Hicks B A, Morris J A, Bass S M, Holcomb G W, Neblett W W
Division of Pediatric Surgery, Vanderbilt University School of Medicine, Nashville, TN.
J Pediatr Surg. 1990 Sep;25(9):944-8; discussion 948-9. doi: 10.1016/0022-3468(90)90235-2.
Trauma is the leading killer of children and adolescents between 1 and 21 years of age. Alcohol-impaired driving represents the single greatest cause of mortality and morbidity of children over the age of 6. We retrospectively reviewed 878 consecutive adolescent (age range, 16 to 20 years) trauma admissions for blood alcohol concentration (BAC). Four hundred sixty-seven patients had BAC drawn, 258 were BAC-negative (group I), 209 (48%) were BAC-positive (group II). The adolescent drinkers were then compared with a group of 748 adult drinkers (group III). Groups I and II differ in sex, age, time of day of the accident, Injury Severity Score, Glasgow Coma Score, and Revised Trauma Score, whereas group II and III differ by type of accident, type of injury, socioeconomic factors (bad debt), time of day of the injury, and BAC. There were no significant differences in TRISS predicted survival, actual survival, nor mean length of stay. We conclude that (1) alcohol is a significant contributor to injury during adolescence, and (2) adolescent drinkers differ from adult drinkers in their habits, demographics, and socioeconomic status. These socioeconomic differences have implications for the access to and cost-effectiveness of interventions.
创伤是1至21岁儿童和青少年的首要死因。酒精影响下的驾驶是6岁以上儿童死亡和发病的单一最大原因。我们回顾性分析了878例连续入院的青少年（年龄范围16至20岁）创伤患者的血液酒精浓度（BAC）。467例患者进行了BAC检测，258例BAC呈阴性（第一组），209例（48%）BAC呈阳性（第二组）。然后将青少年饮酒者与748例成年饮酒者（第三组）进行比较。第一组和第二组在性别、年龄、事故发生时间、损伤严重程度评分、格拉斯哥昏迷评分和修订创伤评分方面存在差异，而第二组和第三组在事故类型、损伤类型、社会经济因素（坏账）、受伤时间和BAC方面存在差异。在TRISS预测生存率、实际生存率或平均住院时间方面没有显著差异。我们得出结论：（1）酒精是青少年受伤的一个重要因素，（2）青少年饮酒者在习惯、人口统计学和社会经济地位方面与成年饮酒者不同。这些社会经济差异对干预措施的可及性和成本效益有影响。
