江苏省2012-2021年儿童青少年伤害死亡流行特征及趋势分析

目的 了解2012-2021年江苏省5~24岁儿童青少年的伤害死亡情况和流行特征及逐年变化趋势。方法 利用2012-2021年江苏省5~24岁儿童青少年伤害死亡资料，计算儿童青少年交通事故、溺水、自杀和跌倒的标化死亡率，以及平均年变化百分比（AAPC），计算不同年龄段和性别的儿童青少年前4位伤害死亡特征及趋势。结果 2012-2021年江苏省5~24岁儿童青少年伤害死亡谱大致相同，前4位伤害类型都是交通事故、溺水、跌倒和自杀。儿童青少年伤害总死亡人数16 052人，标化死亡率为9.58/10万，总体伤害标化死亡率无明显变化趋势（AAPC=-3.450%，P=0.055）。2012-2021年儿童青少年交通伤害标化死亡率呈下降趋势且有统计学意义（AAPC=-9.406%，P<0.001）；溺水和跌倒的标化死亡率无明显变化趋势；但自杀标化死亡率在近10年呈上升趋势且有统计学意义（AAPC=9.000%，P=0.001）。总体伤害死亡率随着年龄增加呈上升趋势。男性和女性自杀呈上升趋势且均有统计学意义（分别为AAPC=9.420%和AAPC=9.607%，均P<0.05）。女性交通事故、溺水标化死亡率和男性交通事故标化死亡率呈下降趋势且有统计学意义（女性交通事故AAPC=-7.364%，女性溺水AAPC=-5.352%，男性交通事故AAPC=-10.242%，均P<0.05）。城市和农村交通事故标化死亡率呈下降趋势且有统计学意义（分别为AAPC=-7.899%和AAPC=-9.421%，均P<0.001）；自杀标化死亡率呈上升趋势且有统计学意义（分别为AAPC=11.009%和AAPC=7.528%，均P<0.05）。结论 2012-2021年江苏省近10年儿童青少年的总体伤害情况有所改善，但自杀死亡率呈上升趋势，应重点关注该年龄段心理健康问题，加强儿童青少年自杀的防控。

Epidemic characteristics and trend analysis of major injuries deaths among children and adolescents in Jiangsu Province from 2012 to 2021

Objective To understand the situation and epidemic characteristics of injury deaths among children aged 5 to 24 years in Jiangsu Province from 2012 to 2021 and the trend of annual changes. Methods The main injury mortality data of children and adolescents was collected, and the crude and standardized mortality rates of road traffic accidents, drowning, suicide, and accidental falls among children and adolescents over a decade and the annual average percentage of change (AAPC) were calculated. The main injury mortality characteristics and trends of children and adolescents of different age groups and genders were analyzed. Results The total number of injury deaths among 5 to 24 adolescents in Jiangsu Province was 16 052, with a standardized mortality rate of 9.58/100 000. There was no significant trend in the overall standardized mortality rate of injuries (AAPC=-3.450%, P=0.055). The standardized mortality rate of road traffic injuries among children and adolescents showed a decreasing trend over the past decade, with statistical significance (AAPC=-9.406%, P<0.001). The standardized suicide mortality rate showed an upward trend over the past decade, with statistical significance (AAPC=9.000%, P=0.001). The overall injury mortality rate showed an upward trend with age. Suicide rates in males and females were on the rise and both have statistical significance (AAPC=9.420% and AAPC=9.607%, both P<0.05). The standardized mortality rates of female traffic accidents, drowning, and male traffic accidents showed a decreasing trend and were statistically significant (AAPC for female traffic accidents=-7.364%, AAPC for female drowning=-5.352%, and AAPC for male traffic accidents=-10.242%, all P<0.05). The standardized mortality rate of urban and rural traffic accidents showed a decreasing trend and was statistically significant(AAPC=-7.899% and AAPC=-9.421%, both P<0.001). The standardized suicide mortality rate showed an upward trend and statistical significance (AAPC=11.009% and AAPC=7.528%, both P<0.05). Conclusions The overall injury situation of children and adolescents in Jiangsu Province improved in the past decade from 2012 to 2021, but the suicide mortality rate was on the rise. It is necessary to focus on the mental health issues of this age group and to strengthen the prevention and control of suicide among children and adolescents, in Jiangsu.