Epidemiological Study And GIS Spatial Analysis Of Pre-hospital Trauma In Haikou

Objective: To study the epidemiological characteristics of through collecting the data of epidemiology of pre-hospital trauma patients in Haikou city,and explore the spatial distribution of pre-hospital trauma patients by using geographic information system(GIS),to determine the high incidence area of trauma accidents,so as to provide theoretical basis for the planning of prevention,control,monitoring and treatment resources.Methods: From January 1 to December 31,2019,medical records of 11433 cases of pre-hospital emergency were selected from the dispatching command system database of the 120 emergency centers in Haikou City.Records of 4413 cases with pre-hospital trauma were selected according to the exclusion criteria.The descriptive statistical analysis of epidemiology of trauma patients was made;then,the location of trauma in the above-mentioned research data was taken as the research object,the longitude and latitude of trauma sites were extracted,and the geographic information database of trauma sites in Haikou City was established by using Arc GIS 10.5 software,and its spatial distribution pattern was analyzed.Results: The results of the epidemiological study and GIS spatial analysis of the data in this group were as follows:(1)The number of trauma patients aged under 70 years old accounted for 85.29% of the total number of trauma patients.Among them,the peak occurred in the age of 20-30,accounting for 20.69% of the total number of trauma patients.Male trauma patients in the age of 20-30 and 30-40 were significantly more than female trauma patients.(2)The number of casualties in January,March,September and December was relatively high,and the number of casualties in February was the lowest.Three peak periods of trauma occurred in each day were from 2: 00 to 3: 00,8:00 to 9: 00 and 21: 00 to 22: 00.(3)The main cause of trauma was traffic accident trauma(47.47%),followed by fall trauma(24.29%),motor cycle or other non-motor vehicle drivers and pedestrians were the main groups of trauma in traffic accident trauma.The most common three injured parts were limb(36.87%),head(32.36%)and multiple areas all over the body(13.35%).As for the severity of injury,the largest number of minor injury accounted for 95.74% of all trauma patients,and moderate and critical injuries accounted for only 4.26%.(4)In the regional distribution,injury in Longhua District accounted for the largest proportion(1173 cases,40.18%),followed by Meilan District(1196 cases,27.09%)and Xiuying District(998 cases,22.62%),while Qiongshan District accounted for the smallest proportion(446 cases,10.11%).(5)The median of pre-hospital reaction time,on-the-spot treatment time and time to leave the scene and arrive at hospital were 13.92 minutes,8.80 minutes and 8.15 minutes,respectively.Among the pre-hospital reaction time and time to leave the scene and arrive at hospital,the longest time was spent in Qiongshan District,with the median of 17.25 minutes and 10.32 minutes respectively,and the longest interquartile range was also in Qiongshan District,with 10.55 minutes and 10.11 minutes respectively.(6)GIS is applied to scientifically reflect the distribution of trauma sites in Haikou City and the main urban area of Haikou City,the spatial analysis is carried out to show the spatial aggregation of trauma sites,which was mainly concentrated in the center of the main urban area.The farther away from the main urban area,the less the number of trauma occurred.according to the population density,Haixiu Town,Xiuying Street and Haiken Street are the three township streets with the highest trauma incidence ratio(cases/10,000 people)in the whole year.The intersection area of Haixiu Middle Road,Haixiu East Road and Longkun South Road is defined as the core,radiating along the Haixiu Middle Road and Haixiu East Road to the east and west direction,and spreading to the area around the road.Conclusions: This study summarized the distribution pattern of population,time and space distribution of pre-hospital trauma patients in Haikou City as follows: male patients aged 21-30 years old were the main trauma victims;the months of January,March,September and December were the high incidence of trauma;the time periods of 2:00-3:00,8:00-9:00 and 21:00-22:00 were the high incidence time periods;the traffic accident was the most important cause of injury,the main injured people were motorbike or other non-motor vehicle drivers and pedestrians.The most common trauma sites were limb,head and multiple parts all over the body,and the main injury types were minor injuries;the most trauma happened in Longhua district and the least trauma happened in Qiongshan district,but the median and interquartile range of prehospital reaction time and time to leave the scene and arrive at hospital were longest in Qiongshan district.There is spatial agglomeration of the distribution of injuries sites in Haixiu Middle Road,Haixiu East Road and Longkun South Road is defined as the core,radiating along the Haixiu Middle Road and Haixiu East Road to the east and west direction,and spreading to the area around the road.This study provides a theoretical basis for the optimization of resource allocation for prevention,control and treatment of trauma,and is of positive significance for the development of trauma treatment in the region.