Dykes E H, Spence L J, Young J G, Bohn D J, Filler R M, Wesson D E
Department of Surgery, Hospital for Sick Children, Toronto, Ontario, Canada.
J Pediatr Surg. 1989 Jan;24(1):107-10; discussion 110-1. doi: 10.1016/s0022-3468(89)80312-4.
All pediatric trauma deaths occurring in metropolitan Toronto (population, 2.2 million) in 1986 were analyzed from the regional coroner's records. Injuries sustained were scored using the Abbreviated Injury Scale (1985; AIS) and Injury Severity Score (ISS). Victims with injuries graded AIS 6 (any region), AIS 5 head/neck (excluding acute epidural hematoma), or ISS greater than 59 were deemed unsalvageable. All other injuries were considered survivable and the deaths from them preventable. Use of these objective criteria indicated that 8/38 of the children (21%) who died from trauma had survivable injuries. Since in three cases medical aid was not sought because of social circumstances, 5/38 (13%) was considered a realistic estimate of preventable death rate (PDR). These results suggest that when objective criteria are used, the PDR in pediatric trauma may be less than that reported in adult trauma victims. Defining the PDR on the basis of objective criteria may prove useful in the conduct of further studies of this kind and permit valid comparisons to be made.
对1986年发生在大多伦多地区（人口220万）的所有儿科创伤死亡病例进行了分析，数据来源于地区验尸官记录。使用简略损伤量表（1985年版；AIS）和损伤严重度评分（ISS）对所受损伤进行评分。损伤分级为AIS 6级（任何部位）、AIS 5级（头部/颈部，不包括急性硬膜外血肿）或ISS大于59分的受害者被视为无法挽救。所有其他损伤被认为可存活，由此导致的死亡可预防。使用这些客观标准表明，38名因创伤死亡的儿童中有8名（21%）所受损伤可存活。由于有3例因社会情况未寻求医疗救助，5/38（13%）被认为是可预防死亡率（PDR）的实际估计值。这些结果表明，使用客观标准时，儿科创伤的PDR可能低于成年创伤受害者报告的PDR。基于客观标准定义PDR可能对开展此类进一步研究有用，并允许进行有效的比较。
