重庆市院前急救创伤患者的流行病学特征与救治结局研究  

Epidemiological characteristics of pre-hospital emergency trauma patients and treatment outcomes in Chongqing City

作　　者：何颖 蒲川[1] 王秋婷 周鑫云 陈英[1] 胡惠 张燕[1] He Ying;Pu Chuan;Wang Qiuting;Zhou Xinyun;Chen Ying;Hu Hui;Zhang Yan(School of Public Health,Research Center for Medical and Social Development,Innovation Center for Social Risk Governance in Health,Chongqing Medical University,Chongqing 400016,China;Department of Trauma Surgery,Chongqing Emergency Medical Center,Chongqing 400014,China)

机构地区：[1]重庆医科大学公共卫生学院,医学与社会发展研究中心,健康领域社会风险预测治理协同创新中心,重庆400016 [2]重庆市急救医疗中心创伤外科,重庆400014

出　　处：《创伤外科杂志》2023年第11期849-855,共7页Journal of Traumatic Surgery

基　　金：重庆市自然科学基金面上项目(cstc2020jcyj-msxmX0584);重庆市科卫联合医学科研项目(2019ZLXM002);重庆市社会科学规划项目(2019YBGL057)。

摘　　要：目的 分析2021年重庆市院前急救创伤患者的流行病学特征、救治结局及其影响因素,为预防创伤发生及提高院前创伤救治水平提供依据。方法 回顾性分析2021年1月1日—2021年12月31日重庆市120调度指挥中心数据库中院前急救创伤患者的数据,分析院前急救创伤患者的流行病学特征,运用卡方检验和二元Logistic回归模型探讨院前急救创伤患者结局的影响因素。结果 2021年重庆市院前急救创伤患者66560例,以男性为主,占59.86%;高发年龄段为41~65岁,占39.27%;平均年龄为(48.8±21.2)岁。道路交通伤是65岁以下人群的首要致伤原因(52.95%),摔跌伤是65岁以上人群首要致伤原因(51.82%)。院前急救创伤患者的病死率为1.22%,主要致死原因为:高处坠落伤(37.04%)、道路交通伤(28.40%)和自杀(12.96%)。高处坠落伤(OR=17.537,95%CI:14.598~21.068)、自杀(OR=176.745,95%CI:126.816~246.331)、凌晨时间段受伤(OR=1.672,95%CI:1.280~2.185)和0~6岁组(OR=9.894,95%CI:7.430~13.174)以及>65岁组(OR=2.676,95%CI:2.117~3.383)的创伤患者更易发生院前死亡。结论 重庆市院前急救创伤患者以青壮年男性为主,道路交通伤、摔跌伤是院前急救创伤患者的主要致伤原因,高处坠落伤、道路交通伤和自杀是病死率最高的致伤原因,0~6岁儿童和>65岁以上老年人是易发生死亡的敏感人群。因此,应针对不同致伤原因和不同人群制定有针对性的预防措施、合理调配院前资源、提高救治能力,预防创伤发生,减少创伤导致的死亡。Objective To analyze the epidemiological characteristics,treatment outcomes,and influencing factors of pre-hospital emergency trauma patients in Chongqing City in 2021,and to provide evidence for trauma prevention and improvement of the pre-hospital care.Methods This retrospective analysis was conducted on trauma patients with pre-hospital care information in the database of Chongqing 120 Dispatching and Command Center from Jan.1,2021 to Dec.31,2021.The epidemiological characteristics of these patients were analyzed,and Chi-square test and binary Logistic regression model were used to further explore the influencing factors of patients outcomes.Results In the year 2021,66560 trauma patients were recorded to receive pre-hospital emergency care in Chongqing City,mainly males(59.86%)and among the 41-65 years group(39.27%),with an average age of(48.8±21.2)years.Road traffic accident was the leading cause of injury for patients under 65 years of age(52.95%)and fall the leading cause among those over 65 years of age(51.82%).The mortality rate was 1.22%,with the leading cause of death being falls from height(37.04%),followed by road traffic accidents(28.40%)and suicide(12.96%).Falls from height(OR=17.537,95%CI:14.598-21.068),suicides(OR=176.745,95%CI:126.816-246.331),injury time during the early morning(0B∶[DK]00-5∶[DK]59,OR=1.672,95%CI:1.280-2.185),and 0-6 years(OR=9.894,95%CI:7.430-13.174)and>65 years(OR=2.676,95%CI:2.117-3.383)were risk factors for pre-hospital death for trauma patients.Conclusion The trauma patients call for pre-hospital care in Chongqing City are predominantly young adult males.Road traffic accidents and falls are the main injury causes while falls from height,road traffic accidents and suicide are more risky to result in death.Children of 0-6 years and the elderly aged 65 years or above are particularly vulnerable to fatal outcomes.Prevention and pre-hospital care strategies can be made based on the above data,to reduce the incidence and improve the pre-hospital care outcomes of trauma in Cho

关 键 词：创伤 院前急救 流行病学 死亡 

分 类 号：R641[医药卫生—外科学]