응급실에 방문한 임신 중 손상 환자의 특성

Abstract

Purpose: In Korea, few studies have compared outcomes in injured pregnant women to their non-pregnant counterparts. The purpose of this study is to describe the characteristics of patients injured during pregnancy who visited seven emergency departments in South Korea. Methods: The Korean Traumatic Brain and Spine Injury Research Network (KTBSIRN) database, based on 7(emergency department) from June, 2008 to September, 2010was used to derive data on all injured patients between 12and 49 years of age. Data were divided into two comparison groups: pregnant and non-pregnant women. For comparison of characteristics and admission by pregnancy, we selected patients using the statistical matching method according to hospital, age, and injury mechanism after comparison with all enrolled patients. Then, members of the pregnant women group were divided into two subgroups:<20 weeks and ≥20 weeks gestational age. Results: A total of 13,449 women were identified in a total of 76,596 injuries. Among them, 164(1.22%) women were pregnant. Fewer alcohol-related injuries were observed in pregnant women compared with non-pregnant women. Transportation was the leading mechanism of ED injury visits by pregnant women (52.4%). Emergency Medical Service (EMS) usage (22.0% vs. 14.6%, p<0.008) and admission (14.0% vs. 7.9%, p<0.001) were more common in pregnant women than in non-pregnant women. However, no significant difference was observed in injury severity scores. After matching,adjusted odds ratio of pregnancy for admission was 2.8(95% CI: 1.46~5.53). Less than half the number of pregnant women underwent an obstetric exam and non-stress test (NST) for the fetus (44.5% and 27.4%, respectively). Conclusion: Injured pregnant women who visited the ED were used more medical resources but showed no significant difference in injury severity. Despite maternal and fetal risk after injury, obstetric exam including fetal monitoring was not performed appropriately. Therefore, establishment of standards for injured pregnant women is needed in many EDs.