Demetriades D, Murray J, Sinz B, Myles D, Chan L, Sathyaragiswaran L, Noguchi T, Bongard F S, Cryer G H, Gaspard D J
Department of Surgery, University of Southern California, Los Angeles 90033, USA.
J Am Coll Surg. 1998 Oct;187(4):373-83. doi: 10.1016/s1072-7515(98)00209-9.
Our objective was to study population-based trauma-related injuries and deaths in the county of Los Angeles and to identify trends and progress towards meeting the "Year 2000 National Health Objectives."
We did a retrospective study for the year 1996. Data were obtained from the Trauma Registry of the Emergency Medical Services of the Department of Health Services, and the Coroner's Department of the County of Los Angeles. Traumatic injuries and deaths per 100,000 of the population were calculated according to mechanism, race, age, and gender.
During 1996, there were 12,136 major trauma admissions in the 13 trauma centers in Los Angeles County. Another 1,929 victims died at the scene or were certified dead at nontrauma centers and were taken to the Coroner's Department (total 14,065 victims). The overall major injury rate was 151.0 per 100,000 population and the death rate was 30.9 per 100,000. The trauma death rate per 100,000 population was 56.4 for African-Americans, 33.5 for Hispanics, 26.3 for Caucasians, and 11.6 for Asians. Homicides were the leading cause of traumatic deaths (45.3%) followed by traffic accidents (31.9% of deaths). Firearms were responsible for 3,899 major injuries or deaths (41.7 per 100,000 population). The overall homicide rate per 100,000 population was 14.0, with a much higher rate for African-Americans (40.4 per 100,000) and Hispanics (18.7 per 100,000) than Caucasians (4.0 per 100,000) or Asians (3.4 per 100,000). African-American males were at very high risk for homicide (73.3 per 100,000), and in the age group 15 to 34 years, this problem reaches epidemic proportions (164.2 per 100,000). Traffic accidents accounted for 69.0 major injuries and 9.6 deaths per 100,000 people. Males were at significantly higher risk of dying in traffic accidents than females. People over 60 years of age were at significantly higher risk of traffic-accident death than younger people, for both passenger and pedestrian groups (p < 0.01). Firearm-related suicides were responsible for 4.6 deaths per 100,000 population. Caucasian males over 65 years were at much higher risk of suicide by penetrating trauma (29.5 per 100,000) than were Hispanics (6.3 per 100,000), Asians (5.4 per 100,000), or African-Americans (no deaths) in the same gender and age group.
Trauma remains a major health problem in the county of Los Angeles. Despite the significant reduction of intentional trauma in 1996, it still exceeds national figures and is much higher than the targeted "Year 2000 National Health Objectives." Aggressive prevention strategies need to focus on the population groups at excessive risks of injury by assault, traffic accidents, and suicides.
我们的目标是研究洛杉矶县基于人群的创伤相关损伤和死亡情况，并确定在实现“2000年国家卫生目标”方面的趋势和进展。
我们对1996年进行了一项回顾性研究。数据来自卫生服务部紧急医疗服务创伤登记处以及洛杉矶县验尸官部门。根据损伤机制、种族、年龄和性别计算每10万人口中的创伤性损伤和死亡人数。
1996年期间，洛杉矶县的13个创伤中心有12136例严重创伤入院病例。另外1929名受害者在现场死亡或在非创伤中心被认证死亡，并被送往验尸官部门（总计14065名受害者）。总体重伤率为每10万人口151.0例，死亡率为每10万人口30.9例。每10万人口中的创伤死亡率，非裔美国人为56.4例，西班牙裔为33.5例，白人为26.3例，亚裔为11.6例。凶杀是创伤死亡的主要原因（45.3%），其次是交通事故（占死亡人数的31.9%）。枪支导致3899例严重损伤或死亡（每10万人口41.7例）。每10万人口中的总体凶杀率为14.0例，非裔美国人（每10万人口40.4例）和西班牙裔（每10万人口18.7例）的凶杀率远高于白人（每10万人口4.0例）或亚裔（每10万人口3.4例）。非裔美国男性的凶杀风险极高（每10万人口73.3例），在15至34岁年龄组，这一问题达到流行程度（每10万人口164.2例）。交通事故导致每10万人中有69.0例重伤和9.6例死亡。男性在交通事故中死亡的风险显著高于女性。60岁以上人群在交通事故死亡方面的风险显著高于年轻人，无论是乘客还是行人组（p<0.01）。与枪支相关的自杀导致每10万人口中有4.6例死亡。65岁以上的白人男性因穿透性创伤自杀的风险（每10万人口29.5例）远高于同性别和年龄组的西班牙裔（每10万人口6.3例）、亚裔（每10万人口5.4例）或非裔美国人（无死亡病例）。
创伤仍然是洛杉矶县的一个主要健康问题。尽管1996年故意创伤显著减少，但仍超过全国数字，远高于“2000年国家卫生目标”的设定值。积极的预防策略需要关注因袭击、交通事故和自杀而面临过高受伤风险的人群。
