Admissions of Children and Adolescents With Deliberate Self-harm to Intensive Care During the SARS-CoV-2 Outbreak in Australia.
Admissions of Children and Adolescents With Deliberate Self-harm to Intensive Care During the SARS-CoV-2 Outbreak in Australia.
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在澳大利亚的SARS-COV-2爆发期间，对儿童和青少年有意自我伤害的儿童和青少年的招生。
DOI：
10.1001/jamanetworkopen.2022.11692
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发表时间：
2022-05-02
影响因子：
13.8
通讯作者：
Oberender, Felix
中科院分区：
文献类型：
--
作者：
Corrigan, Claire;Duke, Graeme;Millar, Johnny;Paul, Eldho;Butt, Warwick;Gordon, Michael;Coleman, Jacinta;Pilcher, David;Oberender, Felix
这项队列研究调查了SARS-CoV-2爆发期间澳大利亚儿童和青少年故意自残的重症监护入院率。澳大利亚的SARS-CoV-2疫情是否与重症监护病房（ICU）收治严重故意自残儿童和青少年的人数增加有关？这项队列研究确定了813名年龄在12至17岁之间的儿童ICU患者，他们在6.5年内故意自残。每百万名儿童及青少年的每月入院人数在疫情爆发时大幅增加，由二零二零年三月的7. 2人增加至二零二零年八月的11. 4人。这项研究发现，澳大利亚的冠状病毒大流行与故意自残的儿童和青少年重症监护的入院率显著增加有关。确定与儿科人群中COVID-19大流行相关的潜在间接结果对于理解当前全球儿童和青少年公共卫生危机的挑战至关重要。调查澳大利亚SARS-CoV-2爆发和随后的有效公共卫生措施是否与故意自残（DSH）儿童和青少年入住重症监护室（ICU）的增加有关。这项全国性多中心队列研究使用澳大利亚和新西兰两国儿科重症监护登记处的澳大利亚数据子集进行，该登记处是一个合作机构，包含超过20万份病历，来自澳大利亚所有8个专科、大学附属儿科ICU、沿着1个产科-儿科联合ICU和14个普通（成人）ICU的连续贡献。研究周期为6.5年，从2015年1月1日至2021年6月30日。纳入了12至17岁的患者。分析了2021年12月至2022年2月的数据。任何以下入院诊断：摄入毒品，摄入非毒品，上吊或勒死，或自伤。主要结局指标是澳大利亚12 - 17岁儿童和青少年每100万例DSH ICU入院的全国发生率的时间趋势。在研究期间，在澳大利亚登记研究子集的64145例0至17岁患者中，共确定了813例因DSH入住ICU的12至17岁儿童和青少年。中位（IQR）年龄为15.1（14.3-15.8）岁; 550例（67.7%）女性患者，261例（32.2%）男性患者，2例（0.2%）患者性别不确定。在大流行开始时，每百万儿童和青少年的DSH ICU入院率从2020年3月的7.2人增加到2020年8月的11.4人的高峰，构成了时间趋势的重大突破（2020年3月或之后与之前DSH ICU入院的比值比为4.84; 95% CI为1.09至21.53; P = 0.04）。这是在所有年龄段（即0-17岁）的儿童和青少年每100万儿童和青少年的全因儿科ICU入院率从长期月中位数（IQR）150.9（138.1-159.8）下降到2020年4月的91.7。这项队列研究发现，澳大利亚的冠状病毒大流行与DSH重症监护儿童和青少年的入院率显著增加有关。
This cohort study investigates the rate of intensive care admissions with deliberate self-harm among children and adolescents in Australia during the SARS-CoV-2 outbreak. Was the SARS-CoV-2 outbreak in Australia associated with an increase in intensive care unit (ICU) admissions of children and adolescents with severe deliberate self-harm? This cohort study identified 813 patients aged 12 to 17 years admitted to pediatric ICUs with deliberate self-harm over 6.5 years. Monthly admissions per million children and adolescents increased significantly at the onset of the pandemic, from 7.2 admissions in March 2020 to 11.4 admissions by August 2020. This study found that the coronavirus pandemic in Australia was associated with a significant increase in admissions of children and adolescents to intensive care with deliberate self-harm. Identification of potential indirect outcomes associated with the COVID-19 pandemic in the pediatric population may be essential for understanding the challenges of the current global public health crisis for children and adolescents. To investigate whether the SARS-CoV-2 outbreak and subsequent effective public health measures in Australia were associated with an increase in admissions to intensive care units (ICUs) of children and adolescents with deliberate self-harm (DSH). This national, multicenter cohort study was conducted using the Australian data subset of the binational Australian and New Zealand Paediatric Intensive Care registry, a collaborative containing more than 200 000 medical records with continuous contributions from all 8 Australian specialist, university-affiliated pediatric ICUs, along with 1 combined neonatal-pediatric ICU and 14 general (adult) ICUs in Australia. The study period encompassed 6.5 years from January 1, 2015, to June 30, 2021. Patients aged 12 to 17 years were included. Data were analyzed from December 2021 through February 2022. Any of the following admission diagnoses: ingestion of a drug, ingestion of a nondrug, hanging or strangulation, or self-injury. The primary outcome measure was the temporal trend for national incidence of DSH ICU admissions per 1 million children and adolescents aged 12 to 17 years in Australia. A total of 813 children and adolescents aged 12 to 17 years admitted to ICUs with DSH were identified among 64 145 patients aged 0 to 17 years in the Australian subset of the registry during the study period. Median (IQR) age was 15.1 (14.3-15.8) years; there were 550 (67.7%) female patients, 261 (32.2%) male patients, and 2 (0.2%) patients with indeterminate sex. At the onset of the pandemic, monthly incidence of DSH ICU admissions per million children and adolescents increased from 7.2 admissions in March 2020 to a peak of 11.4 admissions by August 2020, constituting a significant break in the temporal trend (odds ratio of DSH ICU admissions on or after vs before March 2020, 4.84; 95% CI, 1.09 to 21.53; P = .04). This occurred while the rate of all-cause admissions to pediatric ICUs of children and adolescents of all ages (ie, ages 0-17 years) per 1 million children and adolescents decreased from a long-term monthly median (IQR) of 150.9 (138.1-159.8) admissions to 91.7 admissions in April 2020. This cohort study found that the coronavirus pandemic in Australia was associated with a significant increase in admissions of children and adolescents to intensive care with DSH.
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影响因子：
8
作者：
Kreski NT;Chen Q;Olfson M;Cerdá M;Hasin D;Martins SS;Mauro PM;Keyes KM
通讯作者：
Keyes KM
影响因子：
105.7
作者：
Hawton, K;Rodham, K;Weatherall, R
通讯作者：
Weatherall, R
影响因子：
6.9
作者：
Agüero JM
通讯作者：
Agüero JM
DOI：
10.1590/1413-81232020256.1.11472020
发表时间：
2020-06-01
期刊：
Ciência & Saúde Coletiva
影响因子：
--
作者：
Deslandes, Suely Ferreira;Coutinho, Tiago
通讯作者：
Coutinho, Tiago
影响因子：
2.9
作者：
Cairns, Rose;Karanges, Emily A.;Buckley, Nicholas A.
通讯作者：
Buckley, Nicholas A.