Some epidemiological characteristics of bone fracture of motor organs in 5 years at the 103 military hospital

Nội dung text: Some epidemiological characteristics of bone fracture of motor organs in 5 years at the 103 military hospital

1. Journal of military pharmaco-medicine n o1-2018 SOME EPIDEMIOLOGICAL CHARACTERISTICS OF BONE FRACTURE OF MOTOR ORGANS IN 5 YEARS AT THE 103 MILITARY HOSPITAL Nguyen Huu Chien*; Pham Dang Ninh*; Nguyen Tien Binh** SUMMARY Objectives: To investigate the characteristics of age, gender, occupation, causes, properties of bone fracture in the motor organs at 103 Military Hospital. Subjects and methods: A cross- sectional study, retrospective secondary data on 4,918 records of patients of all ages with bone fracture in the motor organs, who entered 103 Military Hospital in emergency or for treatment for the first time in January 2010 to December 2014. Results: The average age of bone fractured patients was 39.7 ± 18.2. The working age group of 20 - 59 years old accounted for the highest rate (74.1%). 69% were males, 31% females. The rate of traffic accidents in men was 47.4%, 43.3% for women meanwhile occupational accidents were found in 11.9% for men and 4.3% for women. Distribution of fractures by occupation: Farmers accounted for the highest percentage (27.6%), followed by freelance workers (20.2%), workers (17.8%), officials (17.0%), students (13.5%) and the lowest was soldiers (3.9%). The number of patients with one fractured bone occupied the highest proportion (90.42%) whereas two fractured bones were only in 8.03%. Conclusions: Bone fractures can occur at any ages, gender, occupation with difference causes. The percentage of open, closed fractures and types of bone fracture also can differentiate statically. * Keywords: Bone fracture; Motor organs; Epidemiological characteristics. INTRODUCTION countries, the most common causes of fracture are daily activities, athletes Bone fracture of the motor organs such overtraining; while in Vietnam the most as spinal fracture, pelvic bone fracture, or common causes of fracture are traffic and fracture of the extremities not only has a occupational accidents [3, 7]. significant impact on the health and the In the world, there are comprehensive wealth of the people but also causes studies on epidemiological characteristics urgent social issues. of bone fracture in specific countries and There are many causes of bone regions to provide important information fractures, and the rate of fracture can vary for prevention and treatment planning of from one country to another. In developed accidents [8, 9]. * 103 Military Hospital * Vietnam Military Medical University Corresponding author: Nguyen Huu Chien (nhchienkhth@gmail.com) Date received: 20/10/2017 Date accepted: 18/12/2017 172
2. Journal of military pharmaco-medicine n o1-2018 In Vietnam, there have been a number * Selection of research samples: of general studies on the epidemiological - Sample selection criteria: Clear, characteristics of accidental injuries, but informative records of all patients of all there are very few specific studies of the ages with bone fracture in motor organs epidemiological characteristics of bone alone or in combination with other lesions. fracture of the motor organs. Therefore, - Exclusion criteria : The patient records we conducted this study in order to: without sufficient research information; Investigate the characteristics of age, gender, occupation, causes, properties of records of patient entered the hospital for bone fracture in the motor organs. the repeated treatment; patients with disease-induced bone fracture; patients SUBJECTS AND METHODS with skull trauma, spinal trauma or pelvic 1. Subjects. bone fracture alone; patients with bone All the records of patients of all ages fracture who died before getting to the with bone fracture in the motor organs, hospital. who entered 103 Military Hospital in 3. Data processing methods. emergency or for treatment for the first Data from patient records were time in January 2010 to December 2014. collected in the form of raw data sheets, 2. Methods. then processed and analyzed according * Study design: Cross-sectional study, to research objectives by SPSS 22.0 retrospective secondary data. software. RESULTS AND DISCUSION 1. Characteristics of the subjects. Table 1: Distribution of subjects by age and sex (n = 4,918). Male Female Total p-values Ages n % n % n % 1 - 19 414 12.2 124 8.1 538 10,9 0.000 a 20 - 29 992 29.2 242 15.9 1,234 25.1 0.000 a 30 - 39 667 19.6 244 16.0 911 18.5 0.003 a 40 - 49 552 16.3 232 15.2 784 15.9 0.331 a 50 - 59 461 13.6 254 16.7 715 14.5 0.004 a 60 - 69 186 5.5 207 13.6 393 8.0 0.000 a 70 - 79 76 2.2 108 7.1 184 3.7 0.000a 80 - 99 47 1.4 112 7.4 159 3.2 0.000 a Total 3,395 69.0 1,523 31.0 4,918 100.0 X ± SD 36.5 ± 16.3 46.7 ± 20.1 39.7 ± 18.2 0.000 e (Min - max) (1 - 97 ) (2 - 99) (1 - 99) (a: Chi-squared test; e: Mann-Withney test) 173
3. Journal of military pharmaco-medicine n o1-2018 The average age of patients was Chinh et al (2011) [5] on 62,229 injuries in 39.7 ± 18.2 years old (from 1 - 99). The the Viet-Germany Hospital showed that average age of females was 46.7 ± 20.1 patients aged from 20 to 60 years old years old which is significantly higher than accounted for 71.1% and patients under that of male patients (46.5 ± 20.1 years 15 years old accounted for 9.9%. Le old) (p < 0.01). Quang Anh (2012) [6] found that patients in working age accounted for 78.41% The working group aged from 20 to 59 (from 19 to 60 years old). Nguyen Thi Nhu years old accounted for the highest rate Tu et al [7] reported that the average age (74.1%), of which, the age from 21 to 30 was 30.6 ± 15.6 (from 2 to 90 years); the constituted the highest rate (25.1%) and most common age was from 16 to 30 the patients from 31 to 40 years old was years old (51.7% for males and 48.2% for found in 18.5%. Since the people of these females). Ameri M et al (2016) [8] studied ages travel and work more, therefore the 2,480 patients (29.9 ± 17.8 years) who rates of traffic and labor accidents are higher. were treated at ShafaYahyaeian Hospital The age difference in the two groups of (Tehran, Iran) (2013 - 2013), there were men and women was significantly different 685 patients with lower limb bone fracture (p < 0.01). Research by Nguyen Duc (male: 73% and female: 27%). Table 2: Distribution of subjects by accidents and sex (n = 4,918). Male Female Total Type of accident p-values n % n % n % Working accident 403 11.9 66 4.3 469 9.5 < 0.01 Traffic accident 1,609 47.4 659 43.3 2,268 46.1 Others 1,383 40.7 798 52.4 2,181 44.4 Total 3,395 69.0 1,523 31.0 4,918 100,0 (a: Chi-squared test) The rate of men with occupational According to the WHO report, the accidents and traffic accidents were 11.9% global trauma-induced fatality of men and 47.4%, respectively, which were higher doubles that of women. Do Van Dung et than that of women (occupational accidents al (2003) [9] examined the trauma 4.3% and traffic accidents 43.3%) (p < 0.01). prevalence in the South East provinces With other types of accidents, female and found that the rate traffic trauma in patients accounted for 52.4%, higher than men (n = 9,456, 17.8/1,000, 95%CI: male patients (40.7%) (p < 0.01). 15.3 - 20.6) was almost twice as high as 174
4. Journal of military pharmaco-medicine n o1-2018 that in women (n = 9,697; 10.1/1,000: accidents also accounts for the highest 95%CI: 8.3 - 12.3). percentage. Le Thai Ha (2014) studied It is supposed that the cause of fractures 58 patients with tibial fractures found in men due to traffic accidents was mainly 89.7% of traffic accidents and 10.3% daily associated with drinking alcohol, high accidents. Hoang Duc Thai (2016) in a speed driving. On the other hand, men study on 99 cases of fractures found the often do more heavy, dangerous jobs main cause was due to traffic accidents than women, so the occupational accident (92.9%). According to Ameri M et al rate is also higher. (2016) [8], the mechanism of traumatic According to the study, the number of injury in male patients was local falls patients with traffic accidents was the (34.8%), direct trauma (24.6%), motorcycle highest (47.7%), followed by daily accidents accident (10%), fall from buildings (7.9%). (43.6%) and at least occupational accidents The most common mechanisms of (8.7%), which is similar to some studies traumatic injury in female patients were by other authors. For fractures in the local falls (54.2%), direct trauma upper and lower extremities, traffic (15.8%) and fall from buildings (7.5%). Table 3: Distribution by occupation (n = 4,918). Male Female Total Occupation n % n % n % Farmer 787 23.2 572 37.6 1,359 27.6 Worker 724 21.3 151 9.9 875 17.8 Official 556 16.4 280 18.4 836 17.0 Student 505 14.9 160 10.5 665 13.5 Soldier 181 5.3 10 0.7 191 3.9 Freelance workers 642 18.9 350 23.0 992 20.2 Total 3,395 69.0 1,523 31.0 4,918 100.0 Farmer patients accounted for the Thi Kim Khoi (2015) [11]: 38.0% were highest proportion (27.6%) and soldiers farmers, 17.5% were self-employed, occupied the lowest rate of 3.9%. Nguyen followed by students (12.7%), workers, Thi Nhu Tu et al (2012) showed that civil servants, pensioners and housewives farmers (41%), workers (15.3%) and (5.5%). Le Van Sen (2015) [12]: farmers children (3%). Farmers (27.7%) and constituted 38.2%, followed by other freelance workers (21%), followed by occupations (elderly, children, non- workers (13.7%), traffic participants working) (23.1%), traffic participants (10%); pupils, students, civil servants and (16.9%) and the lowest was found in housewives made up about 6%. Huynh housewives (2.5%). 175
5. Journal of military pharmaco-medicine n o1-2018 Traffic accident was the leading type of most common type of trauma and was injury in all occupations and was the most frequently encountered in other occupations common in farmers (52.3%). Fall was the (44.4%). 2. Some characteristics of bone fracture patients in motor organs. Table 4: Relationship between number of fractured bone patients and fracture condition (n = 4,918). Open fracture Closed fracture p-values Total Number of patients patients fractured bones n % n % n % 1 bone 1,071 86.86 3,376 91.61 4,447 90.42 2 bones 137 11.11 258 7.0 395 8.03 < 0.01 ≥ 3 bones 25 2.02 51 1.38 76 1.55 Total 1,233 25.1 3,685 74.4 4,918 100.0 (a: Chi-squared test) The number of patients with one fractured bone was the highest (90.42%) whereas 8.03% of the patients had 2 fractured bones. The patients with 3 or more fractured bones accounted for 1.55%. In group with one bone fracture, the rate of closed fracture was higher than open fracture, but in group with two bone fractures, the rate of open fracture was higher than closed fracture (p < 0.01). With fractures of more than two bones, the incidence of closed fractures and open fractures was statistically insignificant, with p > 0.05. There was no significant difference in the rate of closed fracture and open fracture (p > 0.05). Figure 1: Distribution of patients by site and type of fracture. 176
6. Journal of military pharmaco-medicine n o1-2018 Open fracture of leg bones (40.9%) was 36.5 ± 16.3 years. The working age had the highest incidence of fractures, group of 20 - 59 years old accounted for followed by closed thigh bone fracture the highest rate (74.1%). Males outnumbered (28.9%), open forearm bone fracture females with the corresponding rates of (13.6%), hand and fingers fracture 69% and 31%. The rate of traffic accidents (20.7%), foot and toes fracture (10%). We was 47.4% for men, 43.3% for women; did not experience any fractures in the meanwhile 11.9% of men and 4.3% of spine. The above chart shows that the women suffered from occupational accidents. highest rate was fracture of the two tibias - Distribution of fractures by occupation: in which the rate of open two-tibia fracture Farmers accounted for the highest (40.9%) was significantly higher than that percentage (27.6%), freelance workers of closed two-tibia fracture (22.1%). (20.2%), workers (17.8%), officials (17,0%), Closed fracture of femur ranked students (13.5%) and the lowest was second (28.9%), in which closed femur soldier (3.9%). fracture accounted for 13.1%. Fracture of - The number of patients with one the hand and finger bone accounted for fractured bone accounted for the highest 20.7%, ranked the third among the most proportion (90.42%), followed by two common types of bone fracture. Forearm fractured bones with 8.03%. bone fracture accounted for 13.6%. Fracture of the foot and toe bone REFERENCES accounted for 10%. Research by Nguyen 1. Dang Hanh De, Nguyen Duc Phuc et al . Thi Chinh et al (2013) on a study of 289 Traumatic injury emergency medicine. Medical cases treated at Ducgiang Hospital Publishing House. Hanoi. 2006. showed that the location of injuries was 2. Nguyen Duc Chinh, Tran Van Oanh, chiefly in the limbs (the lower limb was Tran Tuan Anh et al. Emergency situation of high with 122 cases and over 80 cases). accidental injury in Viet-Germany Hospital 2009 - 2010. Journal of Practical Medicine. CONCLUSION 2006, 10 (787), pp.7-9. Studying some epidemiological 3. Le Quang Anh . Study on situation of accidental injury in the Longthanh and characteristics of bone fracture in motor Nhontrach communities in 2011. Journal of organs in 103 Military Hospital in 5 years Practical Medicine. 2012, 12 (854), pp.57- 59. (1 - 2010 to 12 - 2014), we found: 4. Nguyen Thi Nhu Tu, Ngo Van Toan, Vo - Fractures can occur at any age, the Hong Phong. Research on causes of traffic average age was 39.7 ± 18.2 (from 1 to accidents in Binh Dinh province in 2011. 99 years). The average age of women Journal of Practical Medicine. 2012, 8 (838), was 46.7 ± 20.1, the average age of men pp.43-45. 177
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