Surveillance for injury caused by fall in 0−14 year old children in Anhui, 2006−2020
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摘要:
目的 分析2006—2020年安徽省儿童跌倒/坠落伤患者流行病学特征和变化趋势,为制定儿童跌倒/坠落伤预防控制措施与策略提供依据。 方法 利用安徽省2个国家伤害监测点6家哨点医院2006—2020年的0~14岁儿童跌倒/坠落病例监测数据,对跌倒构成比进行趋势分析,计算年度变化百分比(APC),评价儿童跌倒/坠落伤害的时间变化趋势。 结果 2006—2020年安徽省0~14岁儿童跌倒/坠落病例共36372例(男性24487例,女性11885例)。 1~4岁儿童病例最多(13280例,36.51%)。 儿童跌倒/坠落发生在9月最多,2月最少,高峰时间在每天的10:00和17:00。 跌倒发生地点多在家中,占47.13%,发生时活动主要为休闲活动(42.07%)。 伤害部位多为头部(46.41%),性质以挫伤、擦伤为主(57.1%),伤害结局多为处理后离院(95.99%)。 2006—2020年儿童跌倒/坠落整体呈上升趋势[平均年度变化百分比(AAPC)=3.21, P<0.001],其中2006—2015年呈上升趋势(APC=6.26, P<0.001),2015—2020年呈下降趋势(APC=−2.06, P=0.030)。 结论 跌倒/坠落是0~14岁儿童因伤害就诊的首要原因,应积极制定跌倒/坠落相关预防措施,降低儿童跌倒/坠落的发生。 Abstract:Objective To understand the epidemiological characteristics and trends of injury caused by fall in children in Anhui province from 2006 to 2020 and provide evidence for the development of prevention and control measures and strategies. Methods Six sentinel hospitals from two national injury surveillance areas in Anhui were selected to collect the incidence data of injury caused by fall in children aged 0–14 years from 2006 to 2020. Statistical software was used to analyze the trend of proportion of cases of injury caused by fall and the annual percent change (APC) was calculated to evaluate the change trend of injury caused by fall in the children. Results A total of 36372 cases of injury caused by fall, including 24487 cases in boys and 11885 cases in girls, were reported in children aged 0–14 years in Anhui from 2006 to 2020. The cases in children aged 1–4 years (13280 cases) accounted for the highest proportion (36.51%). The incidence of injury caused by fall in children was highest in September and lowest in February, with daily incidence peak between 10:00 and 17:00. Injury caused by fall mainly occurred at home (47.13%) and in leisure activities (42.07%). The injury sites were mainly head (46.41%), and contusion and abrasions were the most common types (57.1%). Most cases only needed general treatment in hospitals (95.99%). The proportion of the cases of injury caused by fall in children showed an increasing trend from 2006 to 2015 (APC=6.26, P<0.001) and a decreasing trend from 2015 to 2020 (APC=−2.06, P=0.030), but the overall proportion showed an increasing trend from 2006 to 2020 (AAPC=3.21, P<0.001). Conclusion Children aged from 0 to 14 years old are most likely to be injured by fall, and fall prevention measures should be actively developed to reduce the incidence of injury caused by fall in children. -
Key words:
- Fall /
- Children /
- Injury /
- Annual percent change
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表 1 2006-2020年安徽省0~14岁儿童跌倒/坠落病例情况及趋势分析
Table 1. Situation and trend of fall cases in children aged 0–14 years in Anhui province, 2006−2020
年度 0~岁 1~岁 5~岁 10~14岁 男性 女性 总计 伤害
病例数跌倒/坠落占全部
伤害比值(%)2006 1(0.18) 115(0.87) 203(1.66) 188(1.82) 368(1.50) 139(1.17) 507(1.39) 1369 37.03 2007 5(0.91) 204(1.54) 304(2.49) 336(3.25) 598(2.44) 251(2.11) 849(2.34) 1992 42.62 2008 0(0.00) 222(1.67) 374(3.07) 390(3.77) 720(2.94) 266(2.24) 986(2.71) 2118 46.55 2009 18(3.26) 340(2.56) 429(3.52) 411(3.97) 870(3.55) 328(2.76) 1198(3.29) 2447 48.96 2010 19(3.44) 453(3.41) 490(4.02) 450(4.35) 977(3.99) 435(3.66) 1412(3.88) 2953 47.82 2011 6(1.09) 441(3.32) 502(4.12) 427(4.13) 985(4.02) 391(3.29) 1376(3.78) 2718 50.63 2012 23(4.17) 540(4.07) 672(5.51) 496(4.79) 1190(4.86) 541(4.55) 1731(4.76) 3230 53.59 2013 19(3.44) 623(4.69) 773(6.34) 627(6.06) 1415(5.78) 627(5.28) 2042(5.62) 3529 57.86 2014 27(4.89) 651(4.90) 679(5.57) 599(5.79) 1347(5.50) 609(5.12) 1956(5.38) 2950 66.31 2015 18(3.26) 1014(7.64) 916(7.51) 792(7.65) 1847(7.54) 893(7.51) 2740(7.53) 3856 71.06 2016 58(10.51) 1526(11.49) 1176(9.65) 1004(9.70) 2519(10.29) 1245(10.48) 3764(10.35) 5779 65.13 2017 82(14.85) 1582(11.91) 1381(11.33) 1095(10.58) 2722(11.12) 1418(11.93) 4140(11.38) 6526 63.44 2018 71(12.86) 1772(13.34) 1401(11.49) 1183(11.43) 2924(11.94) 1503(12.65) 4427(12.17) 7260 60.98 2019 138(25.00) 2150(16.19) 1697(13.92) 1445(13.96) 3503(14.31) 1927(16.21) 5430(14.93) 8713 62.32 2020 67(12.14) 1647(12.40) 1195(9.80) 905(8.75) 2502(10.22) 1312(11.04) 3814(10.49) 6152 62.00 合计 552(100.00) 13280(100.00) 12192(100.00) 10348(100.00) 24487(100.00) 11885(100.00) 36372(100.00) 61592 59.05 注:括号外数据为人数,括号内数据为构成比(%) 表 2 2006-2020年安徽省0~14岁儿童跌倒/坠落病例不同组别人群发生地点分布
Table 2. Sites distribution of fall cases in different groups of children aged 0 to 14 years in Anhui province, 2006−2020
变量 家中 公共居住
场所b学校与
公共场所体育和
运动场所公路/
街道贸易和
服务场所工业和
建筑场所农村/
农田其他 不清楚 总计 性别 男性 10927(44.62) 2961(12.09) 6812(27.82) 728(2.98) 2305(9.41) 673(2.75) 39(0.16) 17(0.07) 7(0.03) 18(0.07) 24487(100.00) 女性 6215(52.29) 1386(11.66) 2482(20.88) 242(2.04) 1178(9.91) 350(2.94) 14(0.12) 7(0.06) 2(0.02) 9(0.08) 11885(100.00) 年龄组(岁)a 0~ 487(88.22) 26(4.71) 5(0.91) 1(0.18) 24(4.35) 8(1.45) 0(0.00) 0(0.00) 1(0.18) 0(0.00) 552(100.00) 1~ 10112(76.15) 1494(11.25) 429(3.23) 60(0.45) 743(5.59) 413(3.11) 17(0.13) 4(0.03) 1(0.01) 7(0.05) 13280(100.00) 5~ 4710(38.63) 1724(14.14) 3686(30.23) 328(2.69) 1300(10.66) 409(3.36) 16(0.13) 11(0.09) 5(0.04) 3(0.03) 12192(100.00) 10~ 1833(17.71) 1103(10.66) 5174(50.00) 581(5.62) 1416(13.68) 193(1.87) 20(0.19) 9(0.09) 2(0.02) 17(0.16) 10348(100.00) 季节 春(3-5月) 4311(44.82) 1063(11.05) 2930(30.46) 235(2.45) 816(8.48) 227(2.36) 19(0.20) 7(0.07) 2(0.02) 9(0.09) 9619(100.00) 夏(6-8月) 4811(54.33) 1282(14.48) 1232(13.91) 275(3.11) 922(10.41) 301(3.40) 15(0.17) 5(0.06) 3(0.03) 9(0.10) 8855(100.00) 秋(9-11月) 4232(40.25) 1223(11.63) 3385(32.19) 318(3.02) 1048(9.97) 279(2.65) 12(0.11) 8(0.08) 2(0.02) 8(0.08) 10515(100.00) 冬(12-2月) 3788(51.31) 779(10.55) 1747(23.66) 142(1.92) 697(9.44) 216(2.93) 7(0.09) 4(0.06) 2(0.03) 1(0.01) 7383(100.00) 合计 17142(47.13) 4347(11.95) 9294(25.55) 970(2.67) 3483(9.58) 1023(2.81) 53(0.15) 24(0.07) 9(0.02) 27(0.07) 36372(100.00) 注:括号外数据为人数,括号内数据为构成比(%);a. Fisher精确概率法;b.公共居住场所:指伤害发生时,患者在宿舍、疗养院、养老院、孤儿院、监狱等公告居住设施内 表 3 2006-2020年安徽省0~14岁儿童跌倒/坠落病例不同组别人群发生伤害时活动分布
Table 3. Activities distribution of fall cases in different groups of children aged 0 to 14 years in Anhui province, 2006−2020
变量 工作 家务 学习 体育活动 休闲活动 生命活动 驾乘交通工具 步行 其他 不清楚 总计 男性 1185(4.84) 5542(22.63) 561(2.29) 2319(9.47) 9995(40.82) 1396(5.70) 1042(4.25) 2377(9.71) 21(0.09) 49(0.20) 24487(100.00) 女性 323(2.72) 2541(21.38) 244(2.05) 812(6.83) 5306(44.64) 764(6.43) 473(3.98) 1383(11.64) 12(0.10) 27(0.23) 11885(100.00) 年龄组(岁)a 0~ 3(0.54) 100(18.12) 0(0.00) 1(0.18) 246(44.56) 157 ( 28.44 ) 14(2.54) 24(4.35) 2(0.36) 5(0.91) 552(100.00) 1~ 49(0.37) 2825(21.27) 23(0.17) 81(0.61) 7053(53.11) 1081(8.14) 532(4.01) 1567(11.80) 19(0.14) 50(0.38) 13280(100.00) 5~ 518(4.25) 2973(24.38) 323(2.65) 1074(8.81) 5003(41.04) 611(5.01) 477(3.91) 1192(9.78) 9(0.07) 12(0.10) 12192(100.00) 10~ 938(9.06) 2185(21.11) 459(4.44) 1975(19.09) 2999(28.98) 311(3.01) 492(4.75) 977(9.44) 3(0.03) 9(0.09) 10348(100.00) 季节 春(3-5月) 408(4.24) 2145(22.30) 217(2.26) 953(9.91) 4003(41.61) 553(5.75) 374(3.89) 941(9.78) 11(0.11) 14(0.15) 9619(100.00) 夏(6-8月) 270(3.05) 2130(24.05) 116(1.31) 538(6.07) 3827(43.22) 608(6.87) 448(5.06) 897(10.13) 5(0.06) 16(0.18) 8855(100.00) 秋(9-11月) 599(5.70) 2208(21.00) 301(2.86) 1070(10.18) 4267(40.58) 564(5.36) 392(3.73) 1075(10.22) 9(0.09) 30(0.28) 10515(100.00) 冬(12-2月) 231(3.13) 1600(21.67) 171(2.32) 570(7.72) 3204(43.40) 435(5.89) 301(4.08) 847(11.47) 8(0.11) 16(0.21) 7383(100.00) 合计 1508(4.15) 8083(22.22) 805(2.21) 3131(8.61) 15301(42.07) 2160(5.94) 1515(4.16) 3760(10.34) 33(0.09) 76(0.21) 36372(100.00) 注:括号外数据为人数,括号内数据为构成比(%);a. Fisher精确概率法 表 4 2006-2020年安徽省0~14岁儿童跌倒/坠落病例不同年龄组人群伤害临床信息
Table 4. Clinical information of fall cases in different age groups of children aged 0 to 14 years in Anhui Province, 2006−2020
分类 0~岁 1~岁 5~岁 10~岁 合计 伤害部位 头部 360(0.99) 8046(22.12) 5884(16.18) 2590(7.12) 16880(46.41) 上肢 138(0.38) 3531(9.71) 2949(8.11) 3202(8.80) 9820(27.00) 下肢 14(0.04) 1041(2.86) 2538(6.98) 3673(10.10) 7266(19.98) 其他部位 40(0.11) 662(1.82) 821(2.26) 883(2.42) 2406(6.61) 伤害性质 骨折 32(0.09) 871(2.39) 1347(3.70) 1621(4.46) 3871(10.64) 扭伤、拉伤 69(0.19) 1804(4.96) 1636(4.50) 2249(6.18) 5758(15.83) 锐器伤、咬伤、开放伤 25(0.07) 2302(6.33) 1700(4.67) 781(2.15) 4808(13.22) 挫伤、擦伤 396(1.09) 7808(21.47) 7108(19.54) 5457(15.00) 20769(57.10) 其他性质 30(0.08) 495(1.36) 401(1.11) 240(0.66) 1166(3.21) 严重程度 轻度 500(1.37) 11995(32.98) 10853(29.84) 9006(24.76) 32354(88.95) 中度 51(0.14) 1271(3.50) 1313(3.61) 1324(3.64) 3959(10.89) 重度 1(0.00) 14(0.04) 26(0.07) 18(0.05) 59(0.16) 结局a 处理后离院 527(1.45) 12877(35.40) 11683(32.12) 9826(27.02) 34913(95.99) 留观、转院、住院 25(0.07) 398(1.09) 506(1.39) 518(1.43) 1447(3.98) 死亡、其他 0(0.00) 5(0.01) 3(0.01) 4(0.01) 12(0.03) 注:括号外数据为人数,括号内数据为构成比(%);a. Fisher精确概率法 -
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