Increased incidence of inflicted traumatic brain injury in children after a natural disaster
Increased incidence of inflicted traumatic brain injury in children after a natural disaster
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DOI：
10.1016/j.amepre.2003.10.023
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发表时间：
2004-04-01
影响因子：
5.5
通讯作者：
Runyan, DK
中科院分区：
文献类型：
--
作者：
Keenan, HT;Marshall, SW;Runyan, DK
背景：自然灾害后儿童虐待的发生率尚未得到深入研究。然而，父母的压力和社会支持的减少与儿童虐待报告的增加有关。我们假设大规模的自然灾害（北卡罗来纳州的飓风弗洛伊德）会增加幼儿创伤性脑损伤（TBI）的发生率。方法：采用生态学研究设计，对受灾地区与未受灾地区进行比较。确定了1998年9月至2001年12月期间在北卡罗来纳州发生的导致进入重症监护病房或死亡的创伤性脑损伤病例。采用泊松回归模型计算不同时期各地理区域的伤害率比。结果：与灾前相比，受灾最严重的县发生的创伤性脑损伤在灾后G个月内有所增加（发生率比5.1,95%可信区间[CI] = 1.3-20.4），未发生创伤性脑损伤的发生率比10.7,95%可信区间[CI] = 2.0-59.4)。在受灾害影响较小或未受影响的县，没有观察到相应的发病率增加。飓风过后6个月，重灾区的受伤率恢复到基线水平；然而，在飓风过后的整个研究期间，非造成伤害的比率似乎仍在上升。结论：灾难发生后，家庭易受致伤性和非致伤性儿童创伤性脑损伤的风险增加。这些信息可能对未来的灾难规划有用。
Background: The incidence of child abuse following natural disasters has not been Studied thoroughly. However, parental stress and decreased social support have been linked to increased reports of child maltreatment. We hypothesized that a large-scale natural disaster (North Carolina's Hurricane Floyd) would increase the incidence of inflicted traumatic brain injury (TBI) in young children.Methods: An ecologic Study design was used to compare regions affected to those regions unaffected by the disaster. Cases of inflicted TBI resulting in admission to an intensive care unit or death from September 1998 through December 2001 in North Carolina were ascertained. Poisson regression modeling was employed to calculate rate ratios of injury for each geographic area by time period.Results: Inflicted TBI in the most affected counties increased in the G months post disaster in comparison to the same region pre-disaster (rate ratio 5.1, 95% confidence interval [CI] = 1.3-20.4), as did non-inflicted TBI (rate ratio 10.7, 95% CI = 2.0-59.4). No corresponding increased incidence was observed in counties less affected or unaffected by the disaster. The rate of inflicted injuries returned to baseline in the severely affected counties 6 months post-hurricane; however, the rate Of non-inflicted injuries appeared to remain elevated for the entire post-hurricane study period.Conclusions: Families are Vulnerable to an elevated risk of inflicted and non-inflicted child TBI following a disaster. This information may be useful in future disaster planning.