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2017年至2022年中国上海儿科重症监护病房收治的意外伤害儿童特征分析。

Analysis of characteristics of children with unintentional injuries admitted in Pediatric Intensive Care Unit from 2017 to 2022 in Shanghai, China.

作者信息

Wang Limin, Zhu Xuemei, Chen Miaomiao, Chen Weiming, Xue Ping, Zheng Jicui, Li Xiaohong

机构信息

Fudan University School of Public Health, Shanghai, China.

Department of Critical Care Medicine, Children's Hospital of Fudan University, Shanghai, China.

出版信息

BMJ Paediatr Open. 2025 Jun 30;9(1):e003339. doi: 10.1136/bmjpo-2025-003339.

Abstract

BACKGROUND

Understanding the patterns of unintentional injuries (UIs) among children admitted to the Pediatric Intensive Care Unit (PICU) is crucial for effective prevention and management. We aimed to explore the demographic, situational and clinical characteristics of children with UIs admitted to the PICU.

METHODS

We conducted a cross-sectional, retrospective study of patients under 18 with UIs admitted to the PICU of Children's Hospital of Fudan University from October 2017 to December 2022.

RESULTS

A total of 395 children were admitted, with a mean (SD) age of 5.6 (3.7) years. Road traffic injuries (RTI) (146 (37%)) and high falls (119 (30.1%)) were dominant. Patients with foreign body injuries had a lower median (Q1, Q3) age of 1.6 (1.1, 1.8) years (P<0.001). Most UIs occurred when children were alone (318 (80.5%), P<0.001), during recreation (61 (15.4%), P<0.001) and indoors (212 (53.7%), P<0.001). Injury types differed significantly in hospital stay length (P<0.001) and prognosis (P<0.001). Compared with RTIs, drowning and poisoning were more likely to result in poor prognosis (drowning OR=9.778 (3.515,28.537), P<0.001; poisoning OR=3.556 (1.123,10.428), p=0.023).

CONCLUSIONS

RTIs and high falls were the leading types of children with UIs admitted to the PICU. Injury patterns varied with age, situational characteristics and involved substantial medical costs. Tailored interventions based on injury patterns are essential to improve child safety and well-being.

摘要

背景

了解入住儿科重症监护病房(PICU)的儿童意外伤害模式对于有效预防和管理至关重要。我们旨在探讨入住PICU的意外伤害儿童的人口统计学、情境和临床特征。

方法

我们对2017年10月至2022年12月入住复旦大学附属儿科医院PICU的18岁以下意外伤害患者进行了一项横断面回顾性研究。

结果

共收治395例儿童,平均(标准差)年龄为5.6(3.7)岁。道路交通伤害(RTI)(146例(37%))和高处坠落(119例(30.1%))占主导。异物伤害患者的年龄中位数(四分位数间距)较低,为1.6(1.1,1.8)岁(P<0.001)。大多数意外伤害发生在儿童独自时(318例(80.5%),P<0.001)、娱乐期间(61例(15.4%),P<0.001)和室内(212例(53.7%),P<0.001)。伤害类型在住院时间(P<0.001)和预后(P<0.001)方面有显著差异。与道路交通伤害相比,溺水和中毒更有可能导致预后不良(溺水比值比=9.778(3.515,28.537),P<0.001;中毒比值比=3.556(1.123,10.428),P=0.023)。

结论

道路交通伤害和高处坠落是入住PICU的意外伤害儿童的主要类型。伤害模式因年龄、情境特征而异,并涉及大量医疗费用。基于伤害模式的针对性干预对于提高儿童安全和福祉至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4654/12211825/9d648e8e456d/bmjpo-9-1-g001.jpg

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