Chong Shu-Ling, Tyebally Arif, Chew Su Yah, Lim Yang Chern, Feng Xun Yi, Chin Sock Teng, Lee Lois K
Department of Emergency Medicine, KK Women's and Children's Hospital, Duke-NUS Medical School, Singapore.
Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
Accid Anal Prev. 2017 Mar;100:59-64. doi: 10.1016/j.aap.2017.01.005. Epub 2017 Jan 19.
Pediatric road traffic injuries remain a significant cause of death and disability in many countries in Asia, despite the implementation of road traffic safety laws. We aim to describe the injuries, the use of restraints among road users, and risk factors associated with severe injuries for children in Singapore.
We performed a retrospective chart review of road traffic injuries presenting to the only two pediatric tertiary care hospitals in Singapore, from January 2012 to April 2016. We included children <16years old presenting to the emergency departments within 24h after injury (pedestrian, bicycle, motorcycle, motor vehicle). We calculated the frequencies for specific injury mechanisms, injury severity scores (ISS), and in-hospital outcomes of severe injuries (death, urgent resuscitation and emergent surgery). We performed a multivariate logistic regression to determine risk factors associated with severe injury.
There were 2468 patients during the study period. The mean age was 7.9 years (SD 4.7); 60.1% of road injuries involved motor vehicle occupants (1483/2468). Most bicyclist/motorcyclists were not wearing helmets (70.0%, 245/350) and 51.1% of motor vehicle passengers (758/1483) were not restrained. Compared to motor vehicle passengers, pedestrians (adjusted OR 2.38, 95% CI 1.41-3.99), bicyclists (adjusted OR 2.12, 95% CI 1.04-4.32) and motorcyclists (adjusted OR 6.09, 95% CI 2.04-18.24) were more likely to sustain severe injuries.
Child pedestrians, bicyclists and motorcyclists are especially vulnerable for severe injures. Further injury prevention efforts must focus on the enforcement of legislation to protect these high-risk groups.
尽管实施了道路交通安全法律，但在亚洲许多国家，儿童道路交通伤害仍是导致死亡和残疾的一个重要原因。我们旨在描述新加坡儿童的伤害情况、道路使用者使用约束装置的情况以及与重伤相关的风险因素。
我们对2012年1月至2016年4月期间前往新加坡仅有的两家儿科三级护理医院就诊的道路交通伤害进行了回顾性病历审查。我们纳入了受伤后24小时内前往急诊科的16岁以下儿童（行人、骑自行车者、骑摩托车者、机动车乘客）。我们计算了特定伤害机制的频率、损伤严重程度评分（ISS）以及重伤的院内结局（死亡、紧急复苏和急诊手术）。我们进行了多因素逻辑回归分析以确定与重伤相关的风险因素。
研究期间共有2468例患者。平均年龄为7.9岁（标准差4.7）；60.1%的道路伤害涉及机动车乘客（1483/2468）。大多数骑自行车者/骑摩托车者未戴头盔（70.0%，245/350），51.1%的机动车乘客（758/1483）未使用约束装置。与机动车乘客相比，行人（调整后的比值比2.38，95%置信区间1.41 - 3.99）、骑自行车者（调整后的比值比2.12，95%置信区间1.04 - 4.32）和骑摩托车者（调整后的比值比6.09，95%置信区间2.04 - 18.24）更有可能遭受重伤。
儿童行人、骑自行车者和骑摩托车者尤其容易受到重伤。进一步的伤害预防工作必须集中在加强立法执行以保护这些高危群体。
