Te Roopū Rakahau Hauora Māori o Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
Te Roopū Rakahau Hauora Māori o Kāi Tahu (Ngāi Tahu Māori Health Research Unit), Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
Injury. 2021 Sep;52(9):2630-2637. doi: 10.1016/j.injury.2021.05.014. Epub 2021 May 16.
This paper identifies predictors of subsequent injury (SI) in a cohort of injured Māori. Interventions to reduce SI among indigenous populations would help overcome the disproportionate burden of subsequent injury experienced, thereby reducing inequities in injury outcomes and the overall burden of injury.
Interview data from the Prospective Outcomes of Injury Study (POIS) were combined with Accident Compensation Corporation (ACC; New Zealand's universal no-fault injury insurer) and hospital discharge datasets. Any injury event resulting in an ACC claim and occurring within 24 months of the injury for which participants were recruited to POIS was considered an SI. This was regardless of whether it was the same type, region or cause as the original injury or not. Predictors of SI were identified using modified Poisson regression.
Of 566 participants, 62% (n=349) experienced ≥1 SI in the 24 months following their sentinel injury. Māori whose sentinel injury was an intracranial injury were more likely to sustain an SI compared to those whose sentinel injury was another type. SI was less likely to occur for participants whose sentinel injury was a lower extremity fracture or classified as "Other" (e.g. crush, burn, poisoning). SI were more common among those aged 18-29 years compared to those aged 30-49 years, and less common among those living with family compared to those who were living alone.
More research into the circumstances of intracranial injury and SI among Māori is warranted. This would help inform the nature of interventions to prevent SI and the points at which these should be implemented.
本研究旨在确定毛利族裔受伤患者发生后续损伤（SI）的预测因素。针对原住民人群实施的干预措施将有助于减少后续损伤的发生，从而减少因受伤而导致的不公平结果和整体受伤负担。
将 Prospective Outcomes of Injury Study（POIS）的访谈数据与 Accident Compensation Corporation（ACC；新西兰的全民无过错伤害保险公司）和医院出院数据集相结合。任何因 ACC 索赔而导致的伤害事件，且发生在 POIS 招募参与者的伤害后 24 个月内，均被视为 SI。无论其与原始损伤的类型、部位或原因是否相同。使用修正泊松回归来确定 SI 的预测因素。
在 566 名参与者中，62%（n=349）在其哨兵损伤后的 24 个月内发生了≥1 次 SI。与哨兵损伤为其他类型的患者相比，哨兵损伤为颅内损伤的患者更有可能发生 SI。与哨兵损伤为下肢骨折或归类为“其他”（例如，挤压伤、烧伤、中毒）的患者相比，发生 SI 的可能性较小。与 30-49 岁的患者相比，18-29 岁的患者发生 SI 的可能性更高，与独居者相比，与家人同住的患者发生 SI 的可能性更低。
需要对毛利族裔颅内损伤和 SI 的情况进行更多研究。这将有助于确定预防 SI 的干预措施的性质以及应在何时实施这些措施。
