Cryer P C, Davidson L, Styles C P, Langley J D
South East Institute of Public Health, Kent, UK.
Public Health. 1996 Nov;110(6):331-8. doi: 10.1016/s0033-3506(96)80004-7.
To demonstrate the significance of injury in relation to other health problems, to describe the pattern of injury in one region of England, and to identify priorities for further epidemiological and prevention work.
Cases were identified retrospectively from secondary data sources, namely using routinely collected data on deaths (OPCS anonymized death registrations for the period 1988-1991) and hospital in-patients (South Thames (East) RHA files of in-patient episodes). Denominator data for rates were obtained from the 1991 mid-year population estimates from the OPCS.
The cohort was defined as those resident in South Thames (East) during the study period, namely Kent, East Sussex, and South East London. The study period was 1988-1991 calendar years inclusive for the fatalities: and was the financial year from 1 April 1991-31 March 1992 for injury resulting in hospital admission.
Injuries were found to be the fifth leading cause of death, the third leading cause of potential years of life lost (PYLL), and the third most common cause of hospital bed utilisation. Injury rates varied dramatically with age, and sex. The highest injury death and hospitalization rates were amongst elderly people. The leading causes of injury death were motor vehicle traffic crashes (25%), and suicide (23%), and falls (15%); for injury hospitalizations they were falls (60% of bed-days), and motor-vehicle traffic crashes (13% of bed-days). The most common places identified for the occurrence of injury death were road, home and residential institutions. Those injuries that accounted for most admissions to hospital were fractures (59% of bed-days).
A number of areas have been identified as regional priorities. These are motor vehicle traffic crashes involving pedestrians (especially children under 15 and those aged 65 and over), car occupants and motor cyclists (especially young adult males); falls (especially those aged 65 and over); those occurring in residential institutions (especially for elderly people); fire and flames (affecting children under 15); suicide/self harm (all ages 15 and above); and homicide/assault (in males aged 15-34).
证明伤害与其他健康问题的相关性，描述英格兰一个地区的伤害模式，并确定进一步开展流行病学和预防工作的重点。
通过二级数据源回顾性确定病例，即使用常规收集的死亡数据（1988 - 1991年期间的OPCS匿名死亡登记）和医院住院患者数据（南泰晤士（东部）区域卫生局住院病历档案）。率的分母数据来自OPCS的1991年年中人口估计数。
队列定义为研究期间居住在南泰晤士（东部）的人群，即肯特郡、东萨塞克斯郡和伦敦东南部。研究期间，死亡数据涵盖1988 - 1991年历年；因伤住院数据为1991年4月1日至1992年3月31日财政年度。
伤害被发现是第五大死亡原因、潜在寿命损失年数（PYLL）的第三大原因以及医院床位使用的第三大常见原因。伤害率因年龄和性别差异极大。伤害死亡率和住院率最高的是老年人。伤害死亡的主要原因是机动车交通事故（25%）、自杀（23%）和跌倒（15%）；因伤住院的主要原因是跌倒（占床位日的60%）和机动车交通事故（占床位日的13%）。确定的伤害死亡最常见发生地点是道路、家中和居民机构。导致大多数住院的伤害是骨折（占床位日的59%）。
已确定若干领域为区域重点。这些领域包括涉及行人（特别是15岁以下儿童和65岁及以上老人）、汽车乘客和摩托车手（特别是年轻成年男性）的机动车交通事故；跌倒（特别是65岁及以上老人）；居民机构内发生的伤害（特别是老年人）；火灾和火焰（影响15岁以下儿童）；自杀/自残（所有15岁及以上年龄组）；以及杀人/袭击（15 - 34岁男性）。
