Chan B S, Walker P J, Cass D T
Paediatric Surgical Unit, Westmead Hospital, Sydney, Australia.
J Trauma. 1989 Nov;29(11):1540-7.
Over a 2-year period 1,116 children admitted to an urban teaching hospital were studied prospectively. The overall group was analysed as to the nature of the injury and a subgroup of seriously injured children was identified and further analysed. All deaths were examined as to their cause and possible preventable as well as salvageable factors. The predictive value of the Trauma Score (T.S.) and Method of Injury (M.O.I.) were evaluated for their prospective prediction of serious injury as determined by the Injury Severity Score and outcome. Most of the children were not seriously injured, with the most common injury being due to a fall (57%) and involving a single injury to the upper limb. With the subgroup of 143 children (13% of the total) who suffered serious injuries, the cranial cavity (90%) was the most common site of injury, occurring most often in pedestrians (31% of the total injured). There were 16 deaths in the series, representing 1.4% of all paediatric trauma admissions and 11% of the admissions who were seriously injured. All deaths were related to motor vehicle accidents and associated with serious head injury. A Trauma Score less than or equal to 12 accurately included all deaths but when correlated with the I.S.S., the Trauma Score had a specificity of 99% and a positive predictive value of 86%; its sensitivity was only 27%. The Method of Injury was associated with an overtriage rate of 300% in relation to the I.S.S.. Of children admitted following pedal cycle accidents only 9% were wearing helmets. Of car occupants injured, 39% were unrestrained.(ABSTRACT TRUNCATED AT 250 WORDS)
在两年时间里，对一家城市教学医院收治的1116名儿童进行了前瞻性研究。对整个群体的损伤性质进行了分析，并确定了一组重伤儿童并进行了进一步分析。对所有死亡病例的死因以及可能可预防和可挽救的因素进行了检查。评估了创伤评分（T.S.）和损伤方式（M.O.I.）对根据损伤严重程度评分和结果确定的重伤的前瞻性预测价值。大多数儿童伤势不严重，最常见的损伤原因是跌倒（57%），且为上肢单一损伤。在143名重伤儿童亚组（占总数的13%）中，颅腔（90%）是最常见的损伤部位，最常发生在行人身上（占受伤总数的31%）。该系列中有16例死亡，占所有儿科创伤入院病例的1.4%，占重伤入院病例的11%。所有死亡均与机动车事故有关，并伴有严重头部损伤。创伤评分小于或等于12准确涵盖了所有死亡病例，但与损伤严重程度评分相关时，创伤评分的特异性为99%，阳性预测值为86%；其敏感性仅为27%。损伤方式与相对于损伤严重程度评分的300%的过度分诊率相关。在因自行车事故入院的儿童中，只有9%佩戴了头盔。在受伤的汽车乘客中，39%未系安全带。（摘要截断于250字）
