Department of Surgery, Alameda County Medical Center, University of California San Francisco - East Bay, Oakland, California, USA.
J Trauma Acute Care Surg. 2012 Sep;73(3):721-5. doi: 10.1097/TA.0b013e318265cdce.
Pediatric penetrating injuries plague inner cities. Based on our clinical observations, we hypothesized that pediatric penetrating trauma (PPT) is increasing with the major increase occurring in communities with lower socioeconomic status.
We retrospectively reviewed the trauma databases between 2000 and 2009 of the three major trauma centers in Alameda and San Francisco counties. Patients with PPT aged 16 years or younger were included. Demographics, Injury Severity Score, probability of survival, and length of hospital stay were collected. Median family incomes (MFI) were obtained from US Census data.
We identified 598 patients with PPT: 432 gunshot wounds (GSWs), 141 stabbings, and 25 other. The rate of PPT increased by 138% from 2000 to 2009 (p = 0.003). The mean (SEM) age of the patients was 13.8 (0.1) years, which did not change during the study period (p = 0.12). The incidence of single GSW to the head increased from 3% to 7% (p = 0.01) and carried a 63% mortality rate. Blacks and Hispanics sustained 82.5% of PPT. The MFI of PPT victims was $39,209. PPT was more prevalent in zip codes with an MFI below the Bay Area MFI of $68,954, (mean [SEM], 8.0 [1.5] victims per zip code below MFI vs. 1.9 [0.3] victims per zip code above MFI; p = < 0.001).
PPT in the Bay Area increased during the last decade, and the increased PPT was associated with lower MFIs. Black and Hispanic children experienced the greatest proportion of penetrating injuries and had the lowest MFIs. The prevalence of single GSW to the head is increasing, which may suggest a deliberate attempt to fatally injure these children.
Prognostic study, level II.
儿科穿透性损伤困扰着内城区。根据我们的临床观察，我们假设儿科穿透性创伤（PPT）随着社会经济地位较低的社区的主要增加而增加。
我们回顾性地审查了 2000 年至 2009 年在阿拉米达和旧金山县的三个主要创伤中心的创伤数据库。纳入年龄在 16 岁以下的 PPT 患者。收集人口统计学、伤害严重程度评分、生存概率和住院时间。中位数家庭收入（MFI）取自美国人口普查数据。
我们确定了 598 名 PPT 患者：432 例枪伤（GSW），141 例刺伤，25 例其他伤。从 2000 年到 2009 年，PPT 的发生率增加了 138%（p = 0.003）。患者的平均（SEM）年龄为 13.8（0.1）岁，在研究期间没有变化（p = 0.12）。头部单一 GSW 的发生率从 3%增加到 7%（p = 0.01），死亡率为 63%。黑人和西班牙裔人遭受了 82.5%的 PPT。PPT 受害者的 MFI 为 39209 美元。PPT 在 MFI 低于海湾地区 68954 美元的邮政编码中更为普遍（平均值[SEM]，MFI 以下每个邮政编码有 8.0[1.5]名受害者，MFI 以上每个邮政编码有 1.9[0.3]名受害者；p < 0.001）。
在过去十年中，海湾地区的 PPT 有所增加，而增加的 PPT 与较低的 MFI 有关。黑人和西班牙裔儿童遭受的穿透性伤害比例最大，MFI 最低。单一头部 GSW 的患病率正在增加，这可能表明有人故意试图重伤这些儿童。
预后研究，II 级。
