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Jiang T, Qian C, Wei G, Cheng L, Zheng W, Chen G. Case report: Fatal traumatic coronary artery dissection-an overlooked complication of chest fracture. Front Cardiovasc Med 2023; 10:1226129. [PMID: 37731523 PMCID: PMC10508907 DOI: 10.3389/fcvm.2023.1226129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 08/22/2023] [Indexed: 09/22/2023] Open
Abstract
Coronary artery dissection caused by trauma is a rare occurrence that can be life-threatening. Accordingly, its rapid identification and treatment are essential to improve patient outcomes. Here, we present a case of a patient who suffered multiple rib and femur fractures after falling from a height of eighteen meters and subsequently experienced persistent chest pain. After the initial diagnostic workup, the medical team diagnosed the patient's chest pain as rib fractures and failed to consider the potential of a cardiac injury as the underlying cause. No emphasis was placed on monitoring changes in myocardial enzymes and ECG, which could have indicated coronary artery dissection. The dissection was confirmed and treated with a stent only after the subsequent coronary angiography (CAG) and optical coherence tomography (OCT) examinations, gradually relieving the patient's chest pain. In this case report, we discuss the management of fractures complicated by traumatic coronary artery dissection and highlight the benefits of OCT in diagnosing and treating this condition. The case also emphasizes the importance of considering coronary artery injury in patients with chest pain due to trauma.
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Affiliation(s)
- Tao Jiang
- Depatment of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Cheng Qian
- Depatment of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Gang Wei
- Depatment of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Ling Cheng
- Depatment of Infection Managrment, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Wenwu Zheng
- Depatment of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Gong Chen
- Depatment of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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2
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Neurosurgical aspects of falls from flat-roofed houses. MARMARA MEDICAL JOURNAL 2021. [DOI: 10.5472/marumj.860214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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3
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Kim OH, Go SJ, Kwon OS, Park CY, Yu B, Chang SW, Jung PY, Lee GJ. Part 2. Clinical Practice Guideline for Trauma Team Composition and Trauma Cardiopulmonary Resuscitation from the Korean Society of Traumatology. JOURNAL OF TRAUMA AND INJURY 2020. [DOI: 10.20408/jti.2020.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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AKDENİZ S, OKUR MH, GÖYA C. Künt Karaciğer Travmalı Hastaların Demografik, Klinik ve Laboratuvar Sonuçları: 2006-2016 Yıllarının Retrospektif İncelemesi. DICLE MEDICAL JOURNAL 2020. [DOI: 10.5798/dicletip.755740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bandte A, Püschel K, Krajewski K. Traumatic brain injury in high versus low falls in young children and adolescents: a retrospective analysis. J Neurosurg Pediatr 2018; 22:233-237. [PMID: 29856297 DOI: 10.3171/2018.2.peds17714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE So-called low falls are gaining interest in traumatology. To date, there are no studies on low versus high falls in the pediatric population. The aim of the current analysis was to characterize the symptoms, diagnostics, and injuries associated with high versus low falls and to examine the effect of fall height on injuries and outcome in the context of current guideline-based recommendations. METHODS After obtaining study approval from the local ethics committee, the authors reviewed the data for patients ages 5-17 years who had been consecutively treated at either hospital associated with the University Medical Center Hamburg in the period from January 2009 to August 2014 for diagnoses including traumatic brain injury (TBI). Retrospective analysis of the electronic patient charts was performed to obtain data on demographics; accident mechanism; initial neurological status with respect to consciousness, symptoms, and Glasgow Coma Scale score; radiological studies; diagnoses; length of stay; all intracranial procedures; and Glasgow Outcome Scale (GOS) score. RESULTS Sixty-five fall-related TBIs among 380 patients were identified; 26 patients fell from a height of 3 m or more and 28 fell from a height under 3 m (height undocumented in 11 cases). Patients who fell from ≥ 3 m were 22 times more likely than those who fell from < 3 m to undergo spiral CT studies in the emergency room (p = 0.05). In addition, there was a 7.4 times greater chance of undergoing cranial CT (p = 0.02). There were significantly more noncerebral injuries requiring surgery in patients who fell from ≥ 3 m versus those who fell from < 3 m (p = 0.007). There was no difference in the frequency of neurosurgical procedures performed between low and high groups. Follow-up ranged from 0 to 92 months (mean 12.5 months, median 0 months). There was no significant difference in good (GOS score 4-5) and poor (GOS score 1-3) outcomes between high and low falls (p = 0.208). CONCLUSIONS Low falls can be associated with intracranial hemorrhages requiring ICU monitoring and/or surgery. The authors encourage intensive monitoring and CT scans based on clinical presentation, not on fall height.
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Affiliation(s)
| | | | - Kara Krajewski
- 2Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Turgut K, Sarihan ME, Colak C, Güven T, Gür A, Gürbüz S. Falls from height: A retrospective analysis. World J Emerg Med 2018; 9:46-50. [PMID: 29290895 DOI: 10.5847/wjem.j.1920-8642.2018.01.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Emergency services manage trauma patients frequently and falls from height comprise the main cause of emergency service admissions. In this study, we aimed to analyse the demographic characteristics of falls from height and their relationship to the mortality. METHODS A total of 460 patients, who admitted to the Emergency Department of Inonu University between November 2011 and November 2014 with a history of fall from height, were examined retrospectively. Demographic parameters, fall characteristics and their effect to mortality were evaluated statistically. RESULTS The study comprised of 292 (63.5%) men and 168 (36.5%) women patients. The mean age of all patients was 27±24.99 years. Twenty-six (5.6%) patients died and the majority of them were in ≥62 years old group. The highest percentage of falls was at 0-5 years age group (28.3%). People fell mainly from 1.1-4 metres(m) level (46.1%). The causes of falls were ordered as unintentional (92.2%), workplace (8.1%) and suicidal (1.7%). Skin and soft tissue injuries (37.4%) were the main traumatic lesions. CONCLUSION Age, fall height, fall place, lineer skull fracture, subarachnoidal hemorrhage, cervical fracture, thoracic vertebra fracture and trauma scores had statistically significant effect on mortality. The casualties died because of subarachnoid hemorrhage mostly.
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Affiliation(s)
- Kasim Turgut
- Department of Emergency Medicine, Education and Research Hospital, Adiyaman University, Adiyaman, Turkey
| | - Mehmet Ediz Sarihan
- Department of Emergency Medicine, School of Medicine, Inonu University, Malatya, Turkey
| | - Cemil Colak
- Department of Biostatistics and Medical Informatics, School of Medicine, Inonu University, Malatya, Turkey
| | - Taner Güven
- Department of Emergency Medicine, School of Medicine, Inonu University, Malatya, Turkey
| | - Ali Gür
- Department of Emergency Medicine, School of Medicine, Inonu University, Malatya, Turkey
| | - Sükrü Gürbüz
- Department of Emergency Medicine, School of Medicine, Inonu University, Malatya, Turkey
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Ustundag M, Aldemir M, Orak M, Guloglu C. Predictors of Mortality in Blunt Multi-Trauma Patients: A Retrospective Review. HONG KONG J EMERG ME 2017. [DOI: 10.1177/102490791001700507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose The purpose of this study was to identify risk factors predicting mortality in multiple blunt trauma patients so as to prompt appropriate management during trauma resuscitation. Method To assess risk factors potentially related to mortality in multiple blunt trauma patients, we reviewed the medical records of 1419 multiple blunt trauma patients who were admitted to the emergency department. The patients were divided into two groups; the survival group (n=1308) and the death group (n=111). Initial data collected on arrival in the emergency department were analyzed. Results In the study, 67.4% (n=956) of 1419 patients were male, 32.6% (n=463) were female. The average age was 21.19±0.50 years (range 1-92). After controlling for the factors significantly related to outcome (all p<0.05), death due to multiple blunt trauma was more likely in patients who were of older age, who had major chest injury, who had intra-abdominal solid organ injury and who had low Glasgow Coma Scale (GCS) score and low Revised Trauma Score (RTS). Conclusion We conclude that older age, major chest injury, intra-abdominal solid organ injury, low GCS and low RTS were identified as possible risk factors for mortality in multiple blunt trauma patients.
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Rowbotham SK, Blau S. Skeletal fractures resulting from fatal falls: A review of the literature. Forensic Sci Int 2016; 266:582.e1-582.e15. [PMID: 27264682 DOI: 10.1016/j.forsciint.2016.04.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 02/11/2016] [Accepted: 04/26/2016] [Indexed: 11/16/2022]
Abstract
To investigate what is currently known about skeletal blunt force trauma (BFT) resulting from falls, and how valuable that research is in contributing to forensic anthropology investigations and interpretations of circumstances of death, a comprehensive review of forensic anthropology, forensic pathology and clinical medicine literature was performed. Forensic anthropology literature identified that establishing the type of fall from the analysis of BFT is difficult given the uniqueness of each fall event, the complexities involved with identify BFT and, in particular, the limited available research documenting fracture patterning and morphologies. Comparatively, skeletal BFT resulting from fatal falls is well documented in the forensic pathology and clinical medicine literature. These disciplines cover a wide range of fall types (free falls, falls in juveniles, specific fractures produced from falls, falls down staircases, falls resulting in impalements, and 'other' fall types), provide details on how the nature of the fall influences the skeletal fracturing, and documents the anatomical regions susceptible to fracturing. Whilst these contributions may assist forensic anthropologists, they provide limited details of fracture patterns and morphologies and thus further research investigating the details of skeletal BFT resulting from fatal falls is required.
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Affiliation(s)
| | - Soren Blau
- Victorian Institute of Forensic Medicine/Department of Forensic Medicine, Monash University, Australia
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Jain V, Jain S, Dhaon B. A Multi Factorial Analysis of the epidemiology of Injuries from Falls from Heights. Int J Crit Illn Inj Sci 2015; 4:283-7. [PMID: 25625058 PMCID: PMC4296329 DOI: 10.4103/2229-5151.147519] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: Fall from height is a common cause of morbidity and mortality in suburban population in India. These cases are either domestic or workplace injuries with different causative factors. We analyzed different aspects of these falls to identify their risk factors. Materials and Methods: We conducted prospective and retrospective epidemiological study to identify various causative, contributory factors, and resultant injuries in cases of fall from height. The study group comprised of semiurban population and involved both domestic and workplace injuries presenting to a tertiary care hospital. Results: There were 208 cases of workplace (112) and domestic (96) fall from height. In domestic cases absence of parapet on roof was the commonest cause, most of falls occurred during summer and rainy season. Alcohol consumption prior to fall was commonest associated factor in adult males. Children mostly fell while playing on roof and climbing trees. Among workplace cases, civil construction site injuries were commonest and absence of any protective gear and long working and evening hours were commonest associated factors. Mean injury severity score was 10.86 in domestic cases and 14.87 in workplace cases. There were 17 mortalities with head injury being commonest associated cause. Only difference in incidence of alcohol consumption and permanent disability was statistically significant between workplace and domestic falls. Conclusion: Different factors are responsible for domestic and workplace cases of fall from height. Most of these cases are potentially preventable.
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Affiliation(s)
- Vineet Jain
- Sports Injury Centre, Safdarjang Hospital, Delhi, India
| | - Shruti Jain
- Department of Anaesthesiology, School of Medical Science and Research, Sharda University, Knowledge Park III, Greater Noida, Uttar Pradesh, India
| | - Bk Dhaon
- Department of Orthopaedics, School of Medical Science and Research, Sharda University, Knowledge Park III, Greater Noida, Uttar Pradesh, India
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Parreira JG, Matar MR, Tôrres ALB, Perlingeiro JAG, Solda SC, Assef JC. Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma. Rev Col Bras Cir 2014; 41:272-7. [DOI: 10.1590/0100-69912014004009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 03/15/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To analyze the lesions diagnosed in victims of falls, comparing them with those diagnosed in other mechanisms of blunt trauma.METHODS: We conducted a retrospective study of trauma protocol charts (prospectively collected) from 2008 to 2010, including victims of trauma over 13 years of age admitted to the emergency room. The severity of injuries was stratified by the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). Variables were compared between the group of victims of falls from height (Group 1) and the other victims of blunt trauma (Group 2). We used the Student t, chi-square and Fisher tests for comparison between groups, considering the value of p <0.05 as significant.RESULTS: The series comprised 4,532 cases of blunt trauma, of which 555 (12.2%) were victims of falls from height. Severe lesions (AISe"3) were observed in the extremities (17.5%), in the cephalic segment (8.4%), chest (5.5%) and the abdomen (2.9%). Victims of Group 1 had significantly higher mean age, AIS in extremities / pelvis, AIS in the thoracic segment and ISS (p <0.05). The group 1 had significantly (p <0.05) higher incidence of tracheal intubation on admission, pneumothorax, hemothorax, rib fractures, chest drainage, spinal trauma, pelvic fractures, complex pelvic fractures and fractures to the upper limbs.CONCLUSION: Victims of fall from height had greater anatomic injury severity, greater frequency and severity of lesions in the thoracic segment and extremities.
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Affiliation(s)
| | | | | | | | - Silvia C. Solda
- Irmandade da Santa Casa de Misericórdia de São Paulo; Santa Casa de São Paulo
| | - José Cesar Assef
- Irmandade da Santa Casa de Misericórdia de São Paulo; Santa Casa de São Paulo
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Buschmann C, Last S, Tsokos M, Kleber C. Tödliche Stürze aus der Höhe in Berlin von 1989–2004. Rechtsmedizin (Berl) 2014. [DOI: 10.1007/s00194-014-0938-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Aslan S, Ozturk G, Uzkeser M, Aydınlı B, Cakir Z, Turkyilmaz A. Falling Ice and Snow Masses: A Rare Mechanism of Injury. J Emerg Med 2010; 39:103-4. [DOI: 10.1016/j.jemermed.2008.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2008] [Revised: 04/27/2008] [Accepted: 05/05/2008] [Indexed: 11/25/2022]
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Baumer TG, Passalacqua NV, Powell BJ, Newberry WN, Fenton TW, Haut RC. Age-Dependent Fracture Characteristics of Rigid and Compliant Surface Impacts on the Infant Skull-A Porcine Model*,†. J Forensic Sci 2010; 55:993-7. [DOI: 10.1111/j.1556-4029.2010.01391.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Nelson ES, Lewandowski B, Licata A, Myers JG. Development and validation of a predictive bone fracture risk model for astronauts. Ann Biomed Eng 2009; 37:2337-59. [PMID: 19707874 DOI: 10.1007/s10439-009-9779-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Accepted: 08/04/2009] [Indexed: 01/04/2023]
Abstract
There are still many unknowns in the physiological response of human beings to space, but compelling evidence indicates that accelerated bone loss will be a consequence of long-duration spaceflight. Lacking phenomenological data on fracture risk in space, we have developed a predictive tool based on biomechanical and bone loading models at any gravitational level of interest. The tool is a statistical model that forecasts fracture risk, bounds the associated uncertainties, and performs sensitivity analysis. In this paper, we focused on events that represent severe consequences for an exploration mission, specifically that of spinal fracture resulting from a routine task (lifting a heavy object up to 60 kg), or a spinal, femoral or wrist fracture due to an accidental fall or an intentional jump from 1 to 2 m. We validated the biomechanical and bone fracture models against terrestrial studies of ground reaction forces, skeletal loading, fracture risk, and fracture incidence. Finally, we predicted fracture risk associated with reference missions to the moon and Mars that represented crew activities on the surface. Fracture was much more likely on Mars due to compromised bone integrity. No statistically significant gender-dependent differences emerged. Wrist fracture was the most likely type of fracture, followed by spinal and hip fracture.
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Affiliation(s)
- Emily S Nelson
- Bioscience and Technology Branch, NASA Glenn Research Center, Cleveland, OH 44135, USA.
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Jacobsen C, Schön CA, Kneubuehl B, Thali MJ, Aghayev E. Unusually extensive head trauma in a hydraulic elevator accident: Post-mortem MSCT findings, autopsy results and scene reconstruction. J Forensic Leg Med 2008; 15:462-6. [DOI: 10.1016/j.jflm.2008.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2007] [Accepted: 03/06/2008] [Indexed: 11/25/2022]
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Chadwick DL, Bertocci G, Castillo E, Frasier L, Guenther E, Hansen K, Herman B, Krous HF. Annual risk of death resulting from short falls among young children: less than 1 in 1 million. Pediatrics 2008; 121:1213-24. [PMID: 18519492 DOI: 10.1542/peds.2007-2281] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The objective of the work was to develop an estimate of the risk of death resulting from short falls of <1.5 m in vertical height, affecting infants and young children between birth and the fifth birthday. METHODS A review of published materials, including 5 book chapters, 2 medical society statements, 7 major literature reviews, 3 public injury databases, and 177 peer-reviewed, published articles indexed in the National Library of Medicine, was performed. RESULTS The California Epidemiology and Prevention for Injury Control Branch injury database yielded 6 possible fall-related fatalities of young children in a population of 2.5 million young children over a 5-year period. The other databases and the literature review produced no data that would indicate a higher short-fall mortality rate. Most publications that discuss the risk of death resulting from short falls say that such deaths are rare. No deaths resulting from falls have been reliably reported from day care centers. CONCLUSIONS The best current estimate of the mortality rate for short falls affecting infants and young children is <0.48 deaths per 1 million young children per year. Additional research is suggested.
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Affiliation(s)
- David L Chadwick
- Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
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Advanced Trauma Life Support (ATLS) and facial trauma: can one size fit all? Int J Oral Maxillofac Surg 2008; 37:209-14. [DOI: 10.1016/j.ijom.2007.11.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Revised: 07/29/2007] [Accepted: 11/06/2007] [Indexed: 11/17/2022]
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Hyder AA, Sugerman D, Ameratunga S, Callaghan JA. Falls among children in the developing world: a gap in child health burden estimations? Acta Paediatr 2007; 96:1394-8. [PMID: 17880412 DOI: 10.1111/j.1651-2227.2007.00419.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM To estimate the incidence and mortality rates for unintentional fall injuries in children under 5 years of age in three developing regions of the world. METHODS This is a systematic review of literature on unintentional childhood fall injuries. A computerized PUBMED search of literature published between 1980 and 2006 was conducted and a manual search of journals was also completed. RESULTS Over 140,000 injuries to children under 19 years were reported in 56 studies (21 from Asia, 20 from Africa and 15 from South America); on an average 36% of injuries (52 575) were due to falls. The median incidence is estimated at 137.5 fall injuries per 100,000 children. The incidence of falls specific to the under-5 age group was reported in 16 studies with a median incidence of 40.6 falls per 100,000. The overall average incidence rate for childhood falls is highest in South America at 1315 followed by Asia at 1036 and Africa at 786 per 100,000, respectively. Average mortality rates were highest for Asia at 27 followed by Africa at 13.2 per 100,000, respectively. CONCLUSION This review demonstrates that the burden of falls on children has not been well documented, and is most likely under-reported. With the large and growing population of children in developing countries, the public health implications of the observed results are tremendous. Appropriate prevention relies on accurate statistics.
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Affiliation(s)
- Adnan A Hyder
- Department of International Health, Center for Injury Research and Policy, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
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Pickett W, Dostaler S, Berg RL, Linneman JG, Brison RJ, Marlenga B. Pediatric Fall Injuries in Agricultural Settings: A New Look at a Common Injury Control Problem. J Occup Environ Med 2007; 49:461-8. [PMID: 17426530 DOI: 10.1097/jom.0b013e31804630d0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Children on farms experience high risks for fall injuries. This study characterized the causes and consequences of fall injuries in this pediatric population. METHODS A retrospective case series was assembled from registries in Canada and the United States. A new matrix was used to classify each fall according to initiating mechanisms and injuries sustained on impact. RESULTS Fall injuries accounted for 41% (484/1193) of the case series. Twenty percent of the fall injuries were into the path of a moving hazard (complex falls), and 91% of complex falls were related to farm production. Sixty-one percent of complex falls from heights occurred while children were not working. Fatalities and hospitalized injuries were overrepresented in the complex falls. CONCLUSIONS Pediatric fall injuries were common. This analysis provides a novel look at this occupational injury control problem.
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Affiliation(s)
- William Pickett
- Department of Emergency Medicine, Queen's University, Kingston, Canada
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Mukhida K, Sharma MR, Shilpakar SK. Pediatric neurotrauma in Kathmandu, Nepal: implications for injury management and control. Childs Nerv Syst 2006; 22:352-62. [PMID: 16170573 DOI: 10.1007/s00381-005-1235-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2005] [Indexed: 10/25/2022]
Abstract
OBJECTS There is a scarcity of data regarding childhood neurological injuries in developing countries such as Nepal. The epidemiology of acute pediatric neurotrauma in Kathmandu was studied to assess the implications of these data for injury prevention programs. METHODS The clinical records of patients <or=18 years who presented to Tribhuvan University Teaching Hospital between April 1, 2001 and April 1, 2004 with acute neurological trauma and were subsequently admitted to hospital were retrospectively reviewed. A standard proforma was used to collect information on patient demographics, the nature and etiology of the injuries, their acute management, and outcomes. CONCLUSIONS Four hundred sixteen injured children were admitted to hospital, and the charts for 352 (85%) were available for review. Spinal injuries were relatively rare (4%) compared to head injuries (96%). Falls were the most common cause of injuries (61%). It took significantly longer (p<0.001) for children injured in rural Nepal (62%) to obtain neurosurgical care (30.1 h) than those injured within Kathmandu (7.1 h). A Glasgow Outcome Score of 5 was obtained for 96%, 76%, and 22% of patients with mild, moderate, or severe head injuries, respectively. Besides efforts to improve prehospital transport and acute management of these injuries, preventive measures that are applicable to the Nepalese scenario are urgently needed. Interventions should focus on health education programs directed at parents and children and upgrading of road safety measures. Neurological injuries must also be viewed in the context of the broader social issues in Nepal that contribute to injury.
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Affiliation(s)
- Karim Mukhida
- Division of Neurosurgery, University of Toronto, Toronto, Canada.
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Ivatury RR. Jumpers, fallers, and stumblers: Children should not drop and elders should not trip*. Crit Care Med 2005; 33:1426-8. [PMID: 15942370 DOI: 10.1097/01.ccm.0000164563.98109.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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