请选择 进入手机版 | 继续访问电脑版
设为首页收藏本站

老西部英语

 找回密码
 立即注册

只需一步,快速开始

[大学生论坛]:[大学生论坛]:儿童和青少年自残后的发病率,临床管理和死亡风险:初级护理队列研究

14

主题

14

资源

68

积分

注册会员

Rank: 2

积分
68
灯光下的小人物 发表于 2017-12-30 21:39:58 | 显示全部楼层 |阅读模式
Incidence, clinical management, and mortalityrisk following self harm among children and adolescents: cohort study inprimary care儿童和青少年自残后的发病率,临床管理和死亡风险:初级护理队列研究BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4351 (Published 18 October 2017)Cite this as: BMJ 2017;359:j4351

Abstract摘要:
Objectives To examine temporal trends in sex and age specificincidence of self harm in children and adolescents, clinical managementpatterns, and risk of cause specific mortality following an index self harmepisode at a young age.
目标:研究儿童和青少年自我伤害的性别和年龄特定发生率的时间趋势,临床管理模式以及青少年指数自我伤害发生后特定病因死亡率的风险。
Design Population based cohort study.
研究设计:基于人群的队列研究
Setting UK Clinical Practice Research Datalink—electronic healthrecords from 674 general practices, with practice level deprivation measuredecologically using the index of multiple deprivation. Patients from eligibleEnglish practices were linked to hospital episode statistics (HES) and Officefor National Statistics (ONS) mortality records.
背景:英国临床实践研究数据链—来自674个一般实践的电子健康记录,使用多次剥夺指数在生态学上测量实践水平的剥夺。符合条件的英语练习的患者与医院事件统计(HES)和国家统计局(ONS)死亡率记录相关联。
Participants For the descriptive analytical phases we examined datapertaining to 16 912 patients aged 10-19 who harmed themselves during 2001-14.For analysis of cause specific mortality following self harm, 8638 patientseligible for HES and ONS linkage were matched by age, sex, and general practicewith up to 20 unaffected children and adolescents (n=170 274).
参与主体:在描述性分析阶段,我们检查了2001年至2004年期间16 912名年龄在10-19岁的患者的数据。 为了分析自残后特定死亡原因,共有8638名符合HES和ONS联系的患者,根据年龄,性别和一般实践与多达20名未受影响的儿童和青少年(n = 170 274)进行匹配。
Main outcome measures In the first phase, temporal trends in sex and agespecific annual incidence were examined. In the second phase, clinicalmanagement was assessed according to the likelihood of referral to mentalhealth services and psychotropic drug prescribing. In the third phase, relativerisks of all cause mortality, unnatural death (including suicide and accidentaldeath), and fatal acute alcohol or drug poisoning were estimated as hazardratios derived from stratified Cox proportional hazards models for the selfharm cohort versus the matched unaffected comparison cohort.
主要观察指标:在第一阶段,对性别和年龄特定年发病率的时间趋势进行了检查。 在第二阶段,根据转介心理健康服务和精神药物处方的可能性对临床管理进行评估。 在第三阶段,全死因,非自然死亡(包括自杀和意外死亡)以及致命的急性酒精中毒或药物中毒的相对风险被估计为来自分层Cox风险比例模型的风险比,这个模型比较的是自残队列与匹配的未受影响的比较队列。
Results The annual incidence of self harm was observed to increasein girls (37.4 per 10 000) compared with boys (12.3 per 10 000), and a sharp68% increase occurred among girls aged 13-16, from 45.9 per 10 000 in 2011 to77.0 per 10 000 in 2014. Referrals within 12 months of the index self harmepisode were 23% less likely for young patients registered at the most sociallydeprived practices, even though incidences were considerably higher in these localities.Children and adolescents who harmed themselves were approximately nine timesmore likely to die unnaturally during follow-up, with especially noticeableincreases in risks of suicide (deprivation adjusted hazard ratio 17.5, 95%confidence interval 7.6 to 40.5) and fatal acute alcohol or drug poisoning(34.3, 10.2 to 115.7).
结果:女童每年发生自我伤害的比例(每万人37.4)与男童(每万人12.3)相比有所增加,13-16岁女童发生率从2011年的45.9%上升至68% 77.0 / 10万。尽管在这些地区发病率较高,但在指数自我伤害发生后的12个月内转诊的人数比在社会最贫困的年轻人中的转诊率低23%。 伤害自己的儿童和青少年在随访期间不自然地死亡的可能性大约是其自杀死亡的9倍,尤其是自杀风险增加(剥夺调整风险比为17.5,95%置信区间为7.6到40.5)以及致命的急性酒精或药物中毒 (34.3,10.2至115.7)。
Conclusions Gaining a better understanding of the mechanismsresponsible for the recent apparent increase in the incidence of self harmamong early-mid teenage girls, and coordinated initiatives to tackle healthinequalities in the provision of services to distressed children andadolescents, represent urgent priorities for multiple public agencies.
进一步了解造成近期明显增加的早中期少女自杀事件的机制,并采取协调一致的行动,解决向贫困儿童和青少年提供服务方面的健康不平等问题,这是众多公共机构的紧急优先事项。
http://www.bmj.com/content/359/bmj.j4351

友荐云推荐
评论

使用道具 举报


QQ|关于我们|联系我们|网络条款|建议反馈|小黑屋|老西部英语 ( 版权所有 粤ICP备11103350号  

GMT+8, 2018-9-18 23:05 , Processed in 0.173034 second(s), 31 queries .

Powered by Discuz! X3

© 2001-2013 Comsenz Inc.