1993-2020年西班牙道路交通事故驾驶员死亡和住院风险的演变:一项年龄期队列分析。

IF 2.4 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Luis Miguel Martín-delosReyes, Virginia Martínez-Ruiz, Mario Rivera-Izquierdo, Eladio Jiménez-Mejías, Nicolás Francisco Fernández Martínez, Pablo Lardelli-Claret
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引用次数: 0

摘要

背景:理解道路碰撞严重程度的时间变化的先决条件是对这一现象进行公正的描述。本研究的目的是估计年龄、时期和队列与严重程度的独立关联趋势,包括死亡风险(RD)和24小时内死亡或住院风险(RDH),涉及西班牙1993年至2020年道路交通事故伤亡的乘用车司机。方法:研究人群包括2,453,911名年龄在18至98岁之间的乘用车司机,这些司机涉及交通总局的登记册。纳入具有足够连续性的碰撞和驾驶员相关变量,建立RD和RDH作为研究结果。使用多变量泊松回归和多变量年龄-时期-队列固有估计模型分析两种结果的时间趋势。对单次碰撞子集进行了额外的敏感性分析。结果:严重性估计显示了不同策略的一些差异。APC模型发现:(1)年龄对严重程度的影响呈j型模式,(2)2001 - 2004年和2013-2016年严重程度呈下降趋势,(3)RD和RDH均存在出生队列效应。特别是1952-1958年队列的风险最高(RD = 1.17;95%CI = 1.11 ~ 1.24, RDH = 1.16;95%CI = 1.13-1.19),随后在后续队列中呈下降趋势。将分析限制到单次碰撞产生了类似的结果,除了年龄效应(严重程度随着年龄的增长而增加)。此外,性别差异也被观察到——女性与严重程度呈负相关,尤其是对于RD。结论:RD和RDH在21世纪的前十年有所下降,但从2013年开始趋于稳定。这项研究的证据支持出生队列与道路交通事故严重程度有关,与年龄和时期无关。这种群体效应可能至少部分是由于一般教育和道路安全教育的改善。需要进一步的研究来阐明我们的发现的原因,并确定造成性别差异的因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evolution of the risk of death and hospitalisation in drivers involved in road crashes in spain, 1993-2020: an age-period-cohort analysis.

Background: A prerequisite for understanding temporal changes in road crash severity is an unbiased description of this phenomenon. The aim of this study was to estimate the independent association trends of age, period and cohort with severity, encompassing the risk of death (RD) and the risk of death or hospitalisation (RDH) within 24 h, for drivers of passenger cars involved in road crashes with casualties in Spain from 1993 to 2020.

Methods: The study population comprised 2,453,911 drivers of passenger cars aged 18 to 98 years involved in road crashes included in the registers of the General Directorate of Traffic. Crash- and driver-related variables with sufficient continuity over time were included, establishing RD and RDH as study outcomes. Temporal trends of both outcomes were analysed using multivariable Poisson regression and multivariable age-period-cohort intrinsic estimator models. An additional sensitivity analysis was performed for the subset of single crashes.

Results: Severity estimates showed some variation across strategies. The APC model identified: (1) a J-shaped pattern for the effect of age on severity, (2) a decline in severity between 2001 and 2004 and 2013-2016, and (3) a birth cohort effect for both RD and RDH. In particular, the 1952-1958 cohort had the highest risk (RD = 1.17; 95%CI = 1.11-1.24 and RDH = 1.16; 95%CI = 1.13-1.19), followed by a decreasing trend in subsequent cohorts. Restricting the analysis to single crashes yielded similar results, with the exception of the age effect (severity increased with age). Furthermore, sex differences were observed-female sex was inversely associated with severity, especially for RD.

Conclusions: RD and RDH decreased during the first decade of the 21st century, but seemed to stabilise from 2013 onwards. Evidence from this study support that birth cohort is associated with road crash severity, independent of age and period. This cohort effect might be due, at least partially, to improvements in general and road safety education. Further studies are needed to elucidate the causes of our findings and to identify factors accounting for sex differences.

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来源期刊
Injury Epidemiology
Injury Epidemiology Medicine-Medicine (all)
CiteScore
3.20
自引率
4.50%
发文量
34
审稿时长
13 weeks
期刊介绍: Injury Epidemiology is dedicated to advancing the scientific foundation for injury prevention and control through timely publication and dissemination of peer-reviewed research. Injury Epidemiology aims to be the premier venue for communicating epidemiologic studies of unintentional and intentional injuries, including, but not limited to, morbidity and mortality from motor vehicle crashes, drug overdose/poisoning, falls, drowning, fires/burns, iatrogenic injury, suicide, homicide, assaults, and abuse. We welcome investigations designed to understand the magnitude, distribution, determinants, causes, prevention, diagnosis, treatment, prognosis, and outcomes of injuries in specific population groups, geographic regions, and environmental settings (e.g., home, workplace, transport, recreation, sports, and urban/rural). Injury Epidemiology has a special focus on studies generating objective and practical knowledge that can be translated into interventions to reduce injury morbidity and mortality on a population level. Priority consideration will be given to manuscripts that feature contemporary theories and concepts, innovative methods, and novel techniques as applied to injury surveillance, risk assessment, development and implementation of effective interventions, and program and policy evaluation.
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