Morrison Jonathan J, Yapp Liam Z, Beattie Anne, Devlin Eimar, Samarage Milan, McCaffer Craig, Jansen Jan O
Academic Unit of Surgery, Glasgow Royal Infirmary, Glasgow, UK; The Academic Department of Military Surgery & Trauma, Royal Centre for Defence Medicine, Birmingham, UK.
Royal Infirmary of Edinburgh, Edinburgh, UK.
Surgeon. 2016 Feb;14(1):1-6. doi: 10.1016/j.surge.2015.02.001. Epub 2015 Mar 13.
To characterise the temporal trends and urban-rural distribution of fatal injuries in Scotland through the analysis of mortality data collected by the National Records of Scotland.
The prospectively collected NRS database was queried using ICD-10 codes for all Scottish trauma deaths during the period 2000 to 2011. Patients were divided into pre-hospital and in-hospital groups depending on the location of death. Incidence was plotted against time and linear regression was used to identify temporal trends.
A total of 13,100 deaths were analysed. There were 4755 (36.3%) patients in the pre-hospital group with a median age (IQR) of 42 (28-58) years. The predominant cause of pre-hospital death related to vehicular injury (27.8%), which had a decreasing trend over the study period (p = 0.004). In-hospital, patients had a median age of 80 (58-88) years and the majority (67.0%) of deaths occurred following a fall on the level. This trend was shown to increase over the decade of study (p = 0.020). In addition, the incidence of urban incidents remained static, but the rate of rural fatal trauma decreased (p < 0.001).
Around a third of Scottish trauma patients die prior to hospital admission and the predominant mechanism of injury is due to road traffic accidents. This contrasts with in-hospital deaths, which are mainly observed in elderly patients following a fall from standing height. Further research is required to determine the preventability of fatal traumatic injury in Scotland.
通过分析苏格兰国家记录所收集的死亡率数据，描述苏格兰致命伤的时间趋势和城乡分布情况。
使用国际疾病分类第十版（ICD - 10）编码查询2000年至2011年期间前瞻性收集的苏格兰国家记录数据库中所有苏格兰创伤死亡病例。根据死亡地点将患者分为院前和院内两组。将发病率随时间作图，并使用线性回归来确定时间趋势。
共分析了13100例死亡病例。院前组有4755例（36.3%）患者，中位年龄（四分位间距）为42岁（28 - 58岁）。院前死亡的主要原因与车辆伤害有关（27.8%），在研究期间呈下降趋势（p = 0.004）。在院内，患者的中位年龄为80岁（58 - 88岁），大多数（67.0%）死亡发生在平地跌倒之后。这一趋势在研究的十年间呈上升趋势（p = 0.020）。此外，城市事故的发生率保持不变，但农村致命创伤的发生率下降（p < 0.001）。
约三分之一的苏格兰创伤患者在入院前死亡，主要受伤机制是道路交通事故。这与院内死亡情况形成对比，院内死亡主要发生在老年患者从站立高度跌倒之后。需要进一步研究以确定苏格兰致命创伤的可预防性。
