Department of Pediatric General Surgery, Stollery Children's Hospital, University of Alberta, Alberta, Canada.
J Trauma Acute Care Surg. 2012 Apr;72(4):1031-4. doi: 10.1097/TA.0b013e3182452270.
Based on our previous study, pediatric intentional trauma injuries with Injury Severity Scores (ISS) ≥ 12 were more commonly observed in the urban than the rural setting (15.2% vs. 5.5%) in Alberta from 1996 to 2006. We wish to understand differences between urban and rural pediatric intentional trauma to plan for prevention and supportive strategies.
Data were extracted from the Alberta Trauma Registry on pediatric patients (0-17 years) with ISS ≥ 12, treated from 1996 to 2010 at the Stollery Children's Hospital. Statistical analysis was made comparing urban versus rural groups using t test and χ2 with p < 0.05 considered significant.
There were 170 pediatric patients who suffered intentional injury (urban = 58.3%; rural = 41.8%; not significant), with a majority of males (72.4%). Two groups were predominant: the very young (<1 year) at 17.1% of all injuries and the teens (≥ 15 years) at 54.1%. The cause of intent injury was child abuse (31.2%), assault with blunt object (24.6%), assault with a sharp object (22.9%), and suicide (18.2%). The mean ISS was 22.9 ± 7.8 standard deviation. Tragically, 29 patients (17.1%) died. There were no differences between urban and rural pediatric trauma in terms of age, gender, cause of injury, ISS, survival, length of stay, pediatric intensive care unit length of stay, number of operations needed, or alcohol.
An important pattern of intentional injuries can be seen where preventative efforts can be strengthened regardless of urban or rural area: the very young as shaken baby cases and the teens, who unfortunately, accounted for the majority of suicidal attempts.
根据我们之前的研究，1996 年至 2006 年期间，艾伯塔省的儿科患者（ISS≥12）中，城市地区的意外伤害发生率（15.2%）高于农村地区（5.5%）。我们希望了解城乡儿科意外伤害之间的差异，以便制定预防和支持策略。
从艾伯塔创伤登记处提取了 ISS≥12 的儿科患者（0-17 岁）的数据，这些患者于 1996 年至 2010 年在斯特罗利儿童医院接受治疗。使用 t 检验和 χ2 检验比较了城乡两组之间的差异，p 值<0.05 认为具有统计学意义。
共有 170 名儿童遭受了故意伤害（城市地区占 58.3%，农村地区占 41.8%，无显著差异），其中男性占多数（72.4%）。两组占比较大：所有伤害中，非常年幼的（<1 岁）占 17.1%，青少年（≥15 岁）占 54.1%。故意伤害的原因是儿童虐待（31.2%）、钝器攻击（24.6%）、锐器攻击（22.9%）和自杀（18.2%）。平均 ISS 为 22.9±7.8 标准差。可悲的是，29 名患者（17.1%）死亡。城乡儿科创伤在年龄、性别、损伤原因、ISS、存活率、住院时间、儿科重症监护病房住院时间、所需手术次数或酒精方面无差异。
可以看出，有一个重要的意外伤害模式，无论城乡地区，都可以加强预防措施：非常年幼的婴儿可能是被摇晃致死，青少年不幸成为自杀未遂的主要人群。
