McDermott Kathleen M, Brearley Matt B, Hudson Steven M, Ward Linda, Read David J
National Critical Care and Trauma Response Centre, Level 8 Royal Darwin Hospital Rocklands Drive, Tiwi, NT 0810, Australia.
Gisbourne Hospital, Gisbourne, New Zealand.
Inj Epidemiol. 2017 Dec;4(1):15. doi: 10.1186/s40621-017-0111-1. Epub 2017 May 15.
While factors including remoteness, alcohol consumption, age and Indigenous ethnicity are well-documented associations of trauma mortality, less is known of trauma seasonality. This is particularly relevant to Australia's Northern Territory, with its tropical regions experiencing a climate of wet (hot and humid) and dry (warm) seasons annually. The aim of this study was to therefore, examine the characteristics of trauma mortality in the Top End, Northern Territory, Australia.
A retrospective review of the National Coroners Information System (NCIS) database from 1 January 2003 to 31 December 2007 analysed four-hundred and sixteen traumatic deaths where the trauma event and death occurred within the Top End of the Northern Territory.
The annual traumatic death rate for the Top End was 58.7 per 100 000, with variance between regions (accessible 38.1; remote 119.1 per 100000, respectively). Overall alcohol was involved in 56.5% of cases. The three most frequent mechanisms of death were suicide, transport related and assault, accounting for 81.5% of deaths. These respective mechanisms of death demonstrated seasonal influence, with transport related deaths 2.5 times more likely to occur in the dry than the wet season (p < 0.001), while assault related deaths were 3.3 times more likely to occur during the wet season (p = 0.005), and suicide was 1.6 times more likely to occur during the wet season (p = 0.022). Transport related deaths were 2.2 times more likely in remote and very remote settings than in accessible or moderately accessible regions (p < 0.003), whereas death by suicide was less likely to occur in remote and very remote regions than in accessible or moderately accessible areas (p = 0.012).
Excessively high rates of traumatic death in the Top End of the Northern Territory were evident, with contrasting seasonal and regional profiles. Based upon the data of this investigation, existing programmes to minimise trauma in the Northern Territory ought to be evaluated for seasonal and regional specificity.
虽然包括地处偏远、饮酒、年龄和原住民种族等因素与创伤死亡率之间的关联已有充分记录,但关于创伤的季节性情况却鲜为人知。这一点在澳大利亚北领地尤为相关,其热带地区每年经历湿季(炎热潮湿)和干季(温暖)。因此,本研究的目的是调查澳大利亚北领地顶端地区创伤死亡率的特征。
对2003年1月1日至2007年12月31日国家验尸官信息系统(NCIS)数据库进行回顾性分析,研究北领地顶端地区发生创伤事件并导致死亡的416例创伤性死亡案例。
顶端地区的年创伤死亡率为每10万人58.7例,各地区之间存在差异(交通便利地区为每10万人38.1例;偏远地区为每10万人119.1例)。总体而言,56.5%的案例涉及酒精。三种最常见的死亡原因是自杀、交通相关事故和袭击,占死亡总数的81.5%。这些各自的死亡原因显示出季节性影响,交通相关死亡在干季发生的可能性是湿季的2.5倍(p<0.001),而袭击相关死亡在湿季发生的可能性是干季的3.3倍(p=0.005),自杀在湿季发生的可能性是干季的1.6倍(p=0.022)。交通相关死亡在偏远和非常偏远地区发生的可能性是交通便利或中等便利地区的2.2倍(p<0.003),而自杀死亡在偏远和非常偏远地区发生的可能性低于交通便利或中等便利地区(p=0.012)。
北领地顶端地区创伤死亡率过高的情况明显,存在不同的季节性和地区性特征。基于本调查的数据,应评估北领地现有的将创伤降至最低的方案,以确定其季节性和地区特异性。