Section of Paediatric Surgery, Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland.
Scand J Surg. 2011;100(2):129-35. doi: 10.1177/145749691110000212.
Injuries are an important public health problem as well as the leading cause of death and disability among children. Our aim was to longitudinally explore the incidence of in-hospital treated traumas, their operative treatment and related mortality among pediatric patients in Finland.
The National Hospital Discharge Register and the Official Cause-of-Death Statistics data of in-hospital treated pediatric trauma patients between 1997 and 2006 in Finland were evaluated for hospitalizations, treatment modality and mortality.
Fractures (69%) and head injuries (28%) were the most common in-hospital treated traumas (477/100,000 persons/year). These were followed by injuries of intra-abdominal (1.4%), thoracic (1.2%) and urological organs (0.6%). Head traumas constituted 67% of injury-related deaths. During the ten-year follow-up period, the annual incidence (per 100,000 persons) of head injuries decreased by 13.6% (152 in 1997 vs. 131 in 2006, p < 0.0001) mainly contributing to a 30% decrease in overall injury-related mortality incidence (from 5.7 in 1997 to 4.0 in 2006, p = 0.0519). The overall trauma incidence, and incidence of fractures and abdominal injuries significantly increased by 5.0% (p < 0.0001), 13.5% (p < 0.0001) and 37% (p < 0.05), respectively, while the incidence of thoracic and urological injuries remained unchanged. Up to 15% of spleen injuries lead to splenectomy.
Although overall and head trauma-related mortality is decreasing, the increasing incidence of fractures and abdominal injuries has amplified the overall incidence of severe injuries among children in Finland. A significant number of unnecessary splenectomies are still performed among children.
伤害是一个重要的公共卫生问题,也是儿童死亡和残疾的主要原因。我们的目的是纵向探讨芬兰儿科患者住院治疗创伤、手术治疗及其相关死亡率的发生率。
评估了芬兰 1997 年至 2006 年期间全国住院儿童创伤患者的国家医院出院登记处和官方住院治疗儿童创伤患者死因统计数据,以评估住院治疗、治疗方式和死亡率。
骨折(69%)和头部损伤(28%)是最常见的住院治疗创伤(477/100000 人/年)。其次是腹部(1.4%)、胸部(1.2%)和泌尿系统器官(0.6%)损伤。头部创伤占与损伤相关的死亡人数的 67%。在十年的随访期间,头部损伤的年发病率(每 100000 人)下降了 13.6%(1997 年为 152 人,2006 年为 131 人,p<0.0001),主要导致与损伤相关的总死亡率发病率下降了 30%(从 1997 年的 5.7 人降至 2006 年的 4.0 人,p=0.0519)。总体创伤发病率以及骨折和腹部损伤的发病率分别显著增加了 5.0%(p<0.0001)、13.5%(p<0.0001)和 37%(p<0.05),而胸部和泌尿系统损伤的发病率保持不变。多达 15%的脾损伤导致脾切除术。
尽管总体和与头部创伤相关的死亡率正在下降,但骨折和腹部损伤发病率的增加放大了芬兰儿童严重损伤的总体发病率。儿童中仍有大量不必要的脾切除术。