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儿童意外事故及玩具致伤急诊调查

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中华预防医学杂志 1990年第6期24卷 380-381页

作者：叶广俊余晓鸣北京医科大学儿童青少年卫生研究所

自本世纪40年代末期,儿童意外事故伤害就被认为是造成儿童死亡和伤残的主要原因。在儿童的意外事故伤害中有相当一部分涉及儿童玩具和游戏器械。据美国消费者协会统计的资料表明,1982年美国因玩具受到不同伤害的儿童达12万以上,其中有些

关键词：创伤和损伤/流行病学急症事故游戏和玩具儿童人类

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嘉兴市农村小学生伤害流行病学调查

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中国学校卫生 2006年第2期27卷 107-108页

作者：俞慧芳陈中文周哲华胡煜浙江省嘉兴市疾病预防控制中心 314001

目的了解农村小学生伤害发生原因及其流行病学特征,为预防农村小学生伤害的健康促进提供方向和指导依据。方法采用整群抽样的方法,运用统一设计的调查问卷,对嘉兴市3 385名农村小学生进行伤害流行病学调查。结果嘉兴市农村小学生伤害发... 详细信息

目的了解农村小学生伤害发生原因及其流行病学特征,为预防农村小学生伤害的健康促进提供方向和指导依据。方法采用整群抽样的方法,运用统一设计的调查问卷,对嘉兴市3 385名农村小学生进行伤害流行病学调查。结果嘉兴市农村小学生伤害发生率为24.38%,居前3位的是跌伤、动物咬伤、运动创伤,其发生率分别为31.2%,10.8%和9.6%。伤害发生原因有25种,居前3位是玩耍、运动、骑车,分别占19.2%,19.1%和11.2%;伤害程度中,中、重度伤占20.3%;平均每位学生每年因伤害支出的医疗费用为25.49元。结论嘉兴市农村小学生伤害发生是多因素的,要采取多部门合作的综合防治措施进行预防。

关键词：创伤和损伤/流行病学卫生保健费用学生保健服务

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Factors associated with severity of motorcycle injuries among young adult riders

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ANNALS OF EMERGENCY MEDICINE 2003年第6期41卷 783-791页

作者： Lin, MR Chang, SH Huang, WZ Hwang, HF Pai, L Taipei Med Univ Inst Injury Prevent & Control Taipei 110 Taiwan Natl Taiwan Univ Sch Publ Hlth Dept Publ Hlth Taipei 10764 Taiwan Harvard Univ Sch Publ Hlth Dept Biostat Boston MA 02115 USA Natl Taipei Coll Nursing Dept Nursing Taipei Taiwan Natl Def Med Ctr Dept Publ Hlth Taipei Taiwan

Study objective: A cohort of 4,729 junior college students in Taiwan was studied to determine risk factors for increased severity of motorcycle injuries. Methods: Crash characteristics were collected by using self-administered questionnaires soon after a student was involved in a motorcycle crash. The proportional odds model with generalized estimating equations, with correlated ordinal responses for collisions categorized into not injured, mildly injured, and severely injured categories, was used to determine the odds of injury severity. Results: A total of 1,889 motorcycle crashes involving 1,284 persons occurred over a 20-month period from November 1994 to June 1996. There were 1,339 noninjuries, 474 mild injuries, and 76 severe injuries. The adjusted odds ratio (OR) of rural to urban roads having a greater level of injury severity was 1.64. Compared with noncollisions, collisions with a moving car (adjusted 011=11.76), a parked car (adjusted OR 1.90), or another stationary object (adjusted OR=2.31) increased the odds for a greater level of injury severity. Riders using Sanyang (adjusted OR=1.63) and Yamaha (adjusted OR=1.39) motorcycles had greater odds of being involved in a crash with a greater level of injury compared with those riding Kymco motorcycles. Darkness (adjusted OR=1.65) and greater speeds (adjusted OR=1.63 to 4.69) also increased the odds of greater injury severity. Conclusion: At the time of motorcycle crashes, factors such as being on rural roads, collisions with a heavier object, some motorcycle makes, darkness, and greater speeds increased the severity of motorcycle injuries among these young adult riders.

关键词：事故交通/统计学和数值数据饮酒头部防护装置摩托车/统计学和数值数据危险因素台湾/流行病学创伤和损伤/流行病学青少年成年人女(雌)性人类男(雄)性

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Injury control in Honduras: A survey of injury mortality

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ANNALS OF EMERGENCY MEDICINE 2000年第4期36卷 333-339页

作者： Richman, M Shayne, P Heron, S Lowery, D Todd, KH Emory Univ Sch Med Dept Emergency Med Atlanta GA 30303 USA

Study objective: We sought to evaluate the methods and accuracy of mortality data collection and summarize the injury mortality rate in one sector of the State of Olancho, Honduras, with the intent to establish a baseline of injury mortality that will identify potential areas of intervention and serve as a comparison after subsequent interventions. Methods: Mortality data were collected from a rural, regional, health center database containing age, sex, and cause of death for one geographic sector in the State of Olancho, Honduras. Causes of death were classified as medical or intentional versus nonintentional injury. Results: Accurate mortality data were difficult to obtain for several reasons: (1) deaths are often recorded by untrained health care workers, (2) causes of death are not coded in a standard manner, and (3) infant mortality is underreported. We found 132 recorded noninfant deaths. A disproportionate number of these resulted from injury, especially from intentional injury, particularly among male subjects aged 12 to 49 years. Eighty-two percent of male subjects aged 12 to 49 years who died did so from injuries, and 52% died from intentional injuries. Overall, 48% of all male deaths were injury related. The estimated male mortality rate (age 12 to 49 years) from injuries was 4.5 times that of the United States. Conclusion: Injury, particularly intentional injury, is an important cause of mortality in rural Honduras, particularly among male subjects aged 12 to 49 years. This suggests a fertile opportunity for intervention. More reliable data collection will be necessary to accurately target which specific causes of injury death are most amenable to interventions and to monitor the effect of injury control programs.

关键词：年龄分布死亡原因洪都拉斯/流行病学性别分布创伤和损伤/流行病学创伤和损伤/死亡率创伤和损伤/预防和控制青少年成年人儿童儿童学龄前女(雌)性人类婴儿男(雄)性中年人

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Occupational fatalities in emergency medical services: A hidden crisis

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ANNALS OF EMERGENCY MEDICINE 2002年第6期40卷 625-632页

作者： Maguire, BJ Hunting, KL Smith, GS Levick, NR Univ Maryland Dept Emergency Hlth Serv Baltimore MD 21250 USA George Washington Univ Dept Environm & Occupat Hlth Washington DC USA Liberty Mutual Res Ctr Safety & Hlth Ctr Safety & Res Hopkinton MA USA Columbia Univ Harlem Hosp New York NY USA

Study objective: We estimate the occupational fatality rate among emergency medical services (EMS) personnel in the United States. Methods: We undertook descriptive epidemiology of occupational fatalities among EMS providers. Analysis was conducted by using data from 3 independent fatality databases: the Census of Fatal Occupational Injuries (1992 to 1997), the National EMS Memorial Service (1992 to 1997), and the National Highway Traffic Safety Administration's Fatality Analysis Reporting System (1994 to 1997). These rates were compared with the occupational fatality rates of police and firefighters and with the rate of all employed persons in the United States. Results: The Census of Fatal Occupational Injuries database documented 91 EMS provider occupational fatalities. The National EMS Memorial Service database contained 70 fatalities, and the Fatality Analysis Reporting System identified 8 ground-transportation EMS occupational fatalities. There was also wide variation in fatality counts by cause of injury. Using the highest cause-specific count from each of the databases, we estimate that there were at least 67 ground transportation-related fatalities, 19 air ambulance crash fatalities, 13 deaths resulting from cardiovascular incidents, 10 homicides, and 5 other causes, resulting in 114 EMS worker fatalities during these 6 years. We estimated a rate of 12.7 fatalities per 100,000 EMS workers annually, which compares with 14.2 for police, 16.5 for firefighters, and a national average of 5.0 during the same time period. Conclusion: This study identifies an occupational fatality rate for EMS workers that exceeds that of the general population and is comparable with that of other emergency public service workers.

关键词：事故职业/死亡率年龄分布数据收集急救技师危险因素美国/流行病学创伤和损伤/流行病学创伤和损伤/病因学创伤和损伤/死亡率成年人女(雌)性人类男(雄)性中年人

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Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia

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BRITISH JOURNAL OF SURGERY 2000年第3期87卷 328-337页

作者： Unwin, N Mackintosh, J LaPorte, R Chang, YF Univ Newcastle Sch Med Dept Diabet Newcastle Upon Tyne NE2 4LP Tyne & Wear England Univ Newcastle Sch Med Dept Epidemiol & Publ Hlth Newcastle Upon Tyne NE2 4LP Tyne & Wear England

Background: This study was established to enable a comparison of lower extremity amputation incidence rates between different centres around the world. Methods: Ten centres, all with populations greater than 200 000, in Japan, Taiwan, Spain, Italy, North America and England collected data on all amputations done between July 1995 and June 1997. Patients were identified from at least two data sources (to allow cheeks on ascertainment);denominator populations were based on census figures. Results: The highest amputation rates were in the Navajo population (43.9 per 100 000 population per year for first major amputation in men) and the lowest in Madrid, Spain (2.8 per 100 000 per year). The incidence of amputation rose steeply with age;most amputations occurred in patients over 60 years. In most centres the incidence was higher in men than women and the incidence of major amputations was greater than that of minor amputations. Diabetes was associated with between 25 and 90 per cent of amputations. Conclusion: Apart from the Navajo centre, differences in the known prevalence of diabetes could not. account for the differences in overall incidence of amputation. Differences in the prevalence of peripheral vascular disease are likely to be important, but this and the role of other factors, including availability of health care, are worthy of further investigation.

关键词：年龄分布截肢术/利用糖尿病/流行病学糖尿病/外科学欧洲/流行病学远东/流行病学发病率感染/流行病学感染/外科学小腿北美洲/流行病学外周血管疾病/流行病学外周血管疾病/外科学性别分布创伤和损伤/流行病学创伤和损伤/外科学青少年成年人老年人老年人 80以上儿童儿童学龄前女(雌)性人类婴儿婴儿新生男(雄)性中年人

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Pedestrian versus motor vehicle accidents: An analysis of 5,000 patients

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JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS 1999年第4期189卷 343-348页

作者： Peng, RY Bongard, FS Univ Calif Los Angeles Harbor Med Ctr Sch Med Dept SurgDiv Trauma & Crit Care Torrance CA 90509 USA

Background: Pedestrian versus motor vehicle accidents are associated with substantial morbidity and mortality. Previous studies have examined pedestrian injury profiles on an individual hospital basis and have been limited by small patient populations. The objective of this study was to examine the demographics and injury profiles of pedestrian versus motor vehicle accidents in a large trauma system. Study Design: Five thousand pedestrians injured by motor vehicles whose records were entered in a centralized county trauma database were reviewed retrospectively over 3 years. Patients were grouped by age: pediatric (less than 15 years), adult (15 to 65 years), and elderly (older than 65 years). The main outcome measures included mortality, hospital stay, ICU stay, Injury Severity Score, Glasgow Coma Scale, Revised Trauma Score, level of residual disability, and payer source. Results: The pediatric group represented 38.1% of the study population, adults 53.9%, and the elderly 8.0%. Mortality was highest among the elderly (27.8%), followed by adults (8.1%) and children (3.1%). Overall, the pediatric group had the lowest Injury Severity Score (6.8 +/- 0.2, mean +/- SEM), the highest Revised Trauma Score (7.5 +/- 0.9), and the highest Glasgow Coma Scale (13.9 +/- 0.1). Hospital stay (4.9 +/- 0.2 days) and ICU stay (4.6 +/- 0.3 days) were also shortest in this age group. Among all patients, injuries included musculoskeletal (34.3%), head and neck (30.0%), external (24.4%), abdomen and pelvis (3.9%), chest (2.4%), spine (1.8%), and other (3.2%). Operations were required in 11%: orthopaedic (67%), thoracic (2%), abdominal(11%), neurosurgical or head (6%), and other (14%). At the time of discharge, 78% of patients had a temporary disability, 4% had a permanent handicap, and only 16% were functioning at preadmission capacity. Among those with identifiable payer sources, 45% were state or federal, 25% were cash or self-pay, 18% of patients belonged to an HMO or had a group carr

关键词：事故交通/死亡率事故交通/统计学和数值数据格拉斯哥昏迷量表损伤严重度评分洛杉矶/流行病学回顾性研究创伤和损伤/流行病学青少年成年人老年人儿童女(雌)性人类男(雄)性中年人

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Advanced trauma and life support principles: An audit of their application in a rural trauma centre

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IRISH JOURNAL OF MEDICAL SCIENCE 1999年第2期168卷 93-98页

作者： Calleary, JG El-Nazir, AK El-Sadig, O Carolan, PE Joyce, WP Cavan Monaghan Hosp Dept Gen & Vasc Surg Cavan Ireland

In December of 1995 a system of trauma care based on Advanced Trauma Life Support (ATLS) principles was instituted to assess the impact of such principles on trauma care in a rural general hospital setting. This audit reviews the results over a 2 yr period to December 1997. All patients admitted with major trauma (i.e. with life threatening or potentially life threatening injuries) to Cavan General Hospital (CGH) were eligible far inclusion. This numbered 70 patients admitted (for at least 3 days), or who were transferred after resuscitation and stabilization as well as inpatient deaths. Twenty-seven patients who died prior to admission are also reviewed. The endpoints assessed were death, disability and survival 3 months post-accident. Based on injury severity scores 7 per sent of cases suffered fatal non-survivable injury, 20-30 per cent had very serious injury with an overall mortality rate of 17 per cent. The predicted mortality rate was 30 per cent. One-third had their full treatment at CGH with a 76 per cent survival rate, The other two-thirds were transferred for specialist intervention with an overall survival of 80 per cent, a disability rate of 16 per cent and a mortality rate of 4 per cent. No patient died during transportation.

关键词：年龄分布危重病/死亡率危重病/治疗指导方针(主题) 损伤严重度评分爱尔兰/流行病学生命支持疗法/标准医学审核登记农村人口性别分布存活率创伤诊治中心/标准创伤和损伤/诊断创伤和损伤/流行病学创伤和损伤/治疗青少年成年人老年人老年人 80以上儿童儿童学龄前女(雌)性人类婴儿男(雄)性中年人

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An armed forces epidemiological board evaluation of injuries in the military

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AMERICAN JOURNAL OF PREVENTIVE MEDICINE 2000年第3期18卷 14-25页

作者： Jones, BH Hansen, BC USA Ctr Hlth Promot & Prevent Med Aberdeen Proving Ground MD USA Univ Maryland Sch Med Baltimore MD 21201 USA

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Evaluation of telemedical support to a free-standing minor accident and treatment service

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JOURNAL OF TELEMEDICINE AND TELECARE 1998年第3期4卷 140-145页

作者： Tachakra, S Wiley, C Dawood, M Sivakumar, A Dutton, D Hayes, J Cent Middlesex Hosp Dept Accident & Emergency Med London NW10 7NS England Cent Middlesex Hosp Dept Radiol London NW10 7NS England

We studied all patients attending a free-standing minor accident and treatment service (MATS) run by emergency nurse practitioners (ENPs). In a six-month period, 5563 patients were seen in the MATS, of whom 2843 (51%) were new attenders. A teleconsultation was carried out with 150 of these patients (2.7% of all cases). The most common reason (39%) was to discuss a radiograph with an accident and emergency consultant. The accuracy of the telemedicine-assisted radiographic diagnosis was checked subsequently by a review panel. The ENPs' working diagnoses (made by viewing the films) had a sensitivity of 90% and a specificity of 96%;this was improved by telemedicine assistance to 97% and 99%, respectively. The telemedicine patients were also surveyed several months after being seen in the MATS;their replies indicated that the telemedicine diagnoses had been correct.

关键词：事故门诊医疗设施/组织和管理门诊医疗设施/利用急救医疗服务/组织和管理急救医疗服务/利用评价研究伦敦/流行病学开业护士远程会诊/统计学和数值数据创伤和损伤/诊断创伤和损伤/流行病学人类

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