple factors that could detect fractures in patients without the need for specialized personnel. Between 2014 and 2015, 798 patients were admitted to an orthopedic emergency department and prospectively included in the study. The patients received a questionnaire before contacting the doctor. Objective and subjective data were evaluated to determine fracture risk for the upper and lower extremities. The highest risk for fractures in one region was the hip (73.21%; = 56), followed by the wrist (60.32%; = 63) and the femoral shaft (4 of 7, 57.14%; = 7). The regions with the lowest risk were the knee (8.41%; = 107), the ankle (18.29%; = 164), and the forearm shaft (30.00%; = 10). Age was a predictor for fracture: patients older than 59 years had a risk greater than 59.26%, and patients older than 90 years had a risk greater than 83.33%. The functional questions could exclude fractures. Three factors seem to be able to predict fracture risk: the injured region, the patient's age, and a functional question. They can be used for a probatory heuristic that needs to be proven in a prospective way.
患者不断涌入急诊部，使得分诊管理的优化成为必要。这项工作的范围是确定一些简单的因素，这些因素可以在不需要专业人员的情况下检测出患者的骨折情况。2014 年至 2015 年，798 名患者被收入骨科急诊部，并前瞻性地纳入研究。患者在联系医生之前接受了问卷调查。评估了客观和主观数据，以确定上肢和下肢的骨折风险。一个部位骨折风险最高的是髋部（73.21%； = 56），其次是腕部（60.32%； = 63）和股骨干（7 例中的 4 例，57.14%； = 7）。骨折风险最低的部位是膝关节（8.41%； = 107）、踝关节（18.29%； = 164）和前臂骨干（30.00%； = 10）。年龄是骨折的预测因素：年龄大于 59 岁的患者风险大于 59.26%，年龄大于 90 岁的患者风险大于 83.33%。功能问题可以排除骨折。有三个因素似乎可以预测骨折风险：受伤部位、患者年龄和功能问题。它们可用于试探性启发式方法，需要通过前瞻性方法加以证明。
