彼得马里茨堡市创伤服务机构处理的儿童创伤的发病率、范围及结果
The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service.
作者信息
Manchev V, Bruce J L, Oosthuizen G V, Laing G L, Clarke D L
机构信息
University of KwaZulu-Natal , South Africa.
出版信息
Ann R Coll Surg Engl. 2015 May;97(4):274-8. doi: 10.1308/003588414X14055925061595.
INTRODUCTION
The Pietermaritzburg Metropolitan Trauma Service (PMTS) has run a systematic quality improvement programme since 2006. A key component included the development and implementation of an effective surveillance system in the form of an electronic surgical registry (ESR). This study used data from the ESR to review the incidence, spectrum and outcome of paediatric trauma in Pietermaritzburg, South Africa.
METHODS
The ESR was reviewed, and all cases of paediatric trauma managed between 1 January 2012 and 30 July 2014 were retrieved for analysis.
RESULTS
During the study period, 1,041 paediatric trauma patients (724 male, 69.5%) were managed by the PMTS, averaging a monthly admission of 36. The mean age was 10.9 years (standard deviation: 5.4 years). The mechanism of injury (MOI) was blunt trauma in 753 patients (72.3%) and penetrating trauma in 170 (16.3%). Pedestrian vehicle collisions accounted for 21% of cases and motor vehicle collisions for a further 11%. Intentional trauma accounted for 282 patients (27.1%) and self-inflicted trauma for 14 cases (1.3%). Ninety patients admitted to the intensive care unit and fifty-one required high dependency unit admission. There were 17 deaths, equating to an in-hospital mortality rate of 1.7%. A total of 172 children died on the scene of an incident. There were 35 road traffic related deaths, 26 suicides by hanging, 27 deaths from blunt assault and 23 deaths from penetrating assault. The overall mortality rate for paediatric trauma was 18.2%.
CONCLUSIONS
The ESR has proved to be an effective surveillance system and has enabled the accurate quantification of the burden of paediatric trauma in Pietermaritzburg. This has improved our understanding of the mechanisms and patterns of injury, and has identified a high incidence of intentional and penetrating trauma as well as road traffic collisions. These data can be used to guide strategies to reduce the burden of paediatric trauma in our environment.
引言
自2006年以来，彼得马里茨堡市创伤服务中心（PMTS）开展了一项系统性质量改进计划。一个关键组成部分包括开发并实施一个以电子手术登记册（ESR）形式存在的有效监测系统。本研究使用ESR中的数据来回顾南非彼得马里茨堡小儿创伤的发病率、范围和结局。
方法
对ESR进行回顾，并检索2012年1月1日至2014年7月30日期间接受治疗的所有小儿创伤病例进行分析。
结果
在研究期间，PMTS共治疗了1041例小儿创伤患者（724例男性，占69.5%），平均每月收治36例。平均年龄为10.9岁（标准差：5.4岁）。损伤机制（MOI）为钝性创伤的患者有753例（72.3%），穿透性创伤的有170例（16.3%）。行人与车辆碰撞占病例的21%，机动车碰撞占另外的11%。故意创伤患者有282例（27.1%），自伤创伤患者有14例（1.3%）。90例患者入住重症监护病房，51例需要入住高依赖病房。有17例死亡，住院死亡率为1.7%。共有172名儿童在事故现场死亡。其中有35例与道路交通相关的死亡，26例上吊自杀死亡，27例钝器袭击死亡，23例穿透性袭击死亡。小儿创伤的总体死亡率为18.2%。
结论
ESR已被证明是一个有效的监测系统，能够准确量化彼得马里茨堡小儿创伤的负担。这增进了我们对损伤机制和模式的理解，并确定了故意创伤、穿透性创伤以及道路交通碰撞的高发病率。这些数据可用于指导减轻我们环境中小儿创伤负担的策略。
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