Minns Robert A, Jones Patricia A, Mok Jacqueline Y-Q
Department of Child Life and Health, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
Am J Prev Med. 2008 Apr;34(4 Suppl):S126-33. doi: 10.1016/j.amepre.2008.01.016.
This study utilized an existing national database of cases of non-accidental head injury (NAHI; also called inflicted traumatic brain injury [inflicted TBI] and shaken baby syndrome [SBS]) in Scotland to report the incidence, confidence intervals, and demography of such cases in Southeast Scotland.
This prospective population-based study was conducted from January 1998 to September 2006. Data from the Lothian region of Scotland, where there is known full ascertainment of infant head injuries, including NAHI, have been used to calculate the incidence rate for this region of Scotland, with government statistics providing the normal annual infant population as the denominator. A new Scottish Index of Multiple Deprivation (SIMD), which assesses a very focused area (data zone population size=750) and provides novel information about social demography for education, housing, employment, health, crime, income, and geographic accessibility to services, was applied to the identified cases of NAHI during this study period.
The mean incidence of NAHI in southeast Scotland for 8.75 years was 33.8/100,000 infants per year. The cases of NAHI were mostly located in the lowest 1 (or 2) quintiles for all SIMD domains (education, housing, employment, health, crime, income), although they had good accessibility to medical and other community services.
The incidence rates from this prospective study for NAHI are considerably higher than other published UK surveys and are not considered to reflect a cluster effect. The perpetrators in this study fit a strongly skewed profile aggregating to the lowest socioeconomic groups in the community.
本研究利用苏格兰现有的非意外性头部损伤（NAHI；也称为非意外创伤性脑损伤[非意外TBI]和摇晃婴儿综合征[SBS]）全国病例数据库，报告苏格兰东南部此类病例的发病率、置信区间和人口统计学特征。
这项前瞻性基于人群的研究于1998年1月至2006年9月进行。来自苏格兰洛锡安地区的数据被用于计算该地区苏格兰的发病率，该地区已知对包括NAHI在内的婴儿头部损伤进行了全面统计，以政府统计的正常年度婴儿人口作为分母。一种新的苏格兰多重贫困指数（SIMD）被应用于本研究期间确定的NAHI病例，该指数评估一个非常集中的区域（数据区人口规模=750），并提供有关教育、住房、就业、健康、犯罪、收入和服务地理可达性等社会人口统计学的新信息。
在8.75年期间，苏格兰东南部NAHI的平均发病率为每年33.8/10万婴儿。NAHI病例大多位于所有SIMD领域（教育、住房、就业、健康、犯罪、收入）的最低1（或2）五分位数，尽管他们能够很好地获得医疗和其他社区服务。
这项前瞻性研究中NAHI的发病率远高于英国其他已发表的调查，且不被认为反映了聚集效应。本研究中的犯罪者呈现出强烈的偏态分布，集中在社区中社会经济地位最低的群体。
