中美急诊道路交通伤患者流行病学调查

Epidemiological investigation on theroad traffic accident victimsin China and America

目的阐明中美两国综合性医院急诊医学科道路交通伤患者的异同点,为两国在道路交通伤医教研方面的合作提供新思路。方法选择浙江省人民医院和美国纽约州立大学上州医科大学两家大型综合性医院急诊医学科为调查研究单位,设计《道路交通伤调查问卷》(中英文版),调查方法为标准流行病学抽样调查。患者纳入标准为年龄≥18周岁的急诊道路交通伤患者,包括电动车、摩托车、汽车等机动车事故人员。计数资料以百分率(%)表示,Pearson卡方检验比较两国患者不同项目的差异,以P<0.05表示差异有统计学意义。结果共有399位道路交通伤患者入选分析,其中中国155人,美国244人。选择救护车转运的比例56.8%(中国)vs.80.7%(美国),P<0.001。中国颅脑损伤患者(27.1%)高于美国(11.1%),P<0.001。发生于汽车内的事故比例62.7%(美国)vs.12.3%(中国),P<0.001。美国影像学检查率明显高于中国,包括CT[79.1%(美国)vs.54.2%(中国),P<0.001]和普通X线检查[84.0%(美国)vs.65.8%(中国),P<0.001]。但两国的住院率、收住ICU比例、死亡率、急诊手术率等差异均无统计学意义。结论中国患者较少选择救护车来进行转运;骑电动车、摩托车和行人的比例高于驾乘汽车患者;颅脑损伤的比例远高于美国;影像学检查比例明显低于美国。

Objective To identify the characteristics of the road traffic accident victims in emergence department of largescale general hospitals in China and America, and provide new insights into further cooperation of the two countries. Methods A standard epidemiologicalsampling investigation with self-designed questionnaire was performed in the emergence department of Zhejiang People＇ s Hospital and Upstate University Hospital. The criteria for inclusion of this study： the road traffic accident victims aged 18 years or over, injured by electric bicycle, motorcycle, automobile or other motor vehicles. The enumeration data was expressed as percentage rate. Pearson chi-square test was performed to evaluate the difference,P 〈 0.05 were considered as statistically significant. Results A total of 399 road traffic accident victims （155 Chinese and 244 American） were enrolled into this study. 56.8% of victims in China were transferred to hospital by ambulance, whereas 80.7% in US, with a significant differences （ P 〈 0.001 ）. The rate of patients with head injury in China was 27.1% and in US 11.1% （P 〈0.001 ）. 62.7% of victims in US were the car drivers or passengers,only 12.3% in China（P 〈0.001）. The imaging examination was performed in most patients in US,79% with CT（54% in China） and 84% with X-ray （65.8 % in China）, P 〈 0.001. There were no significant differences in admission rates, ICU admission rates,mortality and tile ratio of emergency operation. Conclusion Theutihzation of ambulances in saving the road traffic accident victims is not enough. Most of the victims are theelectric bicycle drivers, motorcycle drivers and pedestrians as compared with automobile drivers. The patients with brain injury in China account for the main of victims when compared with US. There is also a significantly lower utilization of imaging in China.