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儿童伤害数据库:儿科急诊科伤害监测系统的开发

Children's injury database: development of an injury surveillance system in a pediatric emergency department.

作者信息

McCain Jennifer E, Bridgmon Ashley E, King William D, Monroe Kathy

机构信息

Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, USA.

Health Education and Safety Center, Children's of Alabama, Birmingham, AL, USA.

出版信息

Inj Epidemiol. 2023 Jul 31;10(Suppl 1):40. doi: 10.1186/s40621-023-00443-8.

Abstract

BACKGROUND

Injuries are the leading cause of death in children and are also a leading cause of all emergency department (ED) visits for children. Obtaining epidemiologic data to define the wide range of childhood injuries for individual communities is challenging. The Children's Injury Database (CID) is an injury surveillance system developed to collect data from injury-related visits to our tertiary care pediatric emergency department.

RESULTS

During 2021, a total of 15,168 injury visits were analyzed representing 22% of total ED visits (68,834). A total of 2053 injury visits (13.5%) resulted in hospital admission. The 10 leading injury types included: falls, poisonings, motor vehicle collision (MVC), assault, dog bite, burns, sports, pedestrian, bicycle, and all-terrain vehicle (ATV). Admission rates varied by age group with children ages 13 years and older having the highest rate of admission (18.4%). The median length of stay (LOS) for all injured children requiring admission was 2 days while the median LOS for preschoolers was 1 day, the median LOS for school-age children was 2 days, and the median LOS for teenagers was 3 days. While MVCs were the most common cause of vehicle-related injuries, ATV-related injuries had the highest rate of admission (51%).

CONCLUSIONS

In this study, teenagers had significantly higher admission rates, lengths of stay, and hospital charges. Black and Hispanic children were under-represented in the number of visits for injuries compared to all ED visits. Further research should focus on disparities in injury-related visits based on race as well as gender. CID has demonstrated that injury surveillance systems can assist with reporting new injury patterns while also acting as a stimulus for new research ideas, planning interventions targeting the most at-risk populations, and evaluating the effectiveness of injury prevention interventions.

摘要

背景

伤害是儿童死亡的主要原因,也是儿童前往急诊科就诊的主要原因之一。获取流行病学数据以界定各个社区中儿童伤害的广泛范围具有挑战性。儿童伤害数据库(CID)是一个伤害监测系统,旨在收集我们三级护理儿科急诊科与伤害相关就诊的数据。

结果

2021年期间,共分析了15168次伤害就诊,占急诊就诊总数(68834次)的22%。共有2053次伤害就诊(13.5%)导致住院。十大主要伤害类型包括:跌倒、中毒、机动车碰撞(MVC)、袭击、狗咬伤、烧伤、运动、行人、自行车和全地形车(ATV)伤害。入院率因年龄组而异,13岁及以上儿童的入院率最高(18.4%)。所有需要住院的受伤儿童的中位住院时间(LOS)为2天,而学龄前儿童的中位住院时间为1天,学龄儿童为2天,青少年为3天。虽然机动车碰撞是与车辆相关伤害的最常见原因,但全地形车相关伤害的入院率最高(51%)。

结论

在本研究中,青少年的入院率、住院时间和医院费用显著更高。与所有急诊就诊相比,黑人及西班牙裔儿童在伤害就诊次数中的占比不足。进一步的研究应关注基于种族和性别的伤害相关就诊差异。儿童伤害数据库已证明,伤害监测系统可协助报告新的伤害模式,同时激发新的研究思路、规划针对高危人群的干预措施并评估伤害预防干预措施的有效性。

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