Stephenson Shaun, Langley John, Cryer Colin
Injury Prevention Research Unit, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, Otago 9001, New Zealand.
Accid Anal Prev. 2005 Sep;37(5):825-32. doi: 10.1016/j.aap.2005.03.024.
Though injury incidence and hospitalisations are likely to be correlated, a range of factors other than incidence of injury in a population may influence trends in hospitalised injuries. These include technical changes in the hospital data's coverage, and real changes in the incidence of hospitalisations independent of the population incidence. This paper addresses the latter using the example of traumatic brain injury (TBI) hospitalisations in New Zealand. Data were New Zealand public hospitals inpatient discharges. Five measures of TBI severity were used. The relative rate of minor to serious TBI hospitalisations declined by approximately 2-6% per year from 1988 to 1998. This decline is observed across different mechanisms and the two severity measures used in the detailed analysis. The relative decline in minor to serious TBI is likely to be related to a change in the probability of admission rather than a change in the population TBI incidence. As most TBI hospitalisations are minor this suggests the trend in TBI hospitalisations was significantly influenced by factors other than changes in population incidence. Any analysis of routinely collected secondary injury data needs to consider case selection carefully, especially if trends are being examined. Applying a severity threshold should give more reliable trends.
尽管伤害发生率与住院率可能相关，但除人群伤害发生率之外，一系列其他因素可能会影响住院伤害的趋势。这些因素包括医院数据覆盖范围的技术变化，以及与人群发生率无关的住院率实际变化。本文以新西兰创伤性脑损伤（TBI）住院情况为例探讨后者。数据来自新西兰公立医院的住院患者出院记录。使用了五种TBI严重程度的衡量指标。从1988年到1998年，轻度与重度TBI住院的相对比率每年下降约2 - 6%。在不同机制以及详细分析中使用的两种严重程度衡量指标中均观察到了这种下降。轻度与重度TBI的相对下降可能与入院概率的变化有关，而非人群TBI发生率的变化。由于大多数TBI住院情况为轻度，这表明TBI住院趋势受人群发生率变化以外的因素显著影响。对常规收集的二次伤害数据进行的任何分析都需要仔细考虑病例选择，尤其是在检查趋势时。应用严重程度阈值应能得出更可靠的趋势。
