A population-based study of injuries in inner-city women.

Although injuries are the number one cause of death for women under age 45 years in the United States, very little is known about nonfatal injuries to women, particularly those from urban, black communities. The Philadelphia Injury Prevention Program is a surveillance system of fatal and nonfatal injuries in a poor, urban, black community in western Philadelphia, Pennsylvania. Nearly 10% of the estimated population of 31,032 women aged 15 years and older suffered an injury resulting in an emergency room visit or death during the 1-year study period from March 1, 1987 through February 29, 1988. The major causes of injury were falls (25.1 per 1,000 women), violence (20.8 per 1,000 women), and motor vehicle incidents (16.8 per 1,000 women). Violence was the leading cause of injury for women aged 15-44 years and the most common cause of injuries among women with two or more injuries during the 1-year period. Injury rates were highest for women aged 25-34 years (157.1 per 1,000 women); nearly 16% of the population in this age group suffered an injury resulting in an emergency room visit or death during the 1-year study period. Rates declined with advancing age for each injury type except for falls; which were most common in young women aged 25-34 years (28.4 per 1,000 women) and in the aged 65 years and older (29.0 per 1,000 women). We conclude that in his population, injuries to young women appear to be a major public health problem. More work is needed to understand the nature of injuries occurring to young women in urban communities.     

Incidence, causes and severity of injuries in Aquitaine, France: a community-based study of hospital admissions and deaths.

This paper reports the results of a study of injuries conducted during a one-year period within a defined geographic population of 2.7 million persons (Aquitaine, France). Cases were defined as unintentional or intentional injuries, either resulting in immediate death before reaching hospital or requiring hospital admission. During the one-year period, 1,181 deaths were registered and 8,190 hospital admissions occurred during the sample periods. The three leading causes of injury were falls (40 per cent), traffic accidents (27 per cent), and poisonings (15 per cent). The overall incidence of injuries was 136 per 10,000 person years. Incidence by sex and age was assessed for the main external causes. The ratios of nonfatal to fatal cases were calculated by sex and age and by external cause. The origin of the injury was suicide in 14 per cent of cases and assault or homicide in 3 per cent. The severity of injuries, assessed using an automatic computation of the Injury Severity Score (ISS), ranged from 1 to 66 with a mean of 6.9. Substantial variations of ISS were observed according to external cause. At the 8th day following admission, 31 per cent of hospital-treated patients were still hospitalized and 0.8 per cent had died in hospital. The outcome correlated well with the ISS.     

The incidence of injuries among 87,000 Massachusetts children and adolescents: results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System

This study describes the incidence of fatal and nonfatal injuries occurring in 87,022 Massachusetts children and adolescents during a one-year period. A surveillance system for injuries at 23 hospitals captured 93 per cent of all discharges for ages 0-19 in the 14 communities under study. Sample data were collected on emergency room visits, hospital admissions, and deaths for all but a few causes of unintentional injuries. The overall incidence was 2,239 per 10,000. The true incidence rates are probably higher than those reported. The ratio of emergency room visits to admissions to deaths was 1,300 to 45 to 1. Injury rates varied considerably by age, sex, cause, and level of severity. Age-specific injury rates were lowest for infants and elementary school age children and highest for toddlers and adolescents. The overall ratio of male to female injury rates was 1.66 to 1. Injuries from falls, sports, and cutting and piercing instruments had a high incidence and low severity. Injuries from motor vehicles, burns, and drownings had lower incidence, but greater severity. Results provide evidence that both morbidity and mortality must be considered when determining priorities for injury prevention. Current prevention efforts must be expanded to target injuries of higher incidence and within the adolescent population.     

2014年广西壮族自治区居民伤害死亡谱及疾病负担分析

目的 了解2014年广西壮族自治区疾病监测点居民伤害死亡谱及疾病负担,为制定伤害预防控制措施提供科学依据。方法 利用死亡率、标化死亡率、潜在寿命损失年（years of potential life lost,YPLL）指标, 分析广西居民伤害死亡谱及所致的疾病负担。结果 2014年广西疾病监测点居民伤害死亡率为45.58/10 万、标化死亡率46.45/10 万,男性伤害死亡率为女性的2.36 倍。居民伤害死因前5 位依次为道路交通事故、意外跌落、其他意外伤害、溺水、自杀及后遗症。伤害首位死因0～14岁组为溺水、15～64岁为道路交通事故、≥65岁年龄组为意外跌落。伤害死亡前5位YPLL为道路交通事故、溺水、其他意外伤害、意外跌落和意外中毒。因伤害“早死”导致的YPLL为269 651.9人年、28.59年/人。结论 伤害给广西居民带来沉重的负担,不同性别及城乡之间伤害谱不尽相同,应根据实际情况制定有效的伤害预防控制策略和措施。     

Epidemiology of injuries and poisonings in emergency departments in Iran

Objectives

There are few reports on epidemiological patterns of injury and injury-related mortality in developing countries. This study aimed to report the epidemiology of injuries and poisonings in emergency departments in Iran.

Study design

Retrospective study using available data from 20 March 2005 to 19 March 2008.

Methods

Recorded Injury Surveillance System (ISS) data including demographics, place of residence, type of injury, and outcome during emergency department stay were extracted from the databank of the national ISS and included in the final analysis.

Results

In total, 2,991,624 emergency department admissions due to injury were recorded at university hospitals during the study period. According to the national census in 2006, Iran had a population of 70,472,846, so the injury admission rate to university hospital emergency departments was 1.4%/year in Iran. The mean age of the patients was 26.5 [standard deviation (SD) 16.9] years, and 72.7% of the cases were male. The most common cause of injury was road traffic accidents (RTAs) (31.9%), followed by hit (25.5%) and falls (10.9%). Intoxication was associated with 5.3% of all injuries. The overall emergency department mortality rate was 0.6%. Of those who died, the mean age was 32.6 (SD 21.1) years. All fatal injuries, except burn injuries, were more common in males. Intoxication-related deaths occurred in 3.8% of cases. In patients aged <13, 13–65 and >65 years, hit (28.2%), RTAs (34%) and RTAs (27.9%) were, respectively, the most common causes of injury. In all age groups, RTAs were the most common cause of death.

Conclusions

This study determined the epidemiology of injuries and poisonings in emergency departments in Iran. The mortality rate in this study was low in comparison with other research, which may be explained in the context of inappropriate prehospital or interhospital care in Iran. This finding can be employed to formulate targeted preventive strategies based on the incidence of the more common types of injury.     

Injuries and poisoning caused by various types of activities. Epidemiologic survey on death and hospitalization in Aquitaine

From the data of a survey conducted in 1986 within the French area of Aquitaine and based on a representative sample of injuries having led to immediate death or hospitalization, different types of injuries were compared. Domestic and recreational accidents constituted the leading cause (41%) of injuries, followed by traffic accidents (28%) and suicides (13%). The overall ratio of immediate deaths to hospitalizations was 1 to 30 (1 to 10 for suicides, 1 to 20 for traffic accidents and 1 to 80 for domestic accidents). The overall annual incidence was 131 per 10,000 (respectively 20, 34 and 53 for suicides, traffic accidents and domestic accidents). The incidence by sex, age and type of accident was assessed. Among hospitalizations, about 3/4 of domestic and school accidents were falls; 45% of work accidents were cutting-piercing or being struck by an object, and 40% were falls; 90% of attempted suicides were poisonings. Using the Injury Severity Score (ISS), severity of injuries was the highest in traffic accidents. Traffic accidents also led to the highest hospital mortality within eight days (1.6%).     

湖北省伤害监测点60岁及以上老年人伤害情况分析

目的 了解湖北省伤害监测点老年人伤害流行状况,为制定伤害干预策略提供科学依据.方法 对天门市伤害监测哨点医院2014年首次因伤害就诊的60岁及以上老年人伤害病例进行分析.结果 共报告60岁及以上老年人伤害病例2 999例,其中男性1 577例.主要伤害原因为跌倒/坠落(1 422例,47.42%);其次是道路交通事故(1 046例,34.88%);伤害发生地点主要是家中(1 083例,36.11%);伤害发生时的主要活动是做家务(1 357例,45.25%)和休闲活动(965例,32.18%);伤害性质以挫伤/擦伤(1 164例,38.81%)为首位;伤害部位主要是头部(842例,28.08%).结论 跌倒/坠落是造成老年人伤害的主要原因,家中是伤害首要发生地点.建议应以家庭为重点,积极主动干预,采用必要的防止跌倒发生的设施,以减少老年伤害的发生.     

The epidemiology of head trauma in Aquitaine (France), 1986: a community-based study of hospital admissions and deaths

This paper reports the findings of a study of head trauma conducted over a one-year period within a defined region with a population of 2.7 million (Aquitaine, France). It includes cases resulting in death prior to hospitalization or requiring hospitalization. During the one-year period, 391 deaths and 8549 hospital admissions due to head trauma occurred, yielding an annual estimate of 8940 head-injured people. The immediate case-fatality rate was 4.4%. Among non-fatal cases, 80% were mild, 11% moderate and 9% severe. The overall annual incidence was 281/100,000 in both sexes (384 and 185/100,000 in males and females respectively). The annual death rate was 22/100,000 (33 and 12, respectively). Patterns of incidence by age and sex were in general agreement with earlier studies. The main causes of head trauma were traffic accidents (60%) and falls (33%). One-third of hospitalized patients had no injury other than the head trauma. The most frequently associated injuries were those involving extremities, whereas the most severe were those involving the abdomen. The Injury Severity Score (ISS) ranged from 4 to 66, with a mean of 9 and a median of 5. At the eighth day following injury, 25% of hospital-treated patients were still hospitalized and 2% had died. The outcome correlated well with the ISS.     

Population-based study of unintentional injury incidence and impact during childhood.

We report a prospective study of medically treated unintentional injuries ascertained in an HMO population of children and adolescents 19 years of age and younger over a one-year period. The overall rate of medically treated injuries was 247 per 1,000, 147/1,000 for those treated in the clinic, and 100/1,000 for those treated in the emergency room (ER). Overall, 2.5 percent of patients were hospitalized. The highest rates of injury were for falls (60 per 1,000), recreational activities (57 per 1,000) and competitive sports (49 per 1,000). The site of care varied little by injury diagnosis or etiology, with the exception that sprains/strains, fractures, and injuries due to play and sports were more commonly treated in the clinic. The impact of trauma on activity was considerable, with 55.9 percent of injuries resulting in restricted activity, 10.6 percent in greater than or equal to 2 days of school missed, and 6.7 percent in greater than or equal to 2 days spent in bed.     

Consumer product-related injuries in Athens, Ohio, 1980-85: assessment of emergency room-based surveillance

Using the National Electronic Injury Surveillance System of the United States Consumer Product Safety Commission, I computed the average annual rates per 1,000 population of consumer product-related injuries in residents of Athens County, Ohio, and seem at one hospital. These rates do not include intentional injuries or injuries to occupants of motor vehicles, to pedestrians hit by motor vehicles, or those occurring on the job or in house fires. Average annual rates for all injuries combined ranged from 102 per 1,000 boys 10-14 years of age to 11.7 per 1.000 men 65-74 years of age. For all males, the annual rate was 53 per 1,000 and for all females, 32 per 1,000. The most common parts of the body injured were the fingers (accounting for 15% of visits), face (12%), ankle (8.5%), hands (8%), and head (7.9%). The most common injury types were lacerations (33%), contusions and abrasions (22%), sprains (16%), and fractures (13%). Hospital admission rates varied by age, sex, type of injury, and part of body injured. Comparison of a sample of NEISS records to emergency room records showed that data were abstracted by clerical personnel with a high degree of accuracy. Review of fractures of the lower leg identified a cluster of injuries in young girls from playground merry-go-rounds. Review of burn injuries identified problems with scald injuries in young adult women and with eye injuries from welding in young men. The system can be used to evaluate injury control measures taken on a local level.     

Northeastern Ohio Trauma Study: II. Injury rates by age, sex, and cause

Using a 1977 sample of emergency department visits in five northeastern Ohio counties, population-based injury rates are tabulated by age, sex, and cause. Case fatality ratios are estimated by comparing these injury rates with population-based mortality rates for 1976-1978. For all age and sex groups, injuries are a major cause of emergency department visits. Falls, striking, cuts, and motor vehicle crashes are the leading causes of injury. Case fatality ratios for motor vehicle crash injuries are considerably higher than those for non-transport injuries. Injury rates and case fatality ratios for males exceed those for females except among the elderly. With increasing age, injury rates decline but the fraction of injuries leading to hospital admission or to fatality rises sharply.     

Quantifying the iceberg effect for injury: using comprehensive community health data

BACKGROUND: Injury is the leading cause of preventable morbidity and mortality in Canada. The "ice berg" effect in injuries was proposed to address the injury statistics that are often poorly documented. The aim of this investigation was to quantify the severity and magnitude of iceberg effect in Ontario, Canada. METHODS: Data from Vital Statistics (1999, mortality), Canadian Institute for Health Information (2001, hospitalizations), Census (2001, demographic information), National Ambulatory Care Reporting System (2001, emergency department visits), and the Canadian Community Health Survey (2000/01, other injuries) were used to construct the Ontario injury iceberg for ages 12 years and older. RESULTS: There were 79,577 fatalities in Ontario in 1999; 2,645 were attributable to injuries (crude rate: 2.3 per 10,000). Of the 913,540 hospitalizations (2001), 67,301 were caused by injuries. There were 3,520,253 emergency department (ED) visits (2001) and 959,278 were attributable to injuries. For injuries treated elsewhere, the most common treatment site was the physician's office (23.3%). The most common cause of injuries (CCHS) was falls (37.4%) and exertion/movement (20.5%). There were 1,928,000 injuries causing functional impairment (one injury to five individuals in the population). INTERPRETATION The high ratio of injury-related ED visits to deaths illustrated the high volume of injuries that present to the ED. The ratio of injuries resulting in functional impairment to the population demonstrates.that such injuries can be problematic, even if not resulting in hospitalization. Constructing the injury iceberg using valid data should assist researchers and decision-makers in priority setting.     

2015—2017年湖南省伤害监测点老年伤害监测结果分析

目的 了解湖南省2015—2017年老年人伤害发生情况及流行病学特征,为制定老年人伤害的一级预防提供参考依据。 方法 收集2015年1月1日—2017年12月31日首次就诊于哨点监测医院的老年伤害病人资料,采用描述流行病学方法统计分析。 结果 2015—2017年湖南省伤害哨点医院老年监测病例共16 151例,城市点13 476例(83.44%),农村点2 675例(16.56%),男女比例为1.01∶1,老年伤害的发生原因前三位依次为:跌倒/坠落(53.33%),机动车车祸(19.45%),刀/锐器伤(6.70%);随着年龄增长,跌倒/坠落所占比例增长,机动车车祸比例下降。伤害发生地点主要是家中(46.67%)、公路/街道(29.74%)。伤害性质前三位为挫伤/擦伤(35.95%),骨伤(28.66%),锐器伤/咬伤/开放伤(14.89%),伤害的严重程度主要为轻度(58.29%)、中度(36.67%)。 结论 湖南省2015—2017年老年居民伤害主要以跌倒/坠落、机动车车祸为主,应该制定相应的预防和干预措施以减少老年人伤害的发生。     

Incidence and outcome of injury in Ghana: a community-based survey

Injury is an increasingly significant health problem in most low-income countries. However, strategies for preventing injury have not been well addressed. The present study was carried out to measure the incidence and outcome of various mechanisms of injury in Ghana in order to provide data for use in developing priorities for injury prevention efforts. For this purpose, using two-stage cluster sampling and household interviews, we surveyed 21,105 persons living in 431 urban and rural sites. During the preceding year, 1609 injuries resulting in one or more days of loss of normal activity were reported. Injury-related mortality was slightly higher in the urban (83 per 100,000) than in the rural area (53 per 100,000). However, the burden of disability from nonfatal injuries, as assessed by disability days, was higher in the rural (4697 disability days per 1000 person-years) than in the urban area (2671 days per 1000 person-years). Based on incidence rates and disability times, the major types of injury in the urban area were transport-related injury and falls. In the rural area, agricultural injuries predominated, followed by falls and transport-related injury. In rural and urban areas combined, 73% of motor vehicle-related injuries involved commercial vehicles. In this and other similar developing-country settings, injury prevention efforts should focus on falls and on transport safety in both urban and rural areas, with special attention being paid to commercial vehicles. In rural areas, agricultural injuries contributed the largest burden of morbidity, and should be a priority for prevention efforts.     

石家庄市居民伤害现况研究

目的：了解石家庄市居民伤害现状,为伤害的预防提供依据。方法：采用多阶段分层整群抽样方法,对城市２个居委会和农村６个自然村居民２１５４４人的伤害情况进行回顾性调查。结果：伤害标准化发生率为４．２１％,农村高于城市,男性高于女性。位居伤害前３位的依次是：交通伤、跌伤、中毒,城市以交通伤居首位,农村以中毒居首位。１４岁以下和６０岁以上年龄组以跌伤为主,１５￣３４岁组煤气中毒,交通伤较多,３５￣５９岁组交     

浙江省慈溪市户籍居民非致死性伤害流行病学调查

目的了解浙江省慈溪市户籍居民非致死性伤害的发生状况,为制定伤害防控措施提供依据。方法采用两阶段抽样法对5个乡镇的10个行政村中的2098名居民进行回顾性问卷调查。结果慈溪市户籍居民的半年标化伤害发生率为11.43%。构成比位于前3位的伤害原因是意外的跌倒/坠落(34.85%)、刀/锐器伤(24.07%)和道路交通伤害(9.13%),各年龄组人群的首位伤害原因均为意外的跌倒/坠落。伤害在家中发生最多(46.47%),其次是工业和建筑场所(18.26%),再次为公路/街道(13.69%)。伤害病例在2010年5—10月的构成比差异无统计学意义。伤害发生时间在一天中的分布不均,绝大多数伤害发生在6∶00—12∶00时段(45.15%),发生在0∶00—6∶00时段的伤害最少(1.27%)。在127例次需要就诊治疗的伤害中,有18例次分布于全国伤害监测哨点医院(人民医院11例次,第二人民医院7例次)。结论慈溪市户籍居民半年伤害发生率较高,已成为威胁居民健康的重要公共卫生问题。     

A comparison of injury death rates in China and the United States, 1986.

BACKGROUND: The importance of injury as a public health problem is not well recognized in many developing countries. Data have recently become available on injury mortality in China. METHOD: We compared Chinese injury data based on a 100 million population segment for 1986 with data for the United States. RESULTS: The age-adjusted death rate from all injuries for China exceeds the rate for the US (69.0 vs 61.3 per 100,000). The US has higher death rates from motor vehicle crashes, fires, and homicide; China has greater mortality from drowning, poisoning, falls, and suicide. Especially noteworthy in China are the high drowning rates among young children and the elderly and the high suicide rates in rural areas among young adults and the elderly. CONCLUSION: Injury is an important public health problem in China, exceeding in many respects the problem in the United States. It is urgent for China to place high priority on injury research and prevention.     

Incidence and costs of injuries in The Netherlands

BACKGROUND: Injuries are a major and persistent public health problem, but a comprehensive and detailed overview of the economic burden is missing. We therefore estimated the number of emergency department (ED) attendances and health care costs as a result of injury. METHODS: We estimated lifetime health care costs of injuries occurring in The Netherlands in the year 1999. Patient groups were defined that are homogeneous in terms of health service use. Health service use and costs per patient group was estimated with data from national databases and a prospective study among 5755 injury patients. RESULTS: Total health care costs due to injury in 1999 were euro 1.15 billion, or 3.7% of the total health care budget. Major cost peaks were observed among males between ages 15 and 44 due to a high incidence, and among females from age 65 onwards due to a high incidence and high costs per patient. For the age groups 0-14, 15-44, 45-64, and 65+ ED attendances per 1000 person years were 85, 85, 43, and 49, respectively, and costs per capita were euro 38, euro 59, euro 43, and euro 210, respectively. Costs per patient rise about linearly up to age 60 and about exponentially thereafter. From age 25 onwards, females have higher costs per patient than males. Hip fracture (20%), superficial injury (13%), open wounds (7%), and skull-brain injury (6%) had the highest total costs. Most costs were attributable to falls (44%) and traffic injuries (19%). CONCLUSION: Young adult males, elderly females, falls, hip fractures, and minor injuries without medical need for hospitalization account for a substantial share of health care costs.     

浙江省城乡4社区居民伤害现况调查

目的 调查浙江省4个社区人群伤害发生现况。方法 选择不同经济状况的城市、农村社区各2个，对城市2843P、农村2985户共16899名居民1年中伤害情况进行回顾性问卷调查。结果 伤害总发生率为15．64％，其中城市17.18％，农村15．30％，男性18．06％，女性14．06％，死亡9例。以跌伤／坠落、刀割／锐器伤、交通伤、碰撞／硬物击伤、烧烫伤和动物咬伤发生率较高，分别为4．80％、3．86％、2．07％、1．99％、1．13％和1．06％。交通伤以45岁以上者发生率为高，其中自行车导致的占37％；5岁以下儿童跌伤／坠落伤发生率为12％，动物咬伤则以15岁以下者较高，农村高于城市。平均每例伤者休息8．62天，活动受限7．92天，医疗费用324．21元。结论 浙江省社区居民伤害发生率较高，导致较大的经济和家庭负担，预防控制社区人群伤害已迫在眉睫。     

Motor vehicle trauma in northeastern Ohio. I: Incidence and outcome by age, sex, and road-use category

Hospital emergency department visits for motor vehicle trauma occurring in a midwestern metropolitan region (Cleveland and Lorain-Elyria, Ohio Standard Metropolitan Statistical Areas; 2.2 million population) were analyzed to determine the incidence and outcome by age, sex, and road-use category. A 50% incidence sample (n = 20,752) of motor vehicle trauma events to residents of this region was identified from the emergency department records of 41 participating hospitals for a one-year period, 1977. These hospitals accounted for 98% of all emergency department cases in the region. The annual motor vehicle trauma incidence rate per 100,000 population was 1,871. The highest annual incidence rate (4,462) was for ages 20-24; the lowest rates were for infants under one year (837) and for the elderly over 74 years (667). Incidence rate rank-ordered road-use categories were as follows: passenger car occupant, motorized cycle rider, other enclosed vehicle occupant, pedestrian, and pedal cyclist. Above age 4, age-specific male incidence rates significantly exceeded female incidence rates for most road-use categories. There were 80 admissions and 7 fatalities per 1,000 motor vehicle trauma incidence cases. Case-admission ratios were highest for pedestrians (266), riders of motorized cycles (184), and pedal cyclists (115); they were lowest for occupants of partially or fully enclosed vehicles (65). Case-fatality ratios per 1,000 cases were also highest for pedestrians (43) and riders of motorized cycles (11). Male case-fatality ratios exceeded female ratios for each road-use category in nearly all age groups, and male case-admission ratios exceeded those for females ages 10-54. For ages 75 and over, the admission ratios and fatality ratios were nearly twice as high as in any other age group.