Pickett W, Ardern C, Brison R J
Departments of Emergency Medicine and Community Health and Epidemiology, Queen's University, Kingston, Ont.
CMAJ. 2001 Aug 7;165(3):288-92.
Brain injury is an important health concern, yet there are few population-based analyses on which to base prevention initiatives. This study aimed, first, to calculate rates of potential brain injury within a defined Canadian population and, second, to describe the external causes, natures and disposition from the emergency department of these injuries.
We studied all cases of blunt head injury that resulted in a visit to an emergency department for all residents of Greater Kingston during 1998. We used data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) and augmented this by examining all records of emergency or inpatient care received at all hospitals in the area.
In 202 (27%) of 760 cases of head injury, there was potential for brain injury. Annual rates of potential brain injury were 16 and 7 per 10,000 population for males and females respectively. CT was performed on 114 (56%) of 202 cases, of which 60 (53%) demonstrated an intracranial pathology, with 11 (10%) showing a diffuse axonal injury pattern on the initial scan. Falls from heights accounted for 14 (47%) of 30 injuries observed in children aged 0-9 years. Individuals aged 10-44 years sustained 32 (63%) of 51 motor vehicle injuries, 15 (88%) of 17 bicycle injuries, 22 (100%) of 22 sports injuries and 8 (89%) of 9 fight-related injuries. Falls accounted for 15 (71%) of 21 injuries among adults aged 65 years or more.
The results indicate the relative importance of several external causes of injury. The findings from our geographically distinct population are useful in establishing rational priorities for the prevention of brain injury.
脑损伤是一个重要的健康问题，但基于人群的分析很少，难以据此制定预防措施。本研究旨在：其一，计算特定加拿大人群中潜在脑损伤的发生率；其二，描述这些损伤的外部原因、性质以及从急诊科的处理情况。
我们研究了1998年大金斯顿地区所有因钝性头部损伤前往急诊科就诊的居民病例。我们使用了加拿大医院伤害报告与预防项目（CHIRPP）的数据，并通过查阅该地区所有医院的急诊或住院护理记录进行补充。
在760例头部损伤病例中，有202例（27%）存在潜在脑损伤。男性和女性潜在脑损伤的年发生率分别为每10,000人口16例和7例。202例病例中有114例（56%）进行了CT检查，其中60例（53%）显示有颅内病变，11例（10%）在初次扫描时显示弥漫性轴索损伤模式。0至9岁儿童中观察到的30例损伤中有14例（47%）是从高处跌落所致。10至44岁的个体承受了51例机动车损伤中的32例（63%）、17例自行车损伤中的15例（88%）、22例运动损伤中的22例（100%）以及9例与打架相关损伤中的8例（89%）。65岁及以上成年人的21例损伤中有15例（71%）是跌倒所致。
结果表明了几种外部损伤原因的相对重要性。我们来自地理上不同人群的研究结果有助于为预防脑损伤确定合理的优先事项。
