在儿童创伤中，跌倒是否比道路交通事故更常见？来自印度新德里一家一级创伤中心的经验。
Are falls more common than road traffic accidents in pediatric trauma? Experience from a Level 1 trauma centre in New Delhi, India.
作者信息
Babu Annu, Rattan Amulya, Ranjan Piyush, Singhal Maneesh, Gupta Amit, Kumar Subodh, Mishra Biplab, Sagar Sushma
机构信息
JPN Apex Trauma Centre, New Delhi 110029, India.
出版信息
Chin J Traumatol. 2016 Apr 1;19(2):75-8. doi: 10.1016/j.cjtee.2015.10.004.
PURPOSE
The epidemiology of pediatric trauma is different in different parts of the world. Some re- searchers suggest falls as the most common mechanism, whereas others report road traffic accidents (RTAs) as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India.
METHODS
Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21.
RESULTS
We had 300 patients over a 33 month period. Among them, 236 (78.6%) were males and 64 (21.3%) females. Overall the predominant cause was RTAs in 132 (43%) patients. On subgroup analysis of up to 12 years age group (n = 147), the most common cause was found to be RTAs again. However, falls showed an incremental upward trend (36.05% in up to 12 age group versus 27% overall), catching up with RTAs (44.89%). Pediatric Trauma Score (PTS) ranged from 0 to 12 with a mean of 8.12 ± 2.022. 223 (74.33%) patients experienced trauma limited to one anatomic region only, whereas 77 (25.66%) patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days (range 1-182).
CONCLUSION
Pediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs (43%) as compared to falls from height (27%); however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatric trauma and local injury patterns must be taken into account when formulating policies to address this unique challenge.
目的
世界各地儿童创伤的流行病学情况各不相同。一些研究人员认为跌倒为最常见的致伤机制，而另一些则报告道路交通事故（RTA）是最常见的原因。本研究的目的是找出印度新德里创伤外科儿童住院患者的主要病因。
方法
回顾性检索2012年1月至2014年9月在贾伊·普拉卡什·纳拉扬顶级创伤中心创伤登记处的住院患者数据。纳入所有首次就诊时年龄在18岁及以下、入住外科病房/重症监护病房或后来由创伤外科接收转院的患者。数据通过预先设计的表格进行检索。如此收集的信息针对每个变量用唯一的字母数字代码进行编码，并使用SPSS 21版进行统计分析。
结果
在33个月的时间里，我们共纳入300例患者。其中，男性236例（78.6%），女性64例（21.3%）。总体而言，主要病因是道路交通事故，共132例（43%）患者。在对12岁及以下年龄组（n = 147）进行亚组分析时，发现最常见的病因仍是道路交通事故。然而，跌倒呈现出上升趋势（12岁及以下年龄组为36.05%，总体为27%），与道路交通事故（44.89%）接近。儿童创伤评分（PTS）范围为0至12分，平均为8.12 ± 2.022。223例（74.33%）患者的创伤仅局限于一个解剖区域，而77例（25.66%）患者为多发伤。288例患者出院回家护理。总体而言，该队列中有12例患者死亡。中位住院时间为6天（范围1 - 182天）。
结论
儿童创伤日益受到关注，尤其是在发展中国家。创伤外科住院患者的主要病因是道路交通事故（43%），相比之下高处坠落为27%；然而，随着年龄组变小，高处坠落呈上升趋势。仅加强道路安全可能并非预防儿童创伤的持久解决方案，在制定应对这一独特挑战的政策时，必须考虑当地的损伤模式。
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