Epidemiology of paediatric injuries in Rwanda using a prospective trauma registry
Epidemiology of paediatric injuries in Rwanda using a prospective trauma registry
复制标题
DOI：
10.1002/bjs5.50222
复制
发表时间：
2019-11-17
期刊：
影响因子：
3.1
通讯作者：
Byiringiro, J. C.
中科院分区：
文献类型：
--
作者：
Petroze, R. T.;Martin, A. N.;Byiringiro, J. C.
儿童生存倡议历来优先努力降低儿童因传染病和孕产妇疾病的发病率和死亡率。在资源有限的情况下，很少有人关注儿科伤害。本研究旨在评估撒哈拉以南非洲国家儿童伤害的人口统计学和结果，以改善预防和治疗。方法在卢旺达大学的两个大学教学校区建立前瞻性创伤登记处，系统记录2011年5月至2015年7月期间的患者人口统计学资料、院前护理、初始生理学和患者结局。对人口统计学特征、损伤机制、地理位置和结局进行单变量分析。对死亡率估计值进行多变量分析。结果在登记的11036例患者中，3010例（27个中心点，3%）年龄在18岁以下。儿科患者主要是男孩（69中心点9%），中位年龄为8岁。死亡率为4个中心点8%，福尔斯是最常见的伤害（45个中心点3%），其次是道路交通事故（30个中心点9%），烧伤（10个中心点7%）和钝器/攻击（7个中心点5%）。在首都基加利接受治疗的患者，头部损伤的发生率更高（7个中心点6%对农村城镇的2个中心点0%，P < 0中心点001;比值比（OR）4个中心点08，95% c.i. 2个中心点61至6个中心点38）和较高的总体损伤相关死亡率（调整OR 3个中心点00，1个中心点50至6个中心点01; P = 0个中心点019）。与其他道路使用者相比，行人有更高的总体损伤相关死亡率（调整OR 3中心点26，1中心点37至7中心点73; P = 0中心点007）。结论儿童伤害是导致儿童死亡的重要因素。在规划资源利用和能力建设工作以解决资源匮乏环境中的儿科伤害问题和确定弱势群体时，描述创伤人口统计数据非常重要。
Background Child survival initiatives historically prioritized efforts to reduce child morbidity and mortality from infectious diseases and maternal conditions. Little attention has been devoted to paediatric injuries in resource-limited settings. This study aimed to evaluate the demographics and outcomes of paediatric injury in a sub-Saharan African country in an effort to improve prevention and treatment. Methods A prospective trauma registry was established at the two university teaching campuses of the University of Rwanda to record systematically patient demographics, prehospital care, initial physiology and patient outcomes from May 2011 to July 2015. Univariable analysis was performed for demographic characteristics, injury mechanisms, geographical location and outcomes. Multivariable analysis was performed for mortality estimates. Results Of 11 036 patients in the registry, 3010 (27 center dot 3 per cent) were under 18 years of age. Paediatric patients were predominantly boys (69 center dot 9 per cent) and the median age was 8 years. The mortality rate was 4 center dot 8 per cent. Falls were the most common injury (45 center dot 3 per cent), followed by road traffic accidents (30 center dot 9 per cent), burns (10 center dot 7 per cent) and blunt force/assault (7 center dot 5 per cent). Patients treated in the capital city, Kigali, had a higher incidence of head injury (7 center dot 6 per cent versus 2 center dot 0 per cent in a rural town, P < 0 center dot 001; odds ratio (OR) 4 center dot 08, 95 per cent c.i. 2 center dot 61 to 6 center dot 38) and a higher overall injury-related mortality rate (adjusted OR 3 center dot 00, 1 center dot 50 to 6 center dot 01; P = 0 center dot 019). Pedestrians had higher overall injury-related mortality compared with other road users (adjusted OR 3 center dot 26, 1 center dot 37 to 7 center dot 73; P = 0 center dot 007). Conclusion Paediatric injury is a significant contributor to morbidity and mortality. Delineating trauma demographics is important when planning resource utilization and capacity-building efforts to address paediatric injury in low-resource settings and identify vulnerable populations.