Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland; New Children's Hospital, University of Helsinki and Helsinki University Hospital, P.O. Box 347, Helsinki, FI-00029, HUS, Finland.
Division of Anesthesiology, Department of Anesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, P.O. Box 340, Helsinki, FI-00029, HUS, Finland; New Children's Hospital, University of Helsinki and Helsinki University Hospital, P.O. Box 347, Helsinki, FI-00029, HUS, Finland.
J Pediatr Surg. 2021 Apr;56(4):760-767. doi: 10.1016/j.jpedsurg.2020.05.040. Epub 2020 Jun 5.
Identifying pediatric populations at risk for traumas would enable development of emergency medical services and emergency departments for children. Elucidation of the nature of socioeconomic differences in the incidence of pediatric out-of-hospital emergencies is needed to overcome inequities in child health.
We retrieved all ambulance contacts during 17.12.2014-16.12.2018 involving children (0-15 years) in Helsinki, Finland and separated traumatic and nontraumatic emergencies. We compared the incidences of these emergencies in the pediatric population with socioeconomic markers of the scene of the emergency and of the residential area of the child.
Of 11,742 ambulance contacts involving children 4113 (35.0%) were traumatic. Traumatic emergencies occurred more often in neighborhoods with lower median income/household (P=0.043) and were more common in children living in areas with lower median income/inhabitant (P=0.001), higher unemployment (P<0.001), and lower education (P<0.001). The associations were weaker for traumatic than nontraumatic emergencies. Higher proportion of a pediatric population in a residential area (P=0.005) had a protective effect. Exclusion of clinically unnecessary ambulance responses did not change the results.
Traumatic emergencies in children are more common in areas with lower socioeconomic status. The possible protective effect of urban planning merits further studies.
Prognostic.
II.
识别易发生创伤的儿科人群，将有助于为儿童开发急诊医疗服务和急诊部门。为了克服儿童健康方面的不平等，需要阐明社会经济差异对儿科院外急救发生率的影响。
我们检索了芬兰赫尔辛基市在 2014 年 12 月 17 日至 2018 年 12 月 16 日期间所有涉及儿童（0-15 岁）的救护车接触情况，并将创伤性和非创伤性急救事件分开。我们比较了这些急救事件在有急救现场和儿童居住地区社会经济标志物的儿科人群中的发生率。
在涉及儿童的 11742 次救护车接触中，有 4113 次（35.0%）是创伤性的。创伤性急救事件在中低收入/家庭中位数较低的社区中更为常见（P=0.043），在中低收入/居民中位数较高的社区中更为常见（P=0.001），失业率较高（P<0.001），教育程度较低（P<0.001）。与非创伤性急救事件相比，创伤性急救事件的相关性较弱。居住地区的儿科人群比例较高（P=0.005）具有保护作用。排除临床不必要的救护车反应并不会改变结果。
儿童创伤性急救事件在社会经济地位较低的地区更为常见。城市规划的可能保护作用值得进一步研究。
预后。
II 级。
