台灣兒童燒燙傷的特性及趨勢

Incidence and trend of child burn injury in Taiwan

目標：探討台灣兒童燒燙傷發生率、變化趨勢及住院相關因素。方法：本研究使用台灣全民健康保險研究資料庫2000年、2005年及2010年百萬人歸人檔資料；依人口學特性呈現0-18歲兒童燒燙傷發生率，以卜瓦松迴歸檢定燒燙傷門急診、住院發生率趨勢，以邏輯斯迴歸探討兒童燒燙傷住院的相關因素。結果：2000年、2005年及2010年兒童門急診燒燙傷整體發生率分別是0.70%、0.74%、0.70%。門急診部分三個時段依性別、年齡標準化之總體發生率，每十萬人口分別是699.68、779.63及737.59人，整體發生率有上升趨勢，但未達統計顯著；於4-6歲兒童(806.71, 1025.62, 970.60)則有顯著上升趨勢；住院部分標準化之發生率，每十萬人口，兒童整體分別是38.03、34.07及26.04人，女童整體分別是38.37、35.65及23.41人，1-3歲兒童分別是169.64、129.49及83.83人，均有顯著下降趨勢。13-18歲兒童燒燙傷住院風險較低，南區兒童及急診就醫兒童住院風險較高。結論：兒童燒燙傷門急診發生率整體有上升趨勢，但未達統計顯著，4-6歲兒童則有顯著上升趨勢；兒童整體、女童整體及1-3歲兒童住院發生率均顯著下降，顯示兒童燒燙傷嚴重度下降。

Objectives: This study investigated the incidence and trends of child burn injuries and factors associated with hospitalization due to burn injuries in 2000, 2005, and 2010. Methods: Data were gathered from the Longitudinal Health Insurance Database 2000, 2005, and 2010 subsets from the Taiwan National Health Insurance Research Database. All patients aged 0–18 years with claim records containing burn injuries were enrolled to analyze the incidence of these injuries according to patient characteristics. Poisson regression was applied to test the linear trend of incidence. Logistic regression was adopted to identify factors associated with hospitalization for burn injuries. Results: The overall incidences of child burn injuries in 2000, 2005, and 2010 were 0.70%, 0.74%, and 0.70%, respectively. The corresponding overall standardized incidences of child burn injuries were 699.68, 779.63, and 737.59 per 100,000 population. The trend of increase was a statistically nonsignificant. The corresponding figures for those aged 4–6 years were 806.71, 1025.62, and 970.60 per 100,000 population, with a significant trend of increase. The overall standardized incidence of hospitalization for child burn injuries for 2000, 2005, and 2010 were 38.03, 34.07, and 26.04 per 100,000 population, respectively. There was a statistically significant trend of decrease. The corresponding figures for girls were 38.37, 35.65, 23.41 per 100,000 population, and those for patients aged 1–3 years were169.64, 129.49, 83.83 per 100,000 population, with statistically significant decreasing trends in both groups. Patients who were living in southern Taiwan, who visited the emergency department, and who were aged 13–18 years had lower risks of hospitalization compared with other groups. Conclusions: The trend of increase in the overall incidence of child burn injuries was nonsignificant, whereas that for children aged 4–6 years was significant. The trends of decrease in the incidence of burn injury hospitalization for all children, girls, and patients aged 1–3 years were significant, which may imply that the severity of burn injury decreased.