地区贫困指数、地理位置和机制对上肢弹道伤害发生率的影响。

IF 1.4 4区 医学 Q3 SURGERY
Danielle J Brown,Amelia C Van Handel,Kevin G Shim,Rachael M Payne,Damini Tandon,David Chi,Adam G Evans,Mitchell A Pet
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引用次数: 0

摘要

简介:本研究调查了弹道伤害、地理位置和地区贫困指数(ADI)之间的相互关系。我们假设 ADI 和地理位置都与上肢弹道损伤的发生率相关。此外,我们还描述并比较了两种不同的上肢枪伤人群:暴力弹道伤害人群和意外自伤人群。我们的目的是评估地理位置和 ADI 对伊利诺伊州和密苏里州上肢枪伤模式的影响。材料和方法这是一项回顾性研究,研究对象是 10 年间在一个城市一级创伤中心接受上肢弹道伤的成年患者(n = 797)。730 名患者的家庭住址位于伊利诺伊州或密苏里州;这些住址已进行地理编码并纳入分析。受伤机制为自我报告。ADI是根据2019年邻里地图集(Neighborhood Atlas)测算的,其中贫困程度从1到100依次递增。组间比较酌情采用非配对 t 检验、费舍尔精确检验或 χ2 检验。结果地址构成了 259 个独特的人口普查区,每个人口普查区的上肢枪伤事件平均为 3 起,最多为 22 起;15.4% 的人口普查区占研究期间弹道伤害总数的近一半(48.4%);97.7% 的暴力伤害发生在城市地区,而意外伤害仅占 60%(P < 0.05)。ADI与上肢弹道损伤的发生率呈正相关。暴力伤害(中位数,94;平均值,86.1)与意外自伤(中位数,79;平均值,70.9)患者的 ADI 有明显差异(P < 0.05)。在我们的数据集中,50% 的暴力伤害发生在 2 个最贫困五分位数的街区。特别是暴力伤害更有可能发生在 ADI 高的城市地区,而意外自伤患者在地理和社会经济方面更加多样化。这些不同的人群需要采取独特的方法来降低发病率和发病率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Impact of Area Deprivation Index, Geography, and Mechanism on Incidence of Ballistic Injury to the Upper Extremity.
INTRODUCTION This study investigates the intersection of ballistic injuries, geography, and Area Deprivation Index (ADI). We hypothesized that both ADI and geography are correlated with incidence of upper extremity ballistic injuries. Further, we characterize and compare 2 distinct upper extremity gunshot injury populations presenting to our institution: those sustaining violent ballistic injuries and those who suffer an accidental, self-inflicted injury. Our purpose is to evaluate the impact of geography and ADI on the pattern of upper extremity gunshot injuries in Illinois and Missouri. MATERIALS AND METHODS This was a retrospective review of adult patients sustaining ballistic injury to the upper extremity at a single urban level I trauma center over 10 years (n = 797). Seven hundred thirty patients had home addresses in Illinois or Missouri; these addresses were geocoded and included for analysis. Mechanism of injury was self-reported. ADI was measured from the 2019 Neighborhood Atlas, in which deprivation increases from 1 to 100. Comparisons between groups were conducted with unpaired t tests, Fisher exact test, or χ2 testing, where appropriate. RESULTS Addresses constituted 259 unique census tracts, and the average number of upper extremity gunshot wound incidents per tract was 3, with a maximum of 22; 15.4% of census block tracts made up almost half (48.4%) of the total ballistic injuries in the study period; 97.7% of violent injuries occurred in Urban areas, as compared with only 60% of accidental injuries (P < 0.05). ADI and incidence of upper extremity ballistic injury were positively correlated. ADI varied significantly between patients sustaining violent (median, 94; mean, 86.1) versus accidental self-inflicted (median, 79; mean, 70.9) injuries (P < 0.05). Fifty percent of violent injuries in our data set occurred in block groups from the 2 most deprived quintiles. CONCLUSIONS Upper extremity gunshot wounds in general are concentrated in census blocks with high ADI. Violent injuries in particular are more likely to occur in urban areas with high ADI, whereas patients with accidental, self-inflicted injuries are more geographically and socioeconomically diverse. These differing populations require unique approaches to reduce incidence and morbidity.
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来源期刊
CiteScore
2.70
自引率
13.30%
发文量
584
审稿时长
6 months
期刊介绍: The only independent journal devoted to general plastic and reconstructive surgery, Annals of Plastic Surgery serves as a forum for current scientific and clinical advances in the field and a sounding board for ideas and perspectives on its future. The journal publishes peer-reviewed original articles, brief communications, case reports, and notes in all areas of interest to the practicing plastic surgeon. There are also historical and current reviews, descriptions of surgical technique, and lively editorials and letters to the editor.
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