Gofin R, Avitzour M, Haklai Z, Jellin N
Department of Social Medicine, Hadassah Medical Organization and the Braun School of Public Health and Community Medicine of the Hebrew University and Hadassah, Jerusalem, Israel.
J Adolesc Health. 2000 Dec;27(6):434-42. doi: 10.1016/s1054-139x(00)00091-4.
To study the incidence and outcome of intentional injuries requiring emergency room (ER) care among children and adolescents in a national sample.
The population included 0- to 17-year-olds who presented to the ER for injuries in 23 hospitals over a 1-year period. A 6% to 9% random sample of days was selected in each hospital, and for each selected day the relevant ER record was reviewed for cause, nature, and outcome of injuries and sociodemographic information.
The annual incidence for intentional injuries resulting in ER visits was 19.6 in 10,000 children and adolescents aged 0 to 17 [95% confidence interval (CI) 17.4-21.8 in 10,000]. Fights/assaults constituted 54.1% of the presentations, abuse and rape, 10.3%, and self-inflicted injuries, 10.8%. Overall rates were higher among 10- to 17 year olds than at younger ages. The rates were higher among boys than girls for fights/assaults and abuse, whereas attempted suicide and rape were three times higher among girls than boys. Nearly twice as many Jewish children and adolescents presented to the ER for intentional injuries than Arab children and adolescents, with the ratio becoming even greater for attempted suicide. Of all the intentionally injured, 21.7% were hospitalized. The mortality rate was 1.1 in 100,000 (95% CI =.7-1.7/100,00) with no significant gender difference observed. No cases of suicide were reported for the Arab population.
Adolescents aged 10 years and older are at higher risk for intentional injuries than younger children. The ethnic differences evident in this study, especially for attempted and completed suicide, may be real or the result of differential disclosure of information owing to sociocultural norms or differential recording by health professionals.
在全国样本中研究需要急诊室（ER）护理的儿童和青少年故意伤害的发生率及结局。
研究对象为在1年时间内到23家医院的急诊室就诊的0至17岁儿童。每家医院选取6%至9%的随机天数样本，对于每个选定的日期，审查相关急诊室记录，以获取伤害的原因、性质、结局以及社会人口统计学信息。
导致急诊室就诊的故意伤害的年发生率为每10000名0至17岁儿童和青少年中有19.6例[95%置信区间（CI）为每10000名中有17.4 - 21.8例]。打架/袭击占就诊病例的54.1%，虐待和强奸占10.3%，自我伤害占10.8%。10至17岁人群的总体发生率高于年幼儿童。打架/袭击和虐待的发生率男孩高于女孩，而自杀未遂和强奸的发生率女孩是男孩的三倍。因故意伤害到急诊室就诊的犹太儿童和青少年人数几乎是阿拉伯儿童和青少年的两倍，自杀未遂的比例差异更大。在所有故意伤害病例中，21.7%住院治疗。死亡率为每100000人中有1.1例（95% CI = 每100000人中有0.7 - 1.7例），未观察到显著的性别差异。阿拉伯人群未报告自杀病例。
10岁及以上青少年遭受故意伤害的风险高于年幼儿童。本研究中明显的种族差异，尤其是自杀未遂和自杀死亡方面，可能是真实存在的，也可能是由于社会文化规范导致信息披露差异或医疗专业人员记录差异的结果。
