Zautcke J L, Morris R W, Koenigsberg M, Carmody T, Stein-Spencer L, Erickson T B
Department of Emergency Medicine, University of Illinois at Chicago, USA.
Am J Emerg Med. 1998 Oct;16(6):553-6. doi: 10.1016/s0735-6757(98)90216-9.
This study was undertaken to evaluate the incidence, epidemiology, and temporal relationships of assaults in the State of Illinois from penetrating trauma presenting to Level I and Level II trauma centers, and to project the impact of these variables on hospital staffing. A retrospective analysis was performed on 4 months of data (7/1/92 to 10/31/92) provided by the Illinois Department of Public Health describing consecutive assaults with firearms or knives presenting to all Level I and Level II trauma facilities in the State of Illinois. Data were analyzed for epidemiological parameters including age, gender, and race. Other variables analyzed included trauma score, Glasgow Coma Scale (GCS) score, ethanol levels, urine toxicology results, and mortality. The data were also analyzed for temporal patterns of hospital presentations with respect to the time of day and day of the week. A total of 1,288 cases of penetrating wounds were analyzed. Of these, 881 (68.4%) resulted from firearms and 407 (31.6%) resulted from stab wounds. Ages of all penetrating trauma victims ranged from less than 1 year to 84 years of age. The mean age for firearm victims was 25.0 +/- 10.8 (SD) years and 30.5 +/- 11.4 years for stabbing victims. Ninety percent of penetrating trauma victims were male and 10% were female. Seventy-two percent of the victims were African-American, 13% Hispanic, 13% Caucasian, and 2% other. Alcohol levels were available for 727 of the 1,288 (56.4%) patients. Of these 727, 433 (59.6%) had measurable levels. The results of drug screens were available for 582 of the 1,288 (45.1%) victims. Of these 582, 208 (35.7%) were positive. Other than alcohol, cocaine was the most frequently detected drug, accounting for 58.4% of the positive drug screens. Firearm victims had significantly lower trauma scores (10.5 v 11.2) and GCS scores (13.2 v 14.3) than stab victims. Significant circadian patterns of penetrating trauma were observed for both types of assaults. For assaults with firearms, the circadian rhythm peaked at 23.1 +/- 0.36 hours. For assaults with knives, the circadian rhythm peaked at 23.7 +/- 0.44 hours. Weekly patterns were not statistically significant for each individual type of assault. However, when the data were pooled, a weekly pattern peaking on Thursday was observed. These patterns of presentation for assaults are a significant finding that may have implications for hospital staff scheduling of trauma center physicians, nurses, technicians, security, social service, and other ancillary staff.
本研究旨在评估伊利诺伊州一级和二级创伤中心收治的穿透伤所致袭击事件的发生率、流行病学特征及时间关系，并预测这些变量对医院人员配备的影响。对伊利诺伊州公共卫生部提供的4个月（1992年7月1日至1992年10月31日）的数据进行回顾性分析，这些数据描述了该州所有一级和二级创伤机构收治的连续枪支或刀具袭击事件。对包括年龄、性别和种族在内的流行病学参数进行数据分析。分析的其他变量包括创伤评分、格拉斯哥昏迷量表（GCS）评分、乙醇水平、尿液毒理学结果及死亡率。还针对一天中的时间和一周中的日期分析了医院就诊的时间模式。共分析了1288例穿透伤病例。其中，881例（68.4%）由枪支所致，407例（31.6%）由刺伤所致。所有穿透伤受害者的年龄范围从不到1岁至84岁。枪支受害者的平均年龄为25.0±10.8（标准差）岁，刺伤受害者为30.5±11.4岁。90%的穿透伤受害者为男性，10%为女性。72%的受害者为非裔美国人，13%为西班牙裔，13%为白种人，2%为其他种族。1288例患者中有727例（56.4%）有乙醇水平数据。其中，433例（59.6%）有可测量水平。1288例受害者中有582例（45.1%）有药物筛查结果。其中，208例（35.7%）呈阳性。除乙醇外，可卡因是最常检测到的药物，占阳性药物筛查的58.4%。枪支受害者的创伤评分（10.5对11.2）和GCS评分（13.2对14.3）显著低于刺伤受害者。两种袭击类型均观察到穿透伤显著的昼夜节律模式。对于枪支袭击，昼夜节律在23.1±0.36小时达到峰值。对于刺伤，昼夜节律在23.7±0.44小时达到峰值。每周模式对每种单独的袭击类型无统计学意义。然而，当数据合并时，观察到周四出现峰值的每周模式。这些袭击事件的就诊模式是一项重要发现，可能对创伤中心医生、护士、技术人员、安保人员及其他辅助人员的排班有影响。
