希腊儿童外伤性断肢：流行病学和预防潜力。

Department of Hygiene, Epidemiology and Medical Statistics, Athens University, Medical School, Athens, Greece.

Inj Prev. 2012 Oct;18(5):309-14. doi: 10.1136/injuryprev-2011-040121. Epub 2011 Dec 17.

BACKGROUND

Traumatic hand and finger amputations frequently lead to permanent disability.

OBJECTIVE

To investigate their epidemiological characteristics and estimate the prevention potential among children 0-14 years old, through a cross-sectional survey.

METHODS

Nationwide extrapolations were produced based on data recorded between 1996 and 2004 in the Greek Emergency Department Injury Surveillance System and existing sample weights. Incident and injury related characteristics were analysed to identify preventable causes.

RESULTS

Among 197,417 paediatric injuries, 28,225(14%) involved the hand and fingers resulting in 236 amputations (∼1% of hand injuries). The annual probability to seek emergency department care for a hand injury was 3%. The estimated incidence rate (IR) of hand amputations was 19.7/100,000 person-years. Over 50% concerned children 0-4 years old (male:female=2:1), peaking at 12-24 months. Male preschoolers suffered the highest IR (38.7/100,000). Migrant children were overrepresented among amputees. Of all amputations, 64% occurred in the house/garden and 14% in day-care/school/sports activities, usually between 08:00 and 16:00 (61%). Doors were the product most commonly involved (55% overall; 72% in day-care/school/gym) followed by furniture/appliances (15%) and machinery/tools (7%). Crushing was the commonest mechanism. Inadequate supervision and preventive measures were also frequently reported. 5% of the amputees were referred to specialised units for replantation/reconstructive surgery.

CONCLUSIONS

The majority of paediatric hand and finger amputations could be prevented in Greece, particularly among preschoolers, by a single product modification, namely door closure systems, coupled with improved supervision. Paediatricians should incorporate this advice into their routine child-safety counselling. This country-specific profile supports the need for maintaining similar databases as an indispensable tool for assisting decision-making and preventing disabling and costly injuries.

背景

手部和手指创伤性截肢常常导致永久性残疾。

目的

通过横断面调查，研究希腊儿童（0-14 岁）手和手指创伤的流行病学特征并评估预防潜力。

方法

根据 1996 年至 2004 年期间希腊急诊损伤监测系统记录的数据以及现有样本权重，进行全国外推。分析受伤相关特征以确定可预防的原因。

结果

197417 例儿科损伤中，28225 例（14%）累及手部和手指，导致 236 例截肢（约占手部损伤的 1%）。手部损伤患者每年前往急诊的概率为 3%。手部截肢的估计发病率（IR）为 19.7/10 万人年。超过 50%的患者为 0-4 岁儿童（男：女=2:1），12-24 个月龄时达到高峰。男学龄前儿童的 IR 最高（38.7/10 万人年）。移民儿童在截肢者中所占比例过高。所有截肢中，64%发生在家庭/花园，14%发生在日托/学校/体育活动中，通常在 08:00 至 16:00 之间（61%）。门是最常见的受伤产品（总体占 55%；日托/学校/健身房占 72%），其次是家具/电器（15%）和机械/工具（7%）。挤压是最常见的受伤机制。也经常报告存在监督不足和预防措施不力的情况。5%的截肢患者被转诊至专科单位进行再植/重建手术。