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澳大利亚儿童伤害住院、健康结局和治疗费用的 10 年回顾。

A 10-year review of child injury hospitalisations, health outcomes and treatment costs in Australia.

机构信息

Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.

Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia.

出版信息

Inj Prev. 2018 Oct;24(5):344-350. doi: 10.1136/injuryprev-2017-042451. Epub 2017 Jul 27.

Abstract

BACKGROUND

Childhood injury is a leading cause of hospitalisation, yet there has been no comprehensive examination of child injury and survival over time in Australia. To examine the characteristics, temporal trend and survival for children who were hospitalised as a result of injury in Australia.

METHOD

A retrospective examination of linked hospitalisation and mortality data for injured children aged 16 years or less during 1 July 2001 to 30 June 2012. Negative binomial regression examined change in injury hospitalisation trends. Cox proportional hazard regression examined the association of risk factors on 30-day survival.

RESULTS

There were 6 86 409 injury hospitalisations, with an age-standardised rate of 1489 per 1 00 000 population (95% CI 1485.3 to 1492.4) in Australia. Child injury hospitalisation rates did not change over the 10-year period. For every severely injured child, there are at least 13 children hospitalised with minor or moderate injuries. The total cost of child injury hospitalisations was $A2.1 billion (annually $A212 million). Falls (38.4%) were the most common injury mechanism. Factors associated with a higher risk of 30-day mortality were: child was aged ≤10 years, higher injury severity, head injury, injured in a transport incident or following drowning and submersion or other threats to breathing, during self-harm and usual residence was regional/remote Australia.

CONCLUSIONS

Childhood injury hospitalisation rates have not reduced in 10 years. Children's patterns of injury change with age, and priorities for injury prevention alter according to developmental stages. The development of a national multisectorial childhood injury monitoring and prevention strategy in Australia is long overdue.

摘要

背景

儿童伤害是住院的主要原因,但迄今为止,澳大利亚尚未全面研究儿童伤害及其随时间的变化。本研究旨在分析澳大利亚因伤住院儿童的特征、时间趋势和生存情况。

方法

对 2001 年 7 月 1 日至 2012 年 6 月 30 日期间因伤住院的 16 岁及以下儿童的住院和死亡数据进行回顾性分析。使用负二项回归分析检验伤害住院趋势的变化,使用 Cox 比例风险回归分析检验 30 天生存率与危险因素的相关性。

结果

澳大利亚共有 686409 例儿童伤害住院病例,年龄标准化率为每 10 万人中有 1489 例(95%CI 1485.3 至 1492.4)。10 年来,儿童伤害住院率并未发生变化。每有 1 例严重受伤儿童,就至少有 13 例儿童因轻微或中度受伤住院。儿童伤害住院总费用为 21 亿澳元(每年 2120 万澳元)。跌倒(38.4%)是最常见的伤害机制。30 天死亡率较高的相关因素为:年龄≤10 岁、伤害严重程度较高、头部受伤、在交通或溺水和淹溺及其他威胁呼吸事件中受伤、自残和通常居住在地区/偏远地区。

结论

10 年来,儿童伤害住院率并未降低。儿童的伤害模式随年龄变化而变化,根据发育阶段,伤害预防重点也会发生变化。澳大利亚急需制定国家多部门儿童伤害监测和预防战略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6490/6173825/6ace19366d6a/injuryprev-2017-042451f01.jpg

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