Koroukian Siran M, Beaird Heather, Duldner John E, Diaz Mireya
Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Ohio 44106-4945, USA.
J Trauma. 2007 Apr;62(4):989-95. doi: 10.1097/01.ta.0000210359.98816.45.
To identify the leading causes of injury- and violence-related deaths in demographic subgroups of the population in Ohio, by Medicaid status.
We used linked Ohio Medicaid and death certificate files, 1992 to 1998, and obtained the probability (p) of dying from a specific mechanism of injury--given death from injury--by Medicaid status, using multinomial multivariable logistic regression analysis. Probabilities were rank-ordered to identify the leading causes of death in each subgroup.
The leading cause of injury-related deaths was homicide among Medicaid decedents in the age groups 0 to 4, 15 to 24, and 25 to 44 (p = 0.283, 0.380, and 0.269, respectively), and motor vehicle crashes among nonMedicaid decedents aged 5 to 14, 15 to 24, 25 to 44, and 45 to 74 (p = 0.448, 0.462, 0.293, and 0.293, respectively). Accidental falls ranked first among the elderly (p = 0.593 and 0.414, respectively in Medicaid and nonMedicaid decedents). Suicide and accidental exposure to smoke, fire, and flames also ranked high among the leading causes of injury-related deaths in many population subgroups.
Findings from this study, pointing to the vulnerability of population subgroups to certain mechanisms of injury, can be used to formulate targeted prevention strategies.
按医疗补助状态确定俄亥俄州人口各亚组中与伤害和暴力相关死亡的主要原因。
我们使用了1992年至1998年俄亥俄州医疗补助与死亡证明的关联文件，通过多项多变量逻辑回归分析，得出了按医疗补助状态，因特定伤害机制导致死亡（给定死于伤害）的概率（p）。对概率进行排序以确定每个亚组中的主要死亡原因。
在0至4岁、15至24岁和25至44岁年龄组的医疗补助死亡者中，与伤害相关死亡的主要原因是杀人（概率分别为0.283、0.380和0.269）；在5至14岁、15至24岁、25至44岁和45至74岁的非医疗补助死亡者中，主要原因是机动车碰撞（概率分别为0.448、0.462、0.293和0.293）。在老年人中，意外跌倒位居首位（医疗补助和非医疗补助死亡者中的概率分别为0.593和0.414）。自杀以及意外接触烟雾、火灾和火焰在许多人口亚组的与伤害相关死亡主要原因中也排名靠前。
本研究结果指出了人口亚组对某些伤害机制的脆弱性，可用于制定有针对性的预防策略。
