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儿科重症监护室创伤 10 年回顾性研究的流行病学分析。

Epidemiological analysis of a 10-year retrospective study of pediatric trauma in intensive care.

机构信息

Department of Surgical Intensive Care Unit, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333 Binsheng Road, Hangzhou, 310052, Zhejiang, People's Republic of China.

出版信息

Sci Rep. 2024 Sep 10;14(1):21058. doi: 10.1038/s41598-024-72161-0.

Abstract

Pediatric trauma plays a crucial role in pediatric mortality, with traffic injuries and falls frequently cited as leading causes of significant injuries among children. A comprehensive investigation, including geographical factors, is essential for developing effective strategies to prevent injuries and alleviate the burden of pediatric trauma. This study involved a retrospective analysis of clinical data from pediatric patients admitted to our hospital's intensive care unit (ICU) due to trauma over a 10-year period. Comprehensive analyses were conducted to elucidate trends, demographics, injury patterns, and risk factors associated with these admissions. This retrospective study included 951 pediatric patients (mean age: 4.79 ± 3.24 years; mean weight: 18.45 ± 9.02 kg; median time to ICU admission post-injury: 10.86 ± 14.95 h). Among these patients, 422 (44.4%) underwent emergency surgery, and 466 (49%) required mechanical ventilation support, with a mean duration of 70.19 ± 146.62 h. The mean duration of ICU stay was 6.24 ± 8.01 days, and the overall mean hospitalization duration was 16.08 ± 15.56 days. The predominant cause of unintentional injury was traffic accidents (47.9%), followed by falls (42.5%) and burns/scalds (5.3%). Most incidents involved children aged 0-6 years (70.7%), with males comprising 60.0% of patients. Injury incidents predominantly occurred between 12 and 6 PM (44.5%) and on non-workdays (37.6%). The most common locations where injuries occurred were roadsides (49%) and rural areas (64.35%). Single-site injuries (58.78%) were more prevalent than multiple-site injuries (41.22%), and head injuries were the most common among single-site injuries (81.57%). At ICU admission, the mean injury severity score was 18.49 ± 8.86. Following active intervention, 871 patients (91.59%) showed improvement, while 80 (8.41%) succumbed to their injuries. Traffic injuries remain the primary cause of pediatric trauma leading to ICU admission, underscoring the importance of using appropriate child restraint systems and protective gear as fundamental preventive measures. The increased incidence of injuries among children aged < 6 years and those residing in rural areas highlights the need for targeted preventive strategies, necessitating tailored interventions and public policy formulations that address these high-risk populations.

摘要

儿科创伤在儿科死亡率中起着至关重要的作用,交通伤害和跌倒经常被认为是导致儿童重伤的主要原因。全面调查,包括地理因素,对于制定预防伤害和减轻儿科创伤负担的有效策略至关重要。本研究对我院 ICU 因创伤住院的儿科患者 10 年来的临床资料进行了回顾性分析。对趋势、人口统计学、损伤模式和与这些入院相关的危险因素进行了综合分析。这项回顾性研究包括 951 名儿科患者(平均年龄:4.79±3.24 岁;平均体重:18.45±9.02 公斤;受伤后 ICU 入院中位数时间:10.86±14.95 小时)。其中 422 例(44.4%)接受急诊手术,466 例(49%)需要机械通气支持,平均时间为 70.19±146.62 小时。ICU 住院时间平均为 6.24±8.01 天,总住院时间平均为 16.08±15.56 天。意外伤害的主要原因是交通意外(47.9%),其次是跌倒(42.5%)和烧伤/烫伤(5.3%)。大多数事故涉及 0-6 岁儿童(70.7%),男性占患者的 60.0%。伤害事件主要发生在下午 12 点至 6 点(44.5%)和非工作日(37.6%)。受伤最常见的地点是路边(49%)和农村地区(64.35%)。单发部位损伤(58.78%)比多发部位损伤(41.22%)更为常见,单发部位损伤中头部损伤最为常见(81.57%)。入住 ICU 时,平均损伤严重程度评分(ISS)为 18.49±8.86。经过积极干预,871 例(91.59%)患者病情好转,80 例(8.41%)死亡。交通伤仍然是导致儿科创伤进入 ICU 的主要原因,这突显了使用适当的儿童约束系统和防护装备作为基本预防措施的重要性。6 岁以下儿童和农村地区儿童受伤发生率增加,这表明需要有针对性的预防策略,需要制定针对这些高风险人群的干预措施和公共政策。

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