Langlois J A, Smith G S, Baker S P, Langley J D
Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
Int J Epidemiol. 1995 Feb;24(1):136-43. doi: 10.1093/ije/24.1.136.
International comparisons of mortality rates for injury, as for other conditions, can suggest priorities for further research and intervention. However, variability in the assignment of underlying cause, especially among the elderly, may lead to difficulty in interpreting cross-national differences in death rates. Despite similarities between the two countries, the injury death rate for ages < or = 65 in New Zealand is substantially higher than the United States rate. The objective of this study was to investigate possible reasons for this difference.
We used data not previously reported for New Zealand to calculate the cause-specific injury death rates for ages > or = 65, compared them with US rates, and examined other injury rates that could help explain the observed difference.
The New Zealand death rate from falls for ages > or = 65 was nearly three times the US rate (92 versus 32 per 100,000), causing the death rate for all injuries in this age group to be 34% higher in New Zealand (153 versus 114 per 100,000). However, hospitalization rates for both falls and hip fractures are similar for the two countries.
The substantially higher fall injury death rates for older New Zealanders are not fully explained by differences in the incidence of falls resulting in injury nor the case fatality rate for fall-related injury. US injury death rates based on underlying cause of death might be similar to New Zealand rates, and thus substantially higher, if subjected to comparable procedures for the completion and coding of death certificates. As in studies of other conditions, international comparisons of injury death rates based on underlying cause, especially in studies of the elderly, must consider variation between countries in death certification and coding practices.
与其他疾病一样，对伤害死亡率进行国际比较可以为进一步的研究和干预指明重点。然而，潜在死因判定的差异，尤其是在老年人中，可能导致难以解释各国死亡率的差异。尽管两国存在相似之处，但新西兰65岁及以下人群的伤害死亡率显著高于美国。本研究的目的是调查造成这种差异的可能原因。
我们使用此前未报告过的新西兰数据来计算65岁及以上人群特定原因的伤害死亡率，将其与美国的死亡率进行比较，并研究其他可能有助于解释所观察到差异的伤害率。
新西兰65岁及以上人群的跌倒死亡率几乎是美国的三倍（每10万人中分别为92人和32人），导致该年龄组所有伤害的死亡率在新西兰高出34%（每10万人中分别为153人和114人）。然而，两国跌倒和髋部骨折的住院率相似。
新西兰老年人跌倒伤害死亡率显著更高，这不能完全用导致伤害的跌倒发生率差异或跌倒相关伤害的病死率差异来解释。如果美国在死亡证明填写和编码方面采用类似程序，基于潜在死因的伤害死亡率可能与新西兰相似，因此也会显著更高。与其他疾病研究一样，基于潜在死因的伤害死亡率国际比较，尤其是在老年人研究中，必须考虑各国在死亡证明和编码做法上的差异。
