Abdalla Adil, Gunst Mark, Ghaemmaghami Vafa, Gruszecki Amy C, Urban Jill, Barber Robert C, Gentilello Larry M, Shafi Shahid
Department of Surgery (Abdalla, Gunst, Ghaemmaghami, Barber, Gentilello, Shafi) and the Department of Pathology (Gruszecki, Urban), The University of Texas Southwestern Medical School, Dallas, TX; and the Institute for Health Care Research and Improvement, Baylor Health Care System, Dallas, TX (Shafi).
Proc (Bayl Univ Med Cent). 2012 Jul;25(3):208-13. doi: 10.1080/08998280.2012.11928829.
This study applied a geographic information system (GIS) to identify clusters of injury-related deaths (IRDs) within a large urban county (26 cities; population, 2.4 million). All deaths due to injuries in Dallas County (Texas) in 2005 (N = 670) were studied, including the geographic location of the injury event. Out of 26 cities in Dallas County, IRDs were reported in 19 cities. Geospatial data were obtained from the local governments and entered into the GIS. Standardized mortality ratios (SMR, with 95% CI) were calculated for each city and the county using national age-adjusted rates. Dallas County had significantly more deaths due to homicides (SMR, 1.76; 95% CI, 1.54-1.98) and IRDs as a result of gunshots (SMR, 1.23; 95% CI, 1.09-1.37) than the US national rate. However, this increase was restricted to a single city (the city of Dallas) within the county, while the rest of the 25 cities in the county experienced IRD rates that were either similar to or better than the national rate, or experienced no IRDs. GIS mapping was able to depict high-risk geographic "hot spots" for IRDs. In conclusion, GIS spatial analysis identified geographic clusters of IRDs, which were restricted to only one of 26 cities in the county.
本研究应用地理信息系统（GIS）来识别一个大型城市县（26个城市；人口240万）内与伤害相关的死亡（IRD）集群。对2005年达拉斯县（得克萨斯州）所有因伤死亡病例（N = 670）进行了研究，包括伤害事件的地理位置。在达拉斯县的26个城市中，有19个城市报告了IRD。地理空间数据从当地政府获取并输入到GIS中。使用全国年龄调整率计算每个城市和县的标准化死亡率（SMR，95%置信区间）。达拉斯县因凶杀案导致的死亡（SMR，1.76；95%置信区间，1.54 - 1.98）以及因枪击导致的IRD（SMR，1.23；95%置信区间，1.09 - 1.37）显著高于美国全国水平。然而，这种增加仅限于该县内的一个城市（达拉斯市），而该县其他25个城市的IRD发生率要么与全国水平相似或优于全国水平，要么没有IRD发生。GIS绘图能够描绘出IRD的高风险地理“热点”。总之，GIS空间分析识别出了IRD的地理集群，这些集群仅局限于该县26个城市中的一个。
