Randall Sean M, Wood Fiona M, Boyd James H, Duke Janine M
Centre for Data Linkage, Curtin University, Perth, Western Australia, Australia.
Burn Injury Research Unit, School of Surgery, University of Western Australia, Perth, Western Australia, Australia; Burns Service of Western Australia, Fiona Stanley Hospital and Princess Margaret Hospital, Perth, Western Australia, Australia.
Burns. 2017 Nov;43(7):1575-1585. doi: 10.1016/j.burns.2017.04.002. Epub 2017 May 20.
To investigate the geographic distribution and temporal trends of burn admissions in an Australian setting.
Health administrative data of all persons hospitalised for a first burn in Western Australia for the period 2000-2012 were used. Crude and standardised incident rates were generated for each region. Maps of crude rates were generated for state regions and postcode-suburbs of Perth, the capital city. Standardised incidence rates were generated for Western Australia, total and regions, and for sub-cohorts defined by age (<20years; ≥20 years), TBSA burn severity and major causes of burns (fire, scalds and contact). Negative binomial regression was used to examine temporal changes and generate incidence rate ratios (IRR) with 95% confidence intervals (CI).
Perth had the lowest burn admission rate per population; clusters of suburbs of lower social advantage and higher immigrant settlement were identified as being at high risk. While the highest observed admission rates were found in Kimberley and Goldfields (remote) regions, after adjustment for the regional demographic structures, the Wheatbelt and Mid-West (rural) regions were found to have the highest adjusted rates of burn admissions. Significant annual declines in admission rates were found for the Kimberley, Pilbara and Goldfields (remote regions); however, stable admission rates were identified for all other regions.
The Mid-West and Wheatbelt rural regions were found to have the highest risk of burn admissions raising concerns about farming-related injury. Safety awareness and burn prevention strategies need to be continued, with specific attention to these high risk areas, to reduce burn admissions in Western Australia.
调查澳大利亚烧伤住院病例的地理分布及时间趋势。
使用西澳大利亚州2000 - 2012年期间因首次烧伤住院的所有人的卫生行政数据。计算每个地区的粗发病率和标准化发病率。绘制该州各地区以及首府珀斯邮政编码区域的粗发病率地图。计算西澳大利亚州整体及各地区、按年龄(<20岁;≥20岁)、烧伤总面积严重程度和主要烧伤原因(火灾、烫伤和接触)定义的亚组人群的标准化发病率。采用负二项回归分析时间变化,并生成发病率比(IRR)及95%置信区间(CI)。
珀斯的人均烧伤住院率最低;社会优势较低且移民聚居的郊区被确定为高风险区域。虽然在金伯利和戈尔菲尔德(偏远)地区观察到最高的住院率,但在调整区域人口结构后,发现小麦带和中西部(农村)地区的调整后烧伤住院率最高。金伯利、皮尔巴拉和戈尔菲尔德(偏远地区)的住院率出现显著年度下降;然而,其他所有地区的住院率保持稳定。
发现中西部和小麦带农村地区烧伤住院风险最高,这引发了对与农业相关伤害的担忧。需要继续开展安全意识和烧伤预防策略,尤其关注这些高风险地区,以降低西澳大利亚州的烧伤住院率。