Cameron C M, Kliewer E V, Purdie D M, McClure R J
School of Medicine, Logan Campus, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia.
J Epidemiol Community Health. 2006 Apr;60(4):341-4. doi: 10.1136/jech.2005.041046.
Estimating the contribution of non-fatal injury outcomes remains a considerable challenge and is one of the most difficult components of burden of disease analysis. The aim of this systematic review was to quantify the effect of being injured compared with not being injured on morbidity and health service use (HSU) in working age adults.
Studies were selected that were population based, had long term health outcomes measured, included a non-injured comparison group, and related to working age adults. Meta-analysis was not attempted because of the heterogeneity between studies.
Nine studies met the inclusion criteria. In general, studies found an overall positive association between injury and increased HSU, exceeding that of the general population, which in some studies persisted for up to 50 years after injury. Disease outcome studies after injury were less consistent, with null findings reported.
Because of the limited injury types studied and heterogeneity between study outcome measures and follow up, there is insufficient published evidence on which to calculate population estimates of long term morbidity, where injury is a component cause. However, the review does suggest injured people have an increased risk of long term HSU that is not accounted for in current methods of quantifying injury burden.
估算非致命伤害结果的影响仍然是一项巨大挑战，并且是疾病负担分析中最困难的部分之一。本系统评价的目的是量化与未受伤相比，受伤对工作年龄成年人的发病率和医疗服务利用（HSU）的影响。
选择基于人群的研究，这些研究测量了长期健康结果，包括一个未受伤的对照组，并且与工作年龄成年人相关。由于研究之间的异质性，未尝试进行荟萃分析。
九项研究符合纳入标准。总体而言，研究发现伤害与医疗服务利用增加之间存在总体正相关，超过了一般人群，在一些研究中，这种情况在受伤后长达50年持续存在。受伤后的疾病结局研究不太一致，报告了无显著结果。
由于所研究的伤害类型有限以及研究结局测量和随访之间的异质性，关于将伤害作为部分病因时计算人群长期发病率估计值的公开证据不足。然而，该评价确实表明，受伤者长期医疗服务利用风险增加，而这在当前量化伤害负担的方法中未得到考虑。
