需急診就醫之意外傷害：台北某區域教學醫院之流行病學調查

為瞭解需急診就醫之意外事故的發生原因及流行病學之形態，及其與死亡意外事故傷害之異同，本研究以前瞻性通報登記之方式，收集並且分析民國82年全年間，台北某市立醫院急診室就醫之意外事故個案，並與同年度衛生署公佈之意外事故死亡個案統計作比較。在研究期間，共有8246例至急診就醫，其中以25至44歲之年齡層佔最高比例，與衛生署公佈之死亡個案相同。急診個案之男女別為2.1: 1，與衛生署統計致死個案之男女別2.9: 1有顯著的差異。交通事故（42.5）及意外墜落（22.2%）是急診個案最常見的原因，也是8三年度衛生署統計致死意外事故之主因：不過，溺水雖是衛生署致死意外事故的第二常見原因，但在醫院急診就醫的意外事故中，溺水僅佔0.01%。相反的，切穿器具的意外事故雖然是急診個案的第三常見原因（14.5%），但在衛生署統計致死個案中僅佔0.6%。意外事故所造成之傷害以開放性傷口（35.2）與表淺皮肉損傷（24.6%）最為常見，其次為顱內損傷（14.0%）及骨折（11.9%）。意外事故中有47.1%發生於道路上，45.9%發生於獨處的時候。本研究中88.4%的意外傷害患者於急診室處置後皆可返家。本調查顯示：需急診就醫之意外事故與衛生署統計致命意外事故之間有相當的差異，由於死亡是最嚴重的意外事故，所以目前的意外防制工作皆以致死的意外為主軸，但需至急診室就醫的意外事故，除了造成傷殘及消耗醫療資源外，發生的機率更高，因此不僅在意外事故防制策略上需要同等注重，也顯示其他不同方向流行病學調查的必要性。

關鍵字

意外墜落；急診；開放性傷口；交通事故；意外傷害

並列摘要

Accidents and their adverse effects have been the third leading cause of death in Taiwan since 1966. Accidents that require hospital emergency care, however, are rarely investigated. To examine the epidemiological characteristics of these accidents, we conducted a 12-month prospective registry of accidents in the Emergency Department of a Taipei municipal hospital. This report described the case of unintentional injuries and compared them with those of the fatal accidents during the same period as reported by the Department of Health (DOH). A total of 8246 consecutive patients were recorded having accident-related injuries in our hospital in 1993. The male to female ratio was 2.1:1, which was lower than that of the fatal cases (2.9:1) in the DOH report. Both traffic accidents (42.5%) and falls (22.2%) were two of the leading causes of accidents in this survey and that of the DOH. Although accidental drowning was the second leading cause of death in the DOH report, our survey indicated otherwise. In contrast, machinery or instrument-induced injuries were common emergency cases in our survey but were rare in the DOH report. The most common injuries due to accidents included open wound (35.2%), superficial injury (24.6%), intracranial injury (14.0%), and fracture (11.9%). Most of the time the accident happened on the street (47.1%), and in most cases (45.9%) the patients were alone when the accident occured. After emergency treatment, 88.4% of the patients were discharged. The epidemiology of unintentional injuries that require emergency care differs from and cannot be extrapolated from that of fatal injuries. Further studies on these frequent accidents are necessary. Intervention and education programs aimed at reducing these accidents are needed too.

並列關鍵字

accidental falls, emergency, open wound, transport accidents, unintentional injury

國際替代計量

需急診就醫之意外傷害：台北某區域教學醫院之流行病學調查

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