中国5~<15岁儿童意外跌落与意外中毒和烧烫伤死亡轨迹模型分析  

Trajectory of mortality due to falls,poisonings and burns and scalds among children aged 5-<15 in China

作　　者：潘晓樱 王琦琦[2] 李俊琦 于石成[2] 吴息凤 PAN Xiaoying;WANG Qiqi;LI Junqi;YU Shicheng;WU Xifeng(Department of Big Data in Health Science,School of Public Health,Zhejiang University,Hangzhou,Zhejiang 310058,China;不详)

机构地区：[1]浙江大学公共卫生学院大数据健康科学系,浙江杭州310058 [2]中国疾病预防控制中心流行病学办公室 [3]浙江大学医学院附属第二医院临床大数据与统计中心 [4]浙江省智能预防医学重点实验室

出　　处：《中国预防医学杂志》2024年第3期307-312,共6页Chinese Preventive Medicine

基　　金：国家社会科学基金重大项目(20&ZD120);中国疾病预防控制中心青年科研基金(2022A301)。

摘　　要：目的 分析2005-2021年中国5~<15岁儿童意外跌落、意外中毒和烧烫伤伤害死亡率的轨迹和变化趋势。方法 基于2005-2021年中国死因监测数据集,采用Joinpoint模型分析中国5~<15岁儿童意外跌落、意外中毒和烧烫伤的整体死亡率变化趋势,计算平均年度变化百分比(average annual percent change,AAPC);将数据按区域、城乡、性别和年龄分层后,应用SAS 9.4统计软件中的Proc traj程序拟合5~<15岁儿童意外跌落、意外中毒和烧烫伤死亡率轨迹模型。结果 2005-2021年中国5~<15岁儿童意外跌落死亡率总体呈上升趋势(AAPC=0.71%,P=0.235);意外中毒和烧烫伤呈下降趋势(AAPC=-2.96%、-2.50%,P=0.014、0.081)。女性意外跌落死亡率呈上升趋势(AAPC=3.11%);10~<15岁儿童意外跌落呈上升趋势(AAPC=3.94%)。轨迹模型行分析结果显示:意外跌落轨迹模型根据拟合结果分为3组,组1呈现下降趋势,集中在5~<15岁西部男孩;组2呈上升趋势但差异无统计学意义;组3呈上升趋势,包含除5~<10岁东部城市男孩外的东部儿童、中部女孩和10~<15岁西部城市女孩。意外中毒轨迹模型分为两组,组1先升后降(P<0.01),包含东部所有儿童、除10~<15岁中部城市女孩外的中部城市儿童,以及5~<10岁西部城市男孩和5~<10岁中部农村女孩;组2线性下降(P=0.013),包含除5~<10岁西部城市男孩外的西部儿童、除5~<10岁中部农村女孩外的农村中部儿童,以及10~<15岁中部城市女孩。在烧烫伤轨迹模型中,组1上升趋势随年份逐渐升高(P=0.005),包含5~<10岁西部城市男孩和10~<15东中西部城市女孩,组2上升较缓(P=0.587)。结论 在意外跌落Joinpoit模型中,女性和10~<15岁儿童死亡率存在上升趋势,是公共卫生防控的重点人群和年龄组。意外跌落轨迹模型中组别3和烧烫伤轨迹模型中组别1的死亡率呈指数上升趋势,应寻找原因,加强防控。Objective To analyze the trends and changes of mortality due to falls,poisonings and burns and scales among children aged 5-<15 in China from 2005 to 2021.Methods The death data of falls,poisonings and burns and scalds among children aged 5-<15 years from 2005 to 2021 were extracted from the China Cause of Death Reporting System,and analyzed using Joinpoint model to investigate the mortality trends,and to estimate the average annual percent change(AAPC).After stratification by region,rurality,gender,and age group,the data were processed using Proc Traj in SAS 9.4 statistical software to fit the mortality trajectory model of falls,poisonings,and burns and scalds in children aged 5-<15 years.Results The results of Joinpoint model analysis showed an increasing trend of the mortality due to accidental fall among children aged 5-<15 years in China from 2005 to 2021(AAPC=0.71%,P=0.235),decreasing trends of mortality due to accidental poisoning(AAPC=−2.96%,P=0.014)and mortality due to burns and scalds(AAPC=−2.50%,P=0.081).The accidental fall mortality in girls showed an increasing trend(AAPC=3.11%)with statistically significant difference.The mortality due to accidental fall in children aged 10-<15 years showed an increasing trend(AAPC=3.94%)with statistically significant difference.The analysis results of trajectory model showed that the accidental fall trajectory was divided into three groups according to the fitting results,in which group 1 showed a downward trend(P<0.01),mainly in boys aged 5-<15 years in western region,group 2 showed an increasing trend with no statistically significant difference,and group 3 showed an increasing trend(P<0.01),including children in eastern region(except boys of 5-<10 years in cities),girls in central region and girls aged 10-<15 years in western region.The accidental poisoning trajectory model was divided into two groups,in which group 1 increased first and then decreased(P<0.01),including all children in eastern China,children in central urban China except girls aged 10-<15 ye

关 键 词：意外中毒 意外跌落 烧烫伤 死亡率 轨迹模型 

分 类 号：R197[医药卫生—卫生事业管理]