Tursz A, Crost M
Inserm U502/Cermes, Paris, France.
Inj Prev. 2000 Sep;6(3):209-13. doi: 10.1136/ip.6.3.209.
To determine the frequency and categories of sequelae related to accidental injuries (of all types) in childhood, a prospective follow up study was conducted on a geographically defined population near Paris, France.
The study concerned all child residents of one health care district, aged under 15 years, and hospitalised in the two public hospitals of the district, and/or transported by mobile emergency units, after an accident, during a one year period (in 1981-82; n = 785). Initial severity was scored using the injury severity score (ISS). Sequelae were defined as established impairments (leading or not to disabilities), identified by physicians, reporting their clinical diagnosis or complaints by the child and/or the family.
After a follow up period of 3.6-29.2 months after the accident, six children died and 78 (10%) were lost to follow up. Among the 701 others, 73 (10.4%) presented 80 sequelae, major (limiting daily activities) in 44 children (6.3%), with no gender difference. These increased significantly with age. The main causes of major sequelae were eye injuries and sports related injuries to the limbs. ISS did not correlate well with sequelae, but the maximum abbreviated injury scale appeared to be a better predictor of long term functional prognosis.
Prospective follow up and population based studies are still needed, especially on children's injuries initially perceived as benign, such as most of the sports related injuries in our study.
为确定儿童期意外伤害(所有类型)相关后遗症的发生率及类别,在法国巴黎附近一个地理区域限定的人群中开展了一项前瞻性随访研究。
该研究涉及一个医疗保健区所有15岁以下的儿童居民,这些儿童在1981 - 1982年的一年期间,因意外事故后在该地区的两家公立医院住院,和/或由移动急救单位运送(n = 785)。初始严重程度使用损伤严重程度评分(ISS)进行评分。后遗症定义为经医生确认的既定损伤(导致或未导致残疾),由儿童和/或家庭报告其临床诊断或症状。
在事故发生后的3.6 - 29.2个月随访期后,6名儿童死亡,78名(10%)失访。在其余701名儿童中,73名(10.4%)出现了80种后遗症,44名儿童(6.3%)出现严重后遗症(限制日常活动),无性别差异。这些后遗症随年龄显著增加。严重后遗症的主要原因是眼部损伤和与运动相关的四肢损伤。ISS与后遗症的相关性不佳,但最大简明损伤量表似乎是长期功能预后的更好预测指标。
仍需要进行前瞻性随访和基于人群的研究,特别是针对那些最初被认为是良性的儿童损伤,如我们研究中的大多数与运动相关的损伤。