King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, KAIMRC, KSAU-HS, Riyadh, Saudi Arabia.
Center for Outcomes Research in Surgery, 702 Rotary Circle, Rm 022A, Indianapolis, IN 46202, USA.
Public Health. 2019 Mar;168:76-82. doi: 10.1016/j.puhe.2018.12.012. Epub 2019 Jan 29.
The objective of this study was to examine the association between childhood injury and health outcomes among survivors and their mothers using a national survey in the United States (US).
This was a longitudinal analysis of a nationally representative sample.
Secondary analysis of the 1997-2013 Medical Expenditure Panel Survey (MEPS) was performed. Children (aged 2-18 years) with or without injuries were followed up for two years. Injuries captured in the study were those associated with at least one hospitalization, emergency department visit, or office-based visit. Outcome measures were child and maternal general and mental health status. Multiple mixed-logistic regressions were used with suboptimal health defined as the response of poor or fair health versus good, very good, or excellent health.
Of the 63,422 children analyzed, 3251 (4.9%) were injured, representing 3.6 million US children. Injured children were more likely to be male, white, and older than those without injuries (P < 0.01). About a fifth of injured children suffered head injuries. Injuries were strongly associated with suboptimal general and mental health status in children (adjusted odds ratios [AORs], 1.35 and 1.36, respectively, P < 0.05). Mothers of children with injuries were also more likely to report suboptimal mental health (AOR, 1.30, P < 0.05).
Injuries among children are associated with lasting adverse effects in general and mental health. To improve health outcomes of pediatric injuries, further follow-up care may be needed to ensure that they return to pre-injury health levels. These results highlight the importance of primary prevention and the long-term impact of injuries on the health of children and their mothers.
本研究旨在通过美国全国性调查,探讨儿童期损伤与幸存者及其母亲健康结局之间的关系。
这是一项全国代表性样本的纵向分析。
对 1997-2013 年医疗支出面板调查(MEPS)进行二次分析。有或无损伤的儿童随访两年。研究中捕获的损伤是那些与至少一次住院、急诊或门诊就诊相关的损伤。结局指标为儿童和母亲的一般和心理健康状况。采用多混合逻辑回归,亚最佳健康定义为较差或一般健康与良好、非常好或极好健康的反应。
在分析的 63422 名儿童中,有 3251 名(4.9%)受伤,代表 360 万美国儿童。受伤儿童更可能是男性、白人且年龄大于无损伤儿童(P<0.01)。约五分之一的受伤儿童患有头部损伤。损伤与儿童亚最佳一般和心理健康状况密切相关(调整后优势比[OR]分别为 1.35 和 1.36,P<0.05)。受伤儿童的母亲也更有可能报告亚最佳心理健康(OR,1.30,P<0.05)。
儿童损伤与一般和心理健康的持久不良后果相关。为改善儿科损伤的健康结局,可能需要进一步的随访护理,以确保其恢复到损伤前的健康水平。这些结果强调了初级预防的重要性以及损伤对儿童及其母亲健康的长期影响。