Pathophysiology Of Injury

This year nearly 40 million people will be seen in this nation's emergency departments as a result of nonintentional injury. Over 2.5 million will remain hospitalized. In 1996 the number of deaths from nonintentional injury increased for the fourth consecutive year to 93,874. This trend is expected to continue.

The most common case of death and disability from nonintentional injury worldwide is the motor vehicle crash. In 1996 deaths from motor vehicle-related incidents in the United States alone rose to 43,300, and nearly 21 million people suffered disabling injury. Forty-one percent of these crashes were alcohol-related.

Falls, the second leading cause of accidental death in the United States, were responsible for 8,436,000 emergency department visits in 1994 and continue to account for more than 20 percent of all injury-related hospital admissions.

Increasing urban violence in the United States presumably has led to the continuously rising incidence of penetrating trauma. While penetrating trauma can be self-inflicted or accidental, more than 55 percent of these fatalities are caused by violence. In 1994 gunshot wounds and stabbing injuries accounted for 4,123,000 (10 percent) of all emergency department visits in the United States.

Abdominal trauma generally is divided into two types: blunt and penetrating. This is somewhat simplistic, and a skilled clinician must make more subtle differentiations within these injury patterns. Patients can suffer both blunt and penetrating trauma simultaneously. Patients involved in motor vehicle crashes may be impaled on objects at the time of impact. In addition, people who are shot or stabbed may be assaulted at the same time.

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