| Objective To reflect the whole injury profile of residents in Cixi utilizing data from different resources, portray a symbolic injury pyramid representative of Cixi residents, probe into the approach used in this research and explore the estimation methods for the whole injury profile taken Cixi as an example.Methods Injury data during May 1st and Oct 31st from four different data resources were integrated to explore the estimation methods for the whole injury profile of residents in Cixi. First, the injury mortality data were extracted from Death Surveillance System according to the ICD-10 codes of external causes of injury and poisoning. Second, the injury hospitalization data were provided by the medical records data base for the hospitals which had this kinds of data base on which the information were reliable, or by the entry data base derived from original medical records which were all previously photographed into pictures at hospitals for conveniences with clinical diagnosis or external causes of injury and poisoning being the criterion for injury cases. Then all the hospitalization data were combined and analyzed. Third, the injury information of ER visits was gained in sentinel hospitals of National Injury Surveillance System (NISS) which submitted monitoring cards as routine. In other hospitals, the number of total ER visits was reported and the proportion of injury visits was obtained by counting injury cases on ER registry. The whole injury information of ER visits was analyzed through data estimation. Last, a household survey was conducted for 2000 residents in 5 communities with two-stage sampling to describe the injury in community. Injury pyramids of Cixi residents were portrayed with injury mortality data extracted from Death Surveillance System and results from the population-based survey during May 1st and Oct 31st, which were also taken as gold criterion to assess the accuracy of injury hospitalization data from all hospitals in Cixi and injury information of ER visits derived from counting injury cases on ER registry in the role of injury pyramids construction. Direct method was used to standardize population injury rate. Comparison of rates and proportions of two groups was performed by Chi-square test.Results During May 1st and Oct 31st, there were 270 fatalities,4108 hospitalizations and 113034 ER visits caused by injury in Cixi.241 injury cases were discovered in population-based survey. Fatality rate and hospitalization rate of injury were 26.14 per 100000 and 39.74 per 10000.Injury rate of ER visits was 10.94%. Standardize population injury rate was 11.43%. Incidence rate of untreated injuries of population was 5.50% with 95% C1 (4.51%,6.48%). The injury pyramid of Cixi residents was that every death was accompanied by 24 hospitalizations, 210 ER visits and 210 untreated injuries. Hospitalization number from all hospitals matched the corresponding result of population-based survey with it being in the 95% C1 of the number of hospitalization cases discovered in population. Injury ER visit number of population was outnumbered by the estimated ER visits of injury in all hospitals. The cause ranks of injuries coming from different data resources were varied. The death causes of the injury cases from the Death Surveillance System were mainly road traffic injuries (37.41%), unintentional falls (23.33%), drowning (12.96%), suicide (7.78%) and electric shock (2.59%). Besides 94 hospitalizations with unknown injury causes,4014 hospitalizations were mostly accounted by unintentional falls (31.64%), road traffic injuries (25.24%), machine accidents (11.19%), assault (7.40%) and crash or smash injuries (3.96%). The injury cases from NISS were mainly attributable to unintentional falls (32.11%), road traffic injuries (24.48%), animal bites (10.28%), blunt injuries (9.62%) and sharp force injuries (8.53%). Unintentional falls (34.85%), sharp force injuries (24.07%), road traffic injuries (9.13%), blunt injuries (9.13%) and burns (7.05%) were the main injury types occurred in community. For hospitals whose grade was no less than second class in Cixi, injury hospitalizations accounted for 96.42%of the total cases and hospitalizations of each age group and gender accounted for over 90% of the total corresponding cases. No statistic differences of injury cause ranks and of the distribution of hospitalizations in 6 months were observed between hospitals whose grade was no less than second class and all hospitals.Conclusion (1) Injury was of great importance as a public health issue in Cixi. Development of preventive strategy and allocation of health resources should be based on injury characteristics and pyramids of Cixi residents. (2) Injury resulting in hospitalization in population was represented by injury hospitalization data from all hospitals in Cixi to some extent. The status of major injury in a small area could be acquainted by collecting and analyzing mortality data from Death Surveillance System and hospitalization data from all hospitals. For a provincial or national area which was larger, it was recommended to launch a large-scale population survey and obtain the proportional relations among the corresponding numbers of injury cases of each level of injury pyramid. And then the proportional relations could be utilized to gain the whole profile of injury based on the injury data from Death Surveillance System and all hospitals. (3) Accessibility and availability of injury data from Death Surveillance System, medical records, NISS and population-based survey were demonstrated by the integrated utilization approach to explore the estimation methods for the whole injury profile of Cixi residents. (4) It was suggested to extract data from hospitals whose grade was no less than second class conveniently to gain representative information for injury hospitalization. (5) It was suggested medical record data base be improved to export IDC-10 codes of external causes of injury. |
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