Trokel Matthew, DiScala Carla, Terrin Norma C, Sege Robert D
Tufts-New England Medical Center, USA.
Child Maltreat. 2004 Feb;9(1):111-7. doi: 10.1177/1077559503260310.
This study sought to evaluate injury causes and patient outcomes in young children with abdominal injuries. Cases of blunt abdominal injury (N = 927) to children ages 0 to 4 years were extracted from the National Pediatric Trauma Registry. Measures included hospital utilization (days hospitalized, intensive care unit use, and surgery) and patient outcome (in-hospital fatality, discharge to rehabilitation facility, home rehabilitation, and home nursing). The three most common mechanisms of abdominal injury were motor vehicles (61.27%), child abuse (15.75%), and falls (13.59%). Hospital utilization was higher in patients with multisystem injuries. Patient outcomes were more severe in abused children or those with concomitant central nervous system (CNS) injury; these were the only variables independently associated with increased mortality in this sample. Pediatric abdominal trauma leads to intense use of hospital resources and a high risk of in-hospital mortality. Child abuse, compared to falls, is independently associated with a 6-fold increase in in-hospital mortality.
本研究旨在评估幼儿腹部损伤的致伤原因及患者预后。从国家儿科创伤登记处提取了0至4岁儿童钝性腹部损伤病例（N = 927）。测量指标包括医院资源利用情况（住院天数、重症监护病房使用情况及手术情况）和患者预后（院内死亡、转至康复机构、家庭康复及家庭护理）。腹部损伤最常见的三种机制是机动车事故（61.27%）、虐待儿童（15.75%）和跌倒（13.59%）。多系统损伤患者的医院资源利用更高。受虐待儿童或伴有中枢神经系统（CNS）损伤的儿童患者预后更严重；在该样本中，这些是与死亡率增加独立相关的唯一变量。小儿腹部创伤导致医院资源的大量使用及较高的院内死亡风险。与跌倒相比，虐待儿童独立导致院内死亡率增加6倍。
