Centre for Paediatric Epidemiology and Biostatistics, University College London Institute of Child Health, London, United Kingdom.
PLoS One. 2013 Jul 10;8(7):e68323. doi: 10.1371/journal.pone.0068323. Print 2013.
Injuries are an increasingly important cause of death in children worldwide, yet injury mortality is highly preventable. Determining patterns and trends in child injury mortality can identify groups at particularly high risk. We compare trends in child deaths due to injury in four UK countries, between 1980 and 2010.
We obtained information from death certificates on all deaths occurring between 1980 and 2010 in children aged 28 days to 18 years and resident in England, Scotland, Wales or Northern Ireland. Injury deaths were defined by an external cause code recorded as the underlying cause of death. Injury mortality rates were analysed by type of injury, country of residence, age group, sex and time period.
Child mortality due to injury has declined in all countries of the UK. England consistently experienced the lowest mortality rate throughout the study period. For children aged 10 to 18 years, differences between countries in mortality rates increased during the study period. Inter-country differences were largest for boys aged 10 to 18 years with mortality rate ratios of 1.38 (95% confidence interval 1.16, 1.64) for Wales, 1.68 (1.48, 1.91) for Scotland and 1.81 (1.50, 2.18) for Northern Ireland compared with England (the baseline) in 2006-10. The decline in mortality due to injury was accounted for by a decline in unintentional injuries. For older children, no declines were observed for deaths caused by self-harm, by assault or from undetermined intent in any UK country.
Whilst child deaths from injury have declined in all four UK countries, substantial differences in mortality rates remain between countries, particularly for older boys. This group stands to gain most from policy interventions to reduce deaths from injury in children.
在全球范围内，伤害是儿童死亡的一个日益重要的原因，但伤害死亡率是高度可预防的。确定儿童伤害死亡率的模式和趋势可以确定特别高风险的群体。我们比较了 1980 年至 2010 年期间，四个英国国家儿童因伤害导致的死亡趋势。
我们从死亡证明中获取了所有在 1980 年至 2010 年期间居住在英格兰、苏格兰、威尔士或北爱尔兰的 28 天至 18 岁的儿童死亡信息。伤害死亡由记录为根本死因的外部原因代码定义。通过受伤类型、居住国家、年龄组、性别和时间段分析伤害死亡率。
所有英国国家的儿童因伤害导致的死亡率都有所下降。英格兰在整个研究期间始终保持最低死亡率。对于 10 至 18 岁的儿童，研究期间各国之间的死亡率差异有所增加。国家间差异最大的是 10 至 18 岁的男孩，2006-10 年威尔士的死亡率比值为 1.38（95%置信区间 1.16，1.64），苏格兰为 1.68（1.48，1.91），北爱尔兰为 1.81（1.50，2.18），与英格兰（基线）相比。伤害死亡率的下降归因于非故意伤害的下降。对于年龄较大的儿童，在任何英国国家，自杀、攻击或意图不明导致的死亡都没有观察到下降。
尽管所有四个英国国家的儿童因伤害导致的死亡人数都有所下降，但各国之间的死亡率仍存在很大差异，尤其是对于年龄较大的男孩。这一群体最有可能从减少儿童伤害死亡的政策干预中获益。
