Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA 98195-7236, USA.
Pediatrics. 2011 Nov;128(5):946-54. doi: 10.1542/peds.2010-2259. Epub 2011 Oct 3.
Traumatic brain injury (TBI) is a major cause of disability among US children. Our goal was to obtain population-based data on TBI incidence rates.
We conducted surveillance through a stratified random sample of hospital emergency departments in King County, Washington, to identify children 0 to 17 years of age with medically treated TBIs during an 18-month study period in 2007-2008. Additional cases were identified through hospital admission logs and the medical examiner's office. For a sample of nonfatal cases, parents were interviewed to verify TBIs, and medical record data on severity and mechanisms were obtained.
The estimated incidence of TBIs in this setting was 304 cases per 100,000 child-years. The incidence was highest for preschool-aged children and lowest for children aged 5 to 9 years. Rates were uniformly higher for boys than for girls; there was a larger gender gap at older ages. Falls were the main mechanism of injury, especially among preschool-aged children, whereas being struck by or against an object and motor vehicle-related trauma were important contributors for older children. Approximately 97% of TBI cases were mild, although moderate/severe TBI incidence increased with age.
TBIs led to many emergency department visits involving children, but a large majority of the cases were clinically mild. Incidence rates for King County were well below recent national estimates but within the range reported in previous US studies. Because mechanisms of injury varied greatly according to age, prevention strategies almost certainly must be customized to each age group for greatest impact.
创伤性脑损伤（TBI）是美国儿童残疾的主要原因。我们的目标是获得基于人群的 TBI 发病率数据。
我们通过华盛顿州金县医院急诊部的分层随机抽样进行监测，以确定在 2007-2008 年 18 个月的研究期间，0 至 17 岁因 TBI 接受医学治疗的儿童。通过住院记录和法医办公室确定了其他病例。对于非致命病例的样本，对父母进行了访谈以验证 TBI，并获得了关于严重程度和机制的医疗记录数据。
在此环境下，TBI 的估计发病率为每 100,000 儿童年 304 例。学龄前儿童的发病率最高，5 至 9 岁儿童的发病率最低。男孩的发病率普遍高于女孩；年龄较大的性别差距更大。跌倒是主要的受伤机制，尤其是在学龄前儿童中，而被物体撞击或撞击以及与机动车相关的创伤是年龄较大儿童的重要原因。大约 97%的 TBI 病例为轻度，但中度/重度 TBI 的发病率随年龄增长而增加。
TBI 导致许多涉及儿童的急诊就诊，但大多数病例临床症状较轻。金县的发病率远低于最近的全国估计数，但在之前的美国研究报告的范围内。由于受伤机制根据年龄有很大差异，因此预防策略几乎肯定必须针对每个年龄组进行定制，以产生最大影响。
