1991-1992年高雄市頭部外傷之發生率與死亡率研究

The Incidence and Mortality Rates of Head Injuries in Kaohsiung City, Taiwan (1991-1992)

陳建立(Chien-Li Chen) ； 洪純隆(Shen-Long Howng)

《The Kaohsiung Journal of Medical Sciences》 11卷9期 (1995/09) Pp. 537-545

https://doi.org/10.6452/KJMS.199509.0537

摘要

事故傷害一直是我國十大死因之一，在意外事故及不良影響死因中，有一半以上是頭部外傷所引起的。其高死亡率與後遺症造成國家人力資源的損失。頭部外傷流行病學的調查更顯得重要與迫切。
從1991年7月至1992年6月，收集高雄市10家及高雄縣1家醫院急診處頭部外傷病人及檢視高雄市警察局車禍現場測繪資料，共3,729病例。高雄市每年每十萬人口年齡調整發生率為267人（男性359/100,000；女性170/100,000），男女發生率比為2.1。發生年齡以70歲以上老人人口群最高，但以性別年齡別觀察之，則以男性20-29歲年輕人為最危險族群，發生率為585/100,000。男性比女性在嚴重頭部外傷有較高的比率，而70歲以上老人，也比29歲以下各年齡群較嚴重。受傷原因有七成是交通事故所致，其次是跌落。在交通事故中，亦有七成涉及機車的使用。估計此地區因機動車輛引起的頭部外傷，每年每十萬人口年齡調整發生率為188人（男性24/100,000；女性125/100,000），各年齡群男性皆高於女性。交通事故中使用安全帽（帶）的比率很低，只有3.7%；但受傷原因與喝酒有關者，高達32.6％。估計高雄市區頭部外傷的死亡率為26/100,000，最高死亡率為老人人口群達98/100,000。病例致死率為9.8％；以60－69歲及70歲以上老人最高，分別為24％與20％。
從本研究結果，可發現高雄市頭部外傷的嚴重程度，且發生原因與機車的使用密切相關。今後加強外傷的防治工作，應為衛生政策的重點之一。

並列摘要

Head injury is a leading cause of mortality, morbidity and disability in Taiwan. This study was based on data form the investigation of head injuries in Kaohsiung City, Taiwan, during the period July 1, 1991 to June 30, 1992. The 3729 cases identified represented an overall incidence rate of 267/100,000 --- 359/100,000 for males and 170/100,000 for females. The highest incidence rate was seen in the elderly group, followed by the 20-29 year age group. The population with the highest risk was males aged 20-29 years, with an incidence rate of 585/100,000. Seventy percent of all cases were from motor vehicle-related causes, followed by falls (15.3 %) and assaults (8.7%). Of the motor vehicle-related head injuries, 70.9% resulted from motorcycle accidents. The incidence rate of motor vehicle head injuries was 188/100,000 --- 248/100,000 for males and 125/100,000 for females. At all ages motor vehicle head injuries were higher in males than in females. Mortality rates from head injuries were 26/100,000 --- 38/100,000 for males and 14/100,000 for females. The overall case fatality rate was 10%, and 61% of all deaths occurred prior to hospitalization. The case fatality rate was highest in older age groups. Initial clinical assessment was recorded using the Glasgow Coma Scale. Eighty-one percent of the cases were considered mild, and 19% moderate to sever in degree including 367 deaths. The males and the aged not only had a higher incidence of head injuries but also had a higher proportion of more severe ones. These findings indicate that head injuries are nonrandom and likely to occur in certain types of individuals under certain circumstances. Results of this study can be used as a reference for public health policies.

並列關鍵字

incidence ； mortality ； headnjuries