进入加拿大的儿科创伤中心:基于人口的回顾性队列研究
Alexandra Lapierre1, Carmel Awlise1, Gabrielle Freire1
1Department of Social and Preventive Medicine (Lapierre, Awlise, Moore), and Research Center CHU de Québec (Lapierre, Berube, Beaulieu, Berthelot, Moore), Université Laval, Québec, Que.; Division of Emergency Medicine (Freire), Department of Pediatrics, Faculty of Medicine, University of Toronto; Child Health Evaluative Sciences Program (Freire), Peter Gilgan Institute for Research and Learning, the Hospital for Sick Children, Toronto, Ont.; Department of Surgery, Medicine and Community Health Sciences (Yanchar), University of Calgary, Calgary, Alta.; Department of Pediatrics (Zemek), Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ont.; Department of Pediatric Surgery (Beaudin), CHU Sainte-Justine, Université de Montréal, Montréal, Que.; Department of Pediatrics, Emergency Medicine, and Community Health Sciences (Stang), Cumming School of Medicine, University of Calgary, Calgary, Alta.; Department of Pediatrics (Weiss, Beaulieu, Berthelot), Université Laval, Québec, Que.; Division of Orthopaedic Surgery (Carsen), Children's Hospital of Eastern Ontario, Ottawa, Ont.; Division of Pediatric Emergency Medicine (Gagnon), McGill University Health Centre, Montreal Children's Hospital; School of Physical and Occupational Therapy (Gagnon), Faculty of Medicine and Health Sciences, McGill University; Montreal Children's Hospital (Burstein), Division of Pediatric Emergency Medicine, McGill University Health Centre; Department of Biostatistics, Epidemiology and Occupational Health (Burstein), McGill University, Montréal, Que.; Faculty of Nursing (Berube), Université Laval, Québec, Que.; Department of Critical Care Medicine (Stelfox), University of Calgary, Calgary, Alta.; Faculty of Medicine and Dentistry (Stelfox), University of Alberta, Edmonton, Alta.; Division of Emergency Medicine (Beno), Hospital for Sick Children, University of Toronto, Toronto, Ont.; Division of Emergency Medicine (Labrosse), Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montréal, Que.; George & Fay Yee Centre for Health Care Innovation (Klassen), Children's Hospital Research Institute of Manitoba, Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Man.; Division of General Surgery (Haas), Sunnybrook Health Sciences Centre; Interdepartmental Division of Critical Care (Tillmann), University of Toronto; Division of Respirology and Critical Care Medicine (Tillmann), Department of Medicine, University Health Network; Tory Trauma Program (Tillmann), Sunnybrook Health Sciences Centre, Toronto, Ont.; Trauma Program (Priestap), London Health Sciences Centre; Department of Surgery (Merritt), Western University, London, Ont.
在加拿大,77.6%的严重创伤儿童进入了儿童创伤中心. 然而,四分之一的儿童没有获得最佳的伤害护理,这表明需要改进创伤系统.
科学领域:
- 儿科创伤护理 儿童创伤护理
- 公共卫生研究 公共卫生研究
- 伤害流行病学 伤害流行病学
背景情况:
- 患有严重创伤的儿童从专门的儿科创伤中心中受益.
- 在加拿大,关于儿童创伤中心访问的基于人口的数据有限.
- 对儿科创伤患者的最佳伤害护理至关重要.
研究的目的:
- 估计加拿大儿童创伤中心的重创儿童比例.
- 为了比较加拿大各省的儿科创伤中心的准入.
- 确定获得专门的儿科创伤护理的差异.
主要方法:
- 从2016年至2021年对患有重大创伤 (伤害严重程度评分>12) 的儿童 (<16岁) 进行基于人口的队列研究.
- 分析包括9个加拿大省份 (不包括北克省).
- 强大的波桑回归用于估计儿童创伤中心访问的调整发病率,并对年龄和受伤严重程度进行子组分析.
主要成果:
- 在3007名遭受重大创伤的儿童中,77.6%的儿童进入了儿科创伤中心 (直接运输或转移).
- 根据年龄和受伤严重程度的不同,儿童的接触率有所不同,年龄较小的儿童和严重受伤的儿童的接触率更高.
- 与安大略省相比,在访问方面观察到显著的省际差异,不列颠哥伦比亚省,大西洋省和萨斯喀彻温省的访问率较低.
结论:
- 在加拿大9个省份,大约22.4%的严重创伤儿童没有在儿科创伤中心接受治疗.
- 在获得医疗服务方面,各省各地区存在显著差异,这突显了儿科创伤护理的不平等现象.
- 加拿大创伤系统需要改进,以确保所有儿童均可获得最佳伤害护理.
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