Schürmann Jutta, Michael Mark, Picker Olaf, Bieler Dan, Heitkötter Kalle, Tremmel Thomas, Schnäbelin Bernd, Bernhard Michael
Zentrale Notaufnahme, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
Klinik für Anästhesiologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf, Deutschland.
Anaesthesiologie. 2024 Jul;73(7):444-453. doi: 10.1007/s00101-024-01420-6. Epub 2024 May 22.
Penetrating injuries are a rare but recurring emergency situation in the out-of-hospital and in-hospital emergency settings. The purpose of this study was to determine the incidence and characteristics of injuries associated with penetrating violence across a German metropolitan region over a 5-year period.
In the retrospective study, a database query of the control center of the Düsseldorf rescue service area was used to identify and descriptively analyze all rescue service operations with penetrating violence-associated injuries in the years 2015, 2017, and 2019. For those patients who were transferred to the major trauma center, a further analysis of the in-hospital course was performed.
In the 3 years 2015, 2017 and 2019 a total of 266 patients (age: 33 ± 14 years, male: 79%) could be recorded (2015 vs. 2017 vs. 2019: n = 81 vs. n = 93 vs. n = 92, respectively). The most common age group involved had an age range of 15-34 years. A particularly higher frequency of emergency calls was found for the areas of Old Town, City Center, and one other district (Oberbilk). A high frequency of rescue missions was found in the nights from Saturday to Sunday between 20.00 p.m. and 04.00 a.m. Rescue missions with emergency physicians on board increased over the years (2015 vs. 2019: 27 vs. 42%, p = 0.04). The primary weapons used were knives (56%), broken glass bottles (18%) and broken glasses (6%). Out of all patients 71 (27%, injury severity score 11 ± 14) were admitted to the major trauma center. Among these patients, the proportion of immediate surgical care (2015 vs. 2019: 20% vs. 35%, p < 0.05) and positive alcohol detection increased over the years (2015 vs. 2019: 10% vs. 43%, p < 0.05). The 30-day mortality in the 3 years studied was 1.1% (n = 3).
Penetrating injuries associated with violence are relevant but rare rescue missions. Future care strategies should focus on deployment of rescue resources close to the scene of the incident ("old town guard", central station), and prevention strategies should focus on weapon prohibition zones. A control of alcohol consumption should be discussed.
穿透性损伤在院外和院内急诊环境中是一种罕见但反复出现的紧急情况。本研究的目的是确定德国一个大都市地区5年内与穿透性暴力相关的损伤的发生率和特征。
在这项回顾性研究中，通过对杜塞尔多夫救援服务区控制中心的数据库查询，识别并描述性分析了2015年、2017年和2019年所有与穿透性暴力相关损伤的救援行动。对于那些被转至主要创伤中心的患者，进一步分析其院内病程。
在2015年、2017年和2019年这3年中，共记录了266例患者（年龄：33±14岁，男性：79%）（2015年对2017年对2019年：分别为n = 81对n = 93对n = 92）。涉及的最常见年龄组为15 - 34岁。在老城区、市中心和另一个区（奥伯比尔克）发现急诊呼叫频率特别高。在周六至周日晚上8点至凌晨4点之间救援任务频率较高。多年来配备急诊医生的救援任务有所增加（2015年对2019年：27%对42%，p = 0.04）。主要使用的武器是刀（56%）、碎玻璃瓶（18%）和碎玻璃（6%）。所有患者中有71例（27%，损伤严重程度评分11±14）被收治到主要创伤中心。在这些患者中，即时手术治疗的比例（2015年对2019年：20%对35%，p < 0.05）和酒精检测呈阳性的比例多年来有所增加（2015年对2019年：10%对43%，p < 0.05）。在研究的3年中，30天死亡率为1.1%（n = 3）。
与暴力相关的穿透性损伤是重要但罕见的救援任务。未来的护理策略应侧重于在事件现场附近部署救援资源（“老城警卫”、中央车站），预防策略应侧重于武器禁区。应讨论对酒精消费的控制。
