Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
Information Services Division, NHS National Services Scotland, Edinburgh, United Kingdom.
PLoS One. 2019 Jan 17;14(1):e0210427. doi: 10.1371/journal.pone.0210427. eCollection 2019.
There is mounting evidence that associates brain injury and offending behaviour, and there is a need to understand the epidemiology of head injury in prisoners in order to plan interventions to reduce associated disability and risk of reoffending. This is the first study to determine the lifetime prevalence of hospitalised head injury (HHI) in a national population of current prison inmates. In addition characteristics of prisoners with HHI and were compared to prisoners without HHI to discover whether those with HI differed demographically.
Whole life hospital records of everyone aged 35 years or younger and resident in a prison in Scotland on a census date in 2015 were electronically linked via their unique NHS identifier and checked for ICD-9 and 10 codes for head injury. Using a case-control design, these data were compared with a sample from the general population matched 3:1 for age, gender and area-based social deprivation. Comparison of demographic variables was made between prisoners with and without HHI.
HHI was found in 24.7% (1,080/4,374) of prisoners and was significantly more prevalent than found in the matched general population sample (18.2%; 2394/13122; OR 2.10; 95%CI 1.87, 2.16). The prevalence of HHI in prisoners and controls was similar with the exception of a higher risk of HHI in prisoners in lower deprivation quintiles. Having three or more HHI was more common in prisoners (OR 3.04; 95%CI 2.33, 3.97) as were HHI with ICD codes for intracranial injuries (OR 1.81; 95% CI 1.54, 2.11), suggesting that more severe HHI is more prevalent in prisoners than the general population. The distributions within demographic variables and the characteristics of HHI admissions in prisoners with and without a history of HHI were similar.
Prisoners in Scotland aged 35 years or younger have a higher lifetime prevalence of HHI than the general population and are more likely to have had repeated HI or intracranial injuries. Further work is required to elucidate the correspondence between self-report of HI and hospitalised records and to ascertain persisting effects of HI in prisoners and the need for services to reduce associated disability and risk of reoffending.
越来越多的证据表明脑损伤与犯罪行为有关，因此需要了解囚犯头部受伤的流行病学情况，以便计划干预措施，减少相关残疾和再犯罪风险。这是第一项旨在确定全国范围内当前囚犯一生中头部受伤（HHI）住院率的研究。此外，还比较了有 HHI 和没有 HHI 的囚犯的特征，以发现 HHI 组的囚犯在人口统计学上是否存在差异。
通过他们独特的国民保健系统标识符，对 2015 年普查日居住在苏格兰监狱的所有 35 岁及以下人群的终身医院记录进行电子链接，并检查 ICD-9 和 10 头部受伤代码。采用病例对照设计，将这些数据与年龄、性别和基于区域的社会贫困程度相匹配的一般人群样本进行比较。比较了有和没有 HHI 的囚犯的人口统计学变量。
在 4374 名囚犯中发现 HHI 占 24.7%（1080 人），明显高于与年龄、性别和基于区域的社会贫困程度相匹配的一般人群样本中的发现率（18.2%；2394 人）（比值比 2.10；95%可信区间 1.87，2.16）。除了贫困程度较低的五分位数囚犯的 HHI 风险更高外，囚犯和对照组的 HHI 患病率相似。HHI 有 3 次或以上的囚犯（比值比 3.04；95%可信区间 2.33，3.97）和有颅内损伤 ICD 代码的 HHI 更常见（比值比 1.81；95%可信区间 1.54，2.11），这表明囚犯中更严重的 HHI 比一般人群更为常见。在人口统计学变量的分布以及有和没有 HHI 病史的囚犯的 HHI 入院特征方面，两组情况相似。
苏格兰 35 岁及以下的囚犯一生中 HHI 的发生率高于一般人群，且更有可能多次发生 HHI 或颅内损伤。需要进一步的工作来阐明自我报告的 HHI 与住院记录之间的一致性，并确定 HHI 对囚犯的持续影响以及减少相关残疾和再犯罪风险的服务需求。
