2015—2018年深圳市南山区老年伤害医院监测患者特征分析

目的分析2015—2018年深圳市南山区老年人伤害监测病例分布及特征,为预防控制老年伤害发生提供依据。方法通过伤害监测系统收集2015—2018年间因伤害首次在深圳市南山区伤害监测哨点医院急诊室就诊的60岁及以上老年病例资料,并进行描述性分析。结果共收集老年伤害病例10616例,男女性别比为1∶1.35;伤害发生原因前五位依次为跌倒/坠落(57.12%)、动物伤(13.97%)、刀/锐器伤(10.41%)、钝器伤(8.18%)、道路交通伤害(7.56%)。动物伤在各年份的占比呈逐年上升的趋势;伤害发生地点主要为家中(45.71%);伤害发生时以进行休闲活动时为主(67.96%);伤害性质以挫伤/擦伤(45.79%)、锐器伤/咬伤/开放伤(28.23%)、骨折(12.79%)居多;伤害严重程度多数为伤势较轻,预后良好。结论老年伤害多发于女性,跌倒/坠落、动物伤及道路交通伤害是老年群体伤害防控的重点。     

南京城区及周边农村地区儿童意外伤害的调查与分析

目的了解南京城区及周边农村地区儿童意外伤害的情况。方法对2007年1月至2009年12月某医科大学附属儿童医院收治的意外伤害儿童2551例进行问卷调查,调查意外伤害儿童的性别、年龄、伤害发生的原因以及治疗结果等。结果南京城区及周边农村地区儿童意外伤害的类型按照人数进行排序,前3位依次为：跌倒/跌落、气管异物及烧/灼/烫伤;1～3岁是儿童意外伤害发生的高峰;发生意外伤害的2551例儿童中,南京周边农村地区儿童1618例（占63.4%）,南京城区儿童933例（占36.6%）,农村地区意外伤害的儿童数多于城区。结论应对儿童及其家长进行针对性的育儿安全宣传教育,使家长了解不同年龄、不同季节儿童发生意外伤害的特点及预防应对方法,避免儿童意外伤害的发生。     

2018-2020年广东省广州市伤害住院病例流行病学特征

目的 分析广东省广州市伤害监测医院伤害住院病例的流行病学特征，为伤害防治提供数据参考。方法 收集2018—2020年广州市5家伤害监测医院伤害住院病例资料，采用Excel 2016及SPSS 22.0软件对其不同年份、伤害发生事件、住院费用及时长等流行病学特征进行统计分析。结果 2018—2020年伤害住院病例共18 978例，其中男性11 794例（62.15%），男女性比为1.64∶1。住院病例60～岁年龄组病例数最多，达5 745例（30.27%）。排在前3位的伤害发生原因为跌倒6 957例（36.66%）、运输事故3 310例（17.44%）、火灾与烫伤3 235例（17.05%）；各年度1—4月报告伤害住院病例数较少，而7月报告伤害住院病例数最高。火灾与烫伤住院时间最长[12(8,20) d]，住院费用最高[18 209.06(9 332.41,36 711.7)元]，其次为跌倒住院时间[10(6,16) d]，住院费用[15 399.55(6 355.96,37 986.53)元]。结论 2018—2020年广东省广州市住院伤害医疗负担沉重，应针对重点人群加强伤害防制，制定...     

2015年天津市14岁以下儿童伤害监测分析

目的 了解天津市0~14岁儿童伤害发生的现状,为制定相关干预政策和开展儿童安全教育提供依据。方法 数据源自天津市发病报告监测体系中2015年首次因伤害就诊于各级医疗机构的病例资料。结果 2015年天津市共报告0~14岁儿童伤害33 751例,发生率为2 624.62/10万,男女性别比为1.78:1,城乡比为1.33:1。伤害原因前5位的是跌倒（13 971例,占41.39%）、动物致伤（8 562例,占25.37%）、交通伤害（2 715例,占8.04%）、砸伤（1 479例,占4.38%）和利器割伤（1 432例,占4.24%）。轻、中、重度和死亡依次为24 947例（73.91%）、7 520例（22.28%）、1 196例（3.54%）和88例（0.26%）,差异有统计学意义（2=50.22,P0.001）,且不同年龄组间差异均有统计学意义（P0.001）。男童和城市儿童是预防伤害发生的重点人群;而死亡分析中,男童和农村儿童是干预的重点人群。结论 应根据儿童不同年龄段、不同性别特征有针对性、有重点的进行干预,减少儿童伤害的发生。     

深圳市南山区托幼机构儿童乳牙龋齿调查分析

目的对深圳市南山区3~6岁儿童乳牙龋齿患病现况进行分析,为制定乳牙龋齿预防措施提供科学依据。方法将2010-2014年深圳市南山区180余家幼儿园共计175 945人次儿童进行口腔检查,并对龋齿的流行特征进行分析。结果深圳南山区托幼机构儿童2010-2014年,5年平均龋齿患病率为44.3%,5年来学龄前儿童龋齿患病率持平(P=0.696)。2010-2014年学龄前儿童龋齿患病率随年龄增长而增高(龋齿患病率3~<4岁为24.8%,4~<5岁为38.7%,5~6岁为54.5%,P<0.001),区级/合格幼儿园龋齿患病率明显高于省/市级幼儿园(P<0.001)。结论随着年龄增长,学龄前儿童龋齿患病率升高,等级低的幼儿园龋齿患病率高于等级高的幼儿园。预防龋齿,要从婴儿抓起,采取综合预防措施,从而降低龋齿发病率。     

深圳市南山区6274例道路交通伤害监测分析

目的:分析广东省深圳市南山区交道路交通伤害情况,为开展相关干预措施提供依据.方法:回顾性分析2008年1月至2010年12月南山区3所医院的急诊伤害监测资料.结果:交通伤6274例,男女性别比为2.15∶1,平均年龄(33.2+18.7)岁.道路交通伤害发生的主要地点为街区(60.7％)和公路(32.1％);伤害严重程度以中等程度和轻微浅表伤为主;预后以经医院处理后回家为主;3.91％的交通伤患者在伤害发生之前有饮酒行为.结论:道路交通伤害的发生存在一定规律,应充分利用医院急诊伤害监测系统,使其成为广东省道路交通伤害发生情况的重要信息来源.     

2004-2008年贵州省独山县住院死亡病例根本死因分析

目的了解2004-2008年贵州省独山县住院死亡病例的死因模式。方法对独山县人民医院2004-2008年296例死亡病例进行根本死因统计分析。结果住院死亡病例占同期出院病例（39 465例）的0.75%;男性死亡193例,女性103例,男女性别比为1.87∶1;5岁以下69例（23.31%）,其中新生儿34例（占5岁以下的49.28%）;5～19岁25例（8.45%）;20～49岁96例（32.43%）;50～69岁59例（19.93%）;70岁以上47例（15.88%）。根本病因以伤害而死亡的人数位居各系统疾病死亡之首,其次是神经系统疾病、呼吸系统疾病、起源于围生期某些情况、循环系统疾病等。结论伤害对人类健康影响日益突出,心脑血管疾病死亡逐年增多,呼吸系统疾病、起源于围生期某些情况不可忽视,针对住院死亡主要成因,积极开展伤害防范、慢性病三级预防、加强妇幼保健工作和提高新生儿疾病诊治水平,是当地当前卫生工作的主要任务。     

超声测量视神经鞘直径联合闪光视觉诱发电位监测颅脑损伤患者颅内压的临床价值

目的 应用超声测量颅脑损伤患者视神经鞘直径（ONSD），探讨其联合闪光视觉诱发电位（FVEP）在颅脑损伤患者颅内压监测中的临床价值。方法 选取我院重症医学科收治的100例颅脑损伤患者，其中仅采用FVEP指导临床治疗者43例（对照组），FVEP联合ONSD指导临床治疗者57例（联合组），比较两组中颅内压升高者ONSD、颅内压的差异；分析ONSD、颅内压与颅内压升高的相关性。比较两组甘露醇使用时间及总量、急性肾损伤例数、住院费用、抗菌药物使用强度、住院时间、机械通气时间。结果 对照组与联合组中出现颅内压升高者分别为29例和22例，两组颅内压升高者颅内压比较差异无统计学意义；联合组和对照组中颅内压升高者ONSD均显著高于颅内压正常者，差异均有统计学意义（均P<0.05）。相关性分析显示，联合组ONSD、颅内压与颅内压升高均呈正相关（r=0.739、0.981，均P<0.05）；且ONSD与颅内压呈正相关（r=0.752,P<0.05）。联合组甘露醇使用时间、住院时间、机械通气时间均短于对照组，甘露醇使用总量、急性肾损伤占比、住院费用、抗菌药物使用强度均少于对照组，差异均有统...     

重庆大坪医院脑梗死急性期住院费用的构成和预测

目的确定重庆大坪医院脑梗死病人急性期住院费用的构成比及其影响因子.方法收集311名在重庆大坪医院神经内科因急性脑梗死住院病人的人文资料、临床资料、住院费用、收费成本比,用逐步回归分析筛选影响住院费用的主要预测因素.结果平均住院天数14 d,平均住院费用6 130元.其中药品费占53.1%,床位费占7.9%,检查费占25.6%,其他治疗费占11.1%.住院费用的影响因子最主要的为NIHSS评分（NIHSS美国国立卫生院卒中评分量表）,其余为并发肺部感染、住院天数、住院2 w ADL评分（生活自理量表）.结论药品费可以说明大部分住院费用.住院费用主要影响因素为NIHSS评分、并发肺部感染、住院天数、住院2 w的ADL,其中NIHSS评分为住院费用最重要的影响因子.     

创伤严重程度与住院不同时间营养不良的关系

目的 探讨创伤病人损伤严重程度与其住院不同时间营养不良的关系.方法 对外伤后24 h内入院的120例创伤病人,入院首日依据创伤严重程度评分（ISS）分为轻度损伤、中度损伤及重度损伤,各40例.入院次日对病人进行营养不良风险筛查（NRS）,住院期间每周进行NRS评分,共4次.并对评分结果进行统计分析.结果 ISS与住院期间第1～3周NRS评分呈正相关（r=0.408～0.752,P〈0.01）.重度损伤组第1～3周NRS评分明显高于其他两组,差异有显著性（F=11.16～121.28,q=2.15～21.15,P〈0.001）.结论 创伤病人营养不良风险与创伤严重程度有关.对创伤病人进行ISS测定可预测病人住院期间不同时间存在营养不良的风险.     

Active hospital-based surveillance of rotavirus diarrhea in Austrian children, period 1997 to 2003

BACKGROUND: Rotavirus is the most common pathogen causing severe dehydrating diarrhea in infants and young children worldwide. Any decision on implementation of rotavirus vaccination will be strongly influenced by the expected reduction in severe and therefore costly outcomes associated with rotavirus infection. The aim of this study was to provide data on hospitalization of young children with rotavirus infection in Austria. METHODS: The data were derived from active hospital-based sentinel surveillance for rotavirus during the period 1997 to 2003. RESULTS: During this period 25,600 children<15 years of age were hospitalized with acute laboratory-confirmed rotavirus gastroenteritis, the infection showing seasonal peaks between February and March. In 5 % of the cases first symptoms of diarrhea occurred at a minimum of 48 hours after hospital admission, indicating healthcare-associated origin of infection. The mean annual incidence of hospitalization per 100,000 population for the age group<5 years was 766 and for those<2 years 1742, the latter meaning that 1 in 60 Austrian children up to 2 years of age required hospitalization. An average peak incidence was observed between 8 and 14 months of age, with an average of 68% of the reported cases occurring in children aged相似文献   

Hospital and emergency department use by young low-income children

BACKGROUND: Limited data are available concerning determinants of health care service usage by low-income young children. OBJECTIVES: To explore predictors of hospitalization and emergency department (ED) use by young children of low-income families by using the Aday and Andersen Access Framework. METHODS: Low-income women (n = 474) with a child younger than 6 years completed a structured face-to-face interview at human service offices or Women, Infants, and Children (WIC) clinics in four central Ohio counties. Women were considered low-income if they or their child were Medicaid eligible or uninsured. Data were collected for both the mother and the index child on sociodemographic status, health services use, health status, and access to care. RESULTS: Fifteen percent of the children had been hospitalized the previous year, and half had an ED visit. Hospitalization was significantly related to maternal hospitalization the previous year (OR = 2.5), child age younger than 1 year old (OR = 2.1) and more than two chronic conditions (OR = 2.2). Maternal ED usage in the last year (OR = 2.2), Medicaid fee for service plan (OR = 1.7), and rural residence (OR = 2.0) were predictive of ED use. CONCLUSIONS: Predisposing characteristics (maternal hospital/ED use) were predictive of both hospitalization and ED use by the index child. Enabling characteristics (fee-for-service Medicaid plan, rurality) were only predictive of ED use, and need characteristics (child's health) were only predictive of hospitalization. Further research to explore linkages between maternal and child use of health care services as well as the effect of changes in health care access, managed care, and other innovations on hospitalization and ED use in young, low-income children is recommended.     

Hospitalization among diabetic children and adolescents and the general population in Germany. German Working Group for Pediatric Diabetology

OBJECTIVE: To compare hospitalization in a multicenter-based cohort of diabetic children and adolescents (aged 1-19 years) in Germany with that of the general population. RESEARCH DESIGN AND METHODS: Based on standardized documentation, hospital stays after manifestation were ascertained in diabetic subjects 1-19 years of age in 1997. Hospitalization data in the general German population were derived from official statistics. Incidence rates and numbers of hospital days were estimated. Ratios of hospitalization incidences and numbers of hospital days between the diabetic and the general population were calculated. Costs for hospital care in the German diabetic population in 1997 were determined. RESULTS: A total of 5,874 patients came from 61 pediatric centers (52% male, age [mean +/- SD] 12.2 +/- 4.3 years, diabetes duration 4.6 +/- 4.4 years). Hospitalization incidence rates and hospital days per person-year (95% CI) were 0.27 (0.25-0.29) and 1.80 (1.75-1.84) in the diabetic population and 0.0948 (0.0946-0.0949) and 0.6416 (0.6412-0.6420) in the general population. The standardized ratio of hospital incidences was 3.1 (2.9-3.2), and the ratio of numbers of hospital days was 2.8 (2.7-2.9). Costs for hospital care after manifestation were estimated to be $506 (U.S. dollars) per person-year and $12.4 million in the whole German diabetic population aged 1-19 years in 1997; including hospital stays at diabetes onset, total annual costs were $24 million ($970 per person-year). CONCLUSIONS: Diabetic children and adolescents in Germany had an approximately three times higher hospitalization risk and three times more hospital days than the age-matched general population. Including hospitalization at diabetes onset, the annual costs of hospital care for the German diabetic population aged 1-19 years amounted to approximately 1% of all costs for hospital care in this age-group. Thus, costs were largely overproportional (diabetes prevalence 0.1%).     

Childhood Soccer Injuries Treated in U.S. Emergency Departments

Objectives: Soccer, an increasingly popular sport among children in the United States, is a common precipitant to injury‐related emergency department (ED) visits. The authors estimated the number of children treated in EDs for soccer‐related injuries and described the nature of these injuries. Methods: Data from the 2000 National Electronic Injury Surveillance System All Injury Program were used to estimate the overall number and rate of soccer injuries in children, calculate injury rates per 1,000 children, and describe the body regions affected and types of injuries. Results were stratified by five‐year age groups (5–9 years, 10–14 years, and 15–19 years). Results: Approximately 144,600 children sustained soccer‐related injuries in 2000 for a rate of 2.36 injuries per 1,000 children. Injury rates increased with age (0.8, 5–9 year olds; 3.1, 10–14 year olds; 3.2, 15–19 year olds). Common types of injuries were strains/sprains (36.7%), fractures (23.0%), and contusions (20.9%). Fractures decreased with age; sprains/strains increased with age. Commonly injured body regions varied by age. Wrist and finger injuries were most common (12.7% and 12.4%, respectively) in the youngest group; in the 10–14‐year‐old group, ankle and wrist injuries were most common (15.7% and 13.6%, respectively). In the oldest age group, ankle injuries were most common (21.9%), followed by knee injuries (17.6%). Conclusions: Substantial numbers of children were treated in EDs for soccer‐related injuries. Injury types and affected body regions varied by age. Injury prevention efforts to reduce soccer‐related injuries may need to be age specific.     

Predictors of medical care utilization by independently living adults with spinal cord injuries

A prospective study of 87 independently living adults with spinal cord injury (SCI) as a major disabling condition showed the following average annual health care utilization rates: 1.3 hospital admissions, 16.8 days hospitalized, 1.7 emergency room (ER) visits, and 22.4 outpatient contacts (in person or by telephone). Those hospitalized (n = 66) experienced a mean of 22.2 days hospitalized per person per year. Mean length of stay (LOS) was 11.1 days per admission. Stepwise regression analysis indicated no statistically significant (p less than or equal to .05) predictors of hospital admissions. There were three independent predictors of days hospitalized (greater age, fewer years of education, and more days hospitalized during the previous year), three predictors of days hospitalized for those hospitalized only (greater age, fewer years of education, and longer hospital LOS during the previous year), one predictor of LOS (self-assessment of health), three of emergency room (ER) visits (more unmet instrumental activities of daily living needs, lack of organizational memberships, and more ER visits during the previous year), and five predictors of outpatient contacts (greater age, less satisfaction with health care providers' expressions of concern for their health, lower frequency of leaving apartments, lower levels of life satisfaction, and nonparticipation in a managed medical care demonstration project). Many predictors of health services utilization are immutable. However, changes which facilitate social interaction and changes in the organization of health services may reduce certain types of medical care utilization by people with SCI.     

2014－2020年广西儿童青少年伤害死亡流行特征分析

  目的   分析2014—2020年广西壮族自治区（广西）儿童青少年伤害死亡情况,为制定儿童青少年伤害防控策略和措施提供参考依据。  方法   收集整理中国疾病预防控制信息系统的人口死亡信息登记管理系统中报告的2014—2020年广西21个国家级监测点的0～19岁儿童青少年伤害死亡资料,按照国际疾病分类法（ICD-10）进行统一编码分类,计算死亡率、年度变化百分比（APC）等指标,并运用χ2检验对组间差异进行统计分析。  结果   2014—2020年广西0～19岁儿童青少年年均伤害死亡率为17.70/10万,占死亡总数的34.93%,是该年龄段第1位死因。 伤害死亡率呈现逐年下降的趋势,男性死亡率22.44/10万,女性死亡率12.04/10万,男性死亡率高于女性,差异有统计学意义（χ2＝283.39,P＜0.001）。 溺水、道路交通事故、意外跌落、意外中毒和窒息为儿童青少年的前5位伤害死因,占伤害死亡总数的81.90%。 首位伤害死因:0～岁组的为窒息,1～14岁组为溺水,15～19岁组为道路交通事故。  结论   2014—2020年广西0～19岁儿童青少年伤害死亡率呈现逐年下降的趋势,前5位伤害死因为溺水、道路交通事故、意外跌落、意外中毒和窒息,应根据儿童青少年人群伤害死亡特点采取相应的防制策略。     

Incidence and management of intermittent claudication in primary care in The Netherlands

OBJECTIVE: To study the incidence and management of intermittent claudication in primary care. DESIGN: In a longitudinal survey among 161 general practitioners (GPs) all incident diagnoses of intermittent claudication (IC) were selected and available information on GP management was studied. Setting: Dutch National Survey of Morbidity and Interventions in General Practice. SUBJECTS: 74153 patients aged 55 years and over. MAIN OUTCOME MEASURES: Age- and sex-specific incidence rates. RESULTS: The overall incidence rate of IC was 6.4 per 1000 person years (95% confidence interval (CI) 5.3-7.7). Incidence rate in creased from 4.0 per 1000 person years in men aged 55-59 to 12.9 per 1000 person years in men aged over 85, and for women in the same age categories from 3.3 per 1000 person years to 8.2 per 1000 person years, respectively. Of the 117 incident cases of IC, 43 (37%) were referred to a hospital specialist. In 55 cases (47%), drugs were prescribed by the GP and in 101 cases (86%) the GP gave advice, notably pertaining to exercise and cessation of smoking. CONCLUSION: The incidence rate of IC in primary care is high in both men and women, and clearly increases with age. Only a minority of patients are referred to a hospital specialist, while the vast majority receive lifestyle advice.     

Burn injuries in small children, a population-based study in Sweden

Aims and objectives. The aim of this study was to describe characteristics in burn injuries in children (zero to six years old), consulting primary care and hospital‐based care in Malmö, Sweden. Burn‐injured children consulting the University Hospital or the 21 Health Centres, during year 1998 and year 2002, were included. Background. Epidemiological studies of burns in children have mostly been hospital‐based and the cases that never reached the hospital have been excluded. Design. The study had a retroperspective design with data collected from medical records. Methods. Chi‐squared test was used to analyse differences in nominal data and cross tables were used to analyse the proportions between the characteristics of the injuries and sex, age and nationality. Results. The burn‐injured children were 148 and 80% of those were scalds, caused by hot liquid (71%) or hot food (29%). The greatest number was boys between one and two years old. Children to foreign born parents were more frequently affected and the extent of the injuries often larger. Almost all the accidents (96%) occurred in home environment, while a family member was next to the child. The Health Centres received more often children affected on hand/arm and by causes like hot food than the University Hospital. Conclusions. Our data demonstrate the importance of developing a programme for the prevention of paediatric scalds with education of family members to be aware of the danger. With present study the knowledge about the occurrence of injuries in scald accidents in children has become deeper. This knowledge may contribute to more individual adept child accident prevention programme, to use in the child health care.