Ogilvie Rebekah, Curtis Kate, Lam Mary, McCloughen Andrea, Foster Kim
Shock Trauma Service at The Canberra Hospital (Ms Ogilvie), The Canberra Hospital, Garran, Australia; Sydney Nursing School (Dr Curtis), University of Sydney, Trauma Service, St George Hospital, Sydney, Australia; Faculty of Health Sciences (Dr Lam), University of Sydney, Sydney, Australia; and Sydney Nursing School (Drs McCloughen and Foster), University of Sydney, Sydney, Australia.
J Trauma Nurs. 2014 Sep-Oct;21(5):218-27. doi: 10.1097/JTN.0000000000000068.
To determine the incidence, characteristics, and factors associated with mortality after major traumatic injury in adolescent and young people in the Australian Capital Territory (ACT). A combined retrospective analysis of the National Coroners Information System and ACT Level 1 Trauma Centre registry data from July 2007 to June 2012 was conducted. Inclusion criteria were age 16 to 24 years, injury occurring within the ACT or surrounding region of responsibility, Injury Severity Score of more than 15, intensive care unit admission, hospital stay of more than 3 days, penetrating injury, or death. There were 714 adolescent and young adults recorded in the TCH trauma registry and National Coroners Information System. Injury rates remained consistent over the 5-year study period. Over half the injuries occurred in the districts surrounding the ACT. The largest subset represented was 18 to 21 years (47.8%). Road trauma was the most prevalent injury mechanism overall (58.4%), reaching statistical significance within the 18- to 21-year subset (39.9%). Other dominant injury mechanisms overall were recreation (15.4%) and violence (15.3%); self-inflicted violence constituted 45.8% within the larger violence group. Variables associated with mortality included those injured within the ACT (odds ratio [OR], 0.4; 95% confidence interval [CI], 0.23-0.76) and the injury categories of severe (OR, 52.27; 95% CI, 24.71-110.58) and critically injured (OR, 770.73; 95% CI, 267.37-2221.73). The largest demographic affected by major trauma in the ACT and surrounds is young people aged 16 to 24 years. The focus of injury prevention may benefit from targeting young people involved in multiple risk behaviors that contribute to road trauma, interpersonal and self-inflicted violence, as well as high-risk recreation activities. Further research examining the complexity and relationship between these risk factors is required, as well as the long-term burden associated with caring for injured patients in this age group.
确定澳大利亚首都直辖区（ACT）青少年和年轻人遭受重大创伤性损伤后的发病率、特征及与死亡率相关的因素。对2007年7月至2012年6月期间国家验尸官信息系统和ACT一级创伤中心登记数据进行了联合回顾性分析。纳入标准为年龄16至24岁、在ACT或其责任周边地区发生的损伤、损伤严重程度评分超过15分、入住重症监护病房、住院时间超过3天、穿透性损伤或死亡。在TCH创伤登记处和国家验尸官信息系统中记录了714名青少年和年轻人。在5年研究期间，损伤发生率保持一致。超过一半的损伤发生在ACT周边地区。最大的年龄组为18至二十一岁（47.8%）。道路创伤是总体上最常见的损伤机制（58.4%），在18至二十一岁年龄组中具有统计学意义（39.9%）。总体上其他主要损伤机制为娱乐活动（15.4%）和暴力行为（15.3%）；在较大的暴力行为组中，自残暴力行为占45.8%。与死亡率相关的变量包括在ACT内受伤者（比值比[OR]为0.4；95%置信区间[CI]为0.23 - 0.76）以及重伤（OR为52.27；95%CI为24.71 - 110.58）和危重伤（OR为770.73；95%CI为267.37 - 2221.73）类别。ACT及其周边地区受重大创伤影响最大的人群是年龄在16至24岁的年轻人。预防损伤的重点可能会受益于针对参与多种导致道路创伤、人际和自残暴力行为以及高风险娱乐活动的风险行为的年轻人。需要进一步研究这些风险因素之间的复杂性和关系，以及照顾该年龄组受伤患者的长期负担。
