Danfeng Yuan

The epidemiology of civilian inpatients’ burns in Chinese military hospitals, 2001–2007

BACKGROUND In China, large sample research directed at the epidemiology of burns is still scarce. Given the leading position of Chinese military hospitals in domestic clinical practice pertaining to burns, a look into their cases would help shed light on the incidence and hospital care of burns in China today. METHODS Data were collected from information systems of all the Chinese military hospitals, for the years 2001-2007 inclusive. Retrospective analyses on the epidemiology characteristics of burns from those in patients admitted to all the Chinese military hospitals within this period were conducted. RESULTS A total of 172,256 cases were studied, with a total number of 1384 fatalities, and the median length of hospital stay (LOS) 11.00 days (interquartile range 6.00-19.00 days). Rate of burn incidence remained high in May, June, July and August. Children of preschool aged and adults in the labor force were at the highest risk of injury. Scalds constituted the majority of injuries (80.5%). Multiple body site burns are the most commonly seen category (31.98%) in terms of injured body region distribution. In fire-related burns, major burns (TBSA>30%) represented a significant proportion. Males with TBSA>30%, fire-related burns resulted in the greatest number of fatalities. Gender, age, site of injury, burn size and outcome are all correlated with the length of hospitalization. CONCLUSION Although this paper cannot provide information on population estimates of burns due to the absence of data on burns attending civilian hospitals, it finds that the epidemiology of burns in China shows distinct characteristics compared with previous studies of other country and regions, including that of other developing or low and middle-income countries (LMICs), irrespective of Chinas inclusion in that group.

Pediatric burns in military hospitals of China from 2001 to 2007: A retrospective study

BACKGROUND Childhood burns are a global health problem. To date, no epidemiological study with a large sample size of hospitalized pediatric burn patients from the Chinese mainland has been conducted. This study retrospectively analyzed pediatric burn cases to identify the characteristics of pediatric burns and their risk factors in China. METHODS Data for pediatric burn inpatients younger than 14 years were retrieved from the Chinese Trauma Databank (CTDB). The epidemiological characteristics of pediatric burns and risk factors for mortality were analyzed. RESULTS A total of 61,068 cases were included in the study. Children under 3 years old were at the highest risk of injury. Scalds were the commonest burns (87.59%). Flame burns occurred more in winter, and electrical burns occurred mainly in July and August. Age, etiology, depth of injury, total body surface area (TBSA), site of injury, and outcome were correlated with length of hospital stay. Risk factors for pediatric burn mortality included being male, having third degree burns, ≥30% TBSA, and having multi-site burns. CONCLUSION The results showed the epidemiological characteristics of pediatric burns in China, which differ from those reported for other countries and regions. These characteristics can be used to develop measures to prevent pediatric burns.

Chinese traffic fatalities and injuries in police reports, hospital records, and in-depth records from one city

Objectives: Claims of sharp reductions in Chinese traffic casualties after 2002 based on police-reported data have been questioned in the literature. The objective of this study is to determine whether a decline in casualties occurred and to better understand the police data. Methods: The first of 2 unrelated studies analyzed data from 210 military hospitals throughout China providing records for inpatients injured in traffic accidents (2001–2007). The second compared in-depth crash records (2000–2006) from one city to officially released data. Results: Hospital data showed that casualties increased from 2002 to 2007. The city investigation showed consistently far more fatalities and injuries in the in-depth data than officially released. For example, in-depth data showed 1,720 fatalities. Only 557 of these were reported officially (data loss = 68%). Disaggregating into 3 regions showed a data loss of 41% in urban areas, 63% in rural areas, and 90% in rural–urban fringe zones. For injuries, data losses were even greater. Conclusions: Traffic fatalities and injuries did not decrease from 2002 to 2006. The in-depth city data contained 3 times as many fatalities and 5 times as many injuries as reported by police. Reasons why this occurred and suggestions to improve data collection and reduce casualties are given.

Epidemiology and management of splenic injury: An analysis of a Chinese military registry

In China, there have been few meta-analyses of the epidemiology and management of splenic injury. Due to the success of Chinese military hospitals in the domestic treatment of splenic injury, the present study conducted a systematic review of such cases, identifying a high occurrence rate of splenic trauma, as well as a number of strategies of managing splenic injury in China. Data were collected from sixteen Chinese military hospitals between July 2000 and March 2009, and retrospectively reviewed. It was observed that between July 2000 and March 2009 a total of 7,807 patients (84.32% male and 15.68% female) with splenic injury were admitted to hospital. The mean duration of hospital stay was 17.9±18.6 days and the gender distribution of splenic injury over the successive years did not differ significantly (P>0.05, c=0.034). However, there was a significant difference in the gender distribution of splenic injury patients in different months (P<0.05, c=0.063). In addition, admission numbers for splenic injury were highest in September, October and November. It was also found that splenic injury may occur at all ages, though patients of working age (20-50 years), which comprises 85.59% of patients, the highest proportion of all recorded cases. Associations between mortality rate and each management strategy were as follows: Operative management, 0.11% and non-operative management, 0.15%. Furthermore, multivariate analysis demonstrated that transfusion, New Injury Severity Score and management strategies were all correlated with mortality rate. Thus, despite a lack of data for inpatients from civilian hospitals, the present study has, in part, identified the epidemiology and management strategies of splenic injury in China. These findings may supplement those from previous analyses of splenic injury in other countries and regions.

Analysis of road traffic injuries by road user type in Chongqing, China

Objective Road traffic injuries are caused by many different factors. This study aimed to analyse road user type information in Chongqing, China in order to develop prevention strategies as well as treatment protocols. Methods Data from road traffic crashes from Chongqing, China were collected prospectively over a seven-year period (2000 to 2006). The data included the road user type, description of the injury, mortality and Abbreviated Injury Scale. Prevalence and cross-tabulations were included in the analysis. Results Forty-nine percent of deaths were pedestrians and 27.84% of deaths were drivers. Head injuries (26.49%) of pedestrians were higher than those of drivers and passengers. Thoracic injuries (22.78%) and spinal injuries (4.44%) of injured passengers were higher than those of drivers and pedestrians. There were significant differences in road user types in both injury severity and injury regions. Conclusions The distribution of road traffic injuries in Chongqing, China is different from that in developed countries and other developing countries. In managing traffic injuries, it is necessary to examine other regions besides the head according to the road user type, such as facial injuries of drivers and passengers, and chest and spinal injuries of passengers.

Research and analysis on the uncertainty data cloud of Chinese road traffic injury

Background In recent 30 years, Chinese road traffic injuries increased dramatically with the rapid development of traffic and transportation. Domestic and foreign researches mostly hold certain views and arguments on the data of Chinese road traffic injuries. Objectives To analyse the differences and causes between Chinese official data of road traffic injuries and the reality to promote the control on Chinese road traffic injuries through the surveys on road traffic accidents and injuries. Methods (1) Sampling survey was made on the original files of all road traffic accidents of three traffic police management sub-groups of a city in 2000–2006 to investigate accidents, casualties, time of death, etc as well as the data of accidents and deaths reported and released every year, etc and analyse whether there are significant differences between the data of original accident files and the data released; (2) the data and information about the inpatients due to wounds and traffic injuries from 210 Chinese hospitals in 2001–2007 were chosen to analyse the casualties and trends of traffic injured persons hospitalised. Results The regional road traffic accidents and injuries and the number of inpatients with traffic injuries to be treated by hospitals tend to increase slowly as a whole. The results of sampling survey shows that the actual number of deaths due to traffic accidents of a city between 2000–2006 is 3.09 times of the released one, resulting in a data loss rate of 67.62%, while the data loss rate in the rural-urban fringe zone is even up to 89.93%; the number of injured persons is 5.59 times of the one released by public security department, resulting in a data loss rate of 82.10%, while the data loss rate in rural-urban fringe zone is even up to 95.73%. 13.21% of these deaths due to traffic accidents have ever been injured for 7 days before death; 26.71% of the deaths due to traffic accidents after being hospitalised have ever been injured for 7 days before death. Conclusions The results of the research suggest that, the rapid and continuous increase of Chinese road traffic injuries was controlled effectively between 2000–2007 as we researched, but there was no significant drop either; the numbers of deaths and injured persons due to traffic accidents in the region surveyed are above three times and five times of those released by police system respectively, the reasons for which involves the statistical standards and methods of Chinese traffic accidents and casualties and the management mechanism of police system, etc. The reasons were discussed and some suggestions were given in this paper.