Trauma-related hospitalizations among urban adolescents in New Zealand: priorities for prevention

National incidence and trends of bicycle injury

Bicycle utilization continues to increase annually, and this trend was recently accelerated by the coronavirus disease of 2019 pandemic. There is limited epidemiologic data, however, regarding the prevalence and nature of bicycle-related injuries. Therefore, the purpose of this study is to characterize trends in bicycle-related injuries. The National Electronic Injury Surveillance System was queried for bicycle-related injuries from 2012 to 2021. Patient demographic and injury data were collected and analyzed to describe trends in incidence, patient demographics, and injury patterns associated with an emergency department encounter for a bicycle-related injury. There were an estimated 4,666,491 (95% confidence interval: 4,661,472-4,671,510) bicycle-related injuries from 2012 to 2021. The incidence of these injuries has significantly decreased over time (R = -0.983, R²  = 0.967, p < 0.001). However, the rate of injury in elderly patients increased over time. Injuries occurred most often during summer months (36%) and on weekend days (31.9%). Males and younger patients were more commonly injured. Head injuries were the most commonly affected body part among all age groups. Fractures were the most common injury type overall. Upper extremity injuries were more common than the lower extremity. Despite increased public bicycle utilization, there is a significant downtrend in bicycle-related injuries over the last decade. Injuries among elderly patients are becoming more common, who demonstrate a high rate of fracture and head injury. Fractures and head injuries were the most common injuries among all age groups, highlighting the importance of bicycle safety initiatives and helmet-wearing regardless of age.

Understanding trauma as a men's health issue: sex differences in traumatic injury presentations at a level 1 trauma center in Australia

Predominantly, males have a higher risk of injury mortality and morbidity than females. However, less is known about gender differences for injury and trauma outcome at a regional level. The aim of this study was to examine the epidemiologic profile and trauma outcomes of males and females at a level 1 trauma center to inform local injury prevention efforts. A retrospective review was conducted of injuries identified from the trauma registry of the New South Wales St George Public Hospital during January 1, 2004, to December 31, 2008. There were 6763 major trauma presentations, and 65.1% of these were of males. Males had a higher proportion of trauma presentations in each age group, except for those younger than 15 years, 45 to 54 years, and older than 65 years. Almost all presentations were as a result of unintentional injuries. However, 8% of males were victims of assault compared with 2% of females. Males were more likely to be injured while working and during leisure or sports activities and at sporting, farming, home, trade, and industrial locations than females. Males were more likely to be more severely injured than females and generally had a longer hospital length of stay. There was no significant difference in the rate of mortality between the genders. There are distinct differences between the sexes regarding the mechanism and severity of injury and trauma outcomes. Local injury prevention initiatives should be targeted to address gender differences. Future social research should examine the interplay of the construction of masculinities with male injury.

Injury risk behaviours among young Asian New Zealanders: a national survey of secondary school students

OBJECTIVE

To investigate injury risk behaviours among young Asian New Zealanders.

METHOD

Secondary analysis of data from Youth2000, a nationwide cross-sectional youth health survey conducted in 2001 in a random sample of New Zealand (NZ) secondary schools using a multimedia, computer-assisted, self-administered interview. Of the 9,567 survey participants (aged 12 to 18 years), this study was restricted to students who identified with an 'Asian' ethnic category (n=922).

RESULTS

Many young Asian New Zealanders report engaging in injury risk behaviours, including: not using helmets when cycling; dangerous drink and drug driving; and being intentionally physically harmed by others. NZ-born Asian students are more likely than overseas-born Asian students to report most of these risky behaviours. Chinese and Indian students are less likely to engage in most of these behaviours than their NZ European peers.

CONCLUSION

While young Asian New Zealanders are a relatively healthy population, many engage in well-recognised injury risk behaviours. The lower levels of these risky behaviours in Indian and Chinese students compared with NZ European students, and the positive dose-response effect seen in relation to duration of residence in NZ, are likely to be due to the effect of acculturation.

IMPLICATIONS

Injury prevention strategies for young people in NZ need to specifically consider the diversity, context and specific risk profiles of young Asian New Zealanders. Health promotion efforts for this group should target the use of safety equipment and risky driving behaviours and consider traditional cultural practices that may be protective.

Adolescent injury deaths and hospitalization in Canada: magnitude and temporal trends (1979-2003)

PURPOSE

To understand the magnitude and the national trends of mortality and hospitalization due to injuries among Canadian adolescents aged 15-19 years in 1979-2003.

METHODS

Data on injury deaths and hospitalizations were obtained from the national Vital Statistical System and the Hospital Morbidity Database. Injuries were classified by intent and by mechanism.

RESULTS

In 15-19-year-olds, 75.6% of all deaths and 16.6% of all hospitalizations were attributed to injuries. Unintentional and self-inflicted injuries accounted for 70.2% and 24.1%, respectively, of total injury deaths as well as 72.6% and 17.4%, respectively, of total injury hospitalizations. The main causes for injury were motor vehicle traffic-related injury (MVT), suffocation, firearm, poisoning, and drowning for injury deaths; and MVT, poisoning, fall, struck by/against, and cut/pierce for injury hospitalizations. Mortality and hospitalization rates of total and unintentional injuries decreased substantially, whereas those of self-inflicted injuries decreased only slightly, with a small increase in females. Rates also decreased for all causes except suffocation, which showed an increasing trend. Males had higher rates for all intents and causes than females, except for self-inflicted injury hospitalization (higher in females). The territories and Prairie Provinces also had higher ones of total injuries and self-inflicted injuries than in other provinces.

CONCLUSIONS

Injury is the leading cause of deaths and a major source of hospitalizations in Canadian adolescents. However, prevention programs in Canada have made significant progress in reducing injury mortality and hospitalization. The graduated driver licensing, enforcement of seat-belt use, speed limit and alcohol control, and Canadian tough gun control may have contributed to the decline.

Reporting of the incidence of hospitalised injuries: numerator issues

OBJECTIVES

To examine and discuss the implications on the incidence of hospitalised injuries of selecting cases from principal diagnosis field only compared with considering all diagnosis fields, the inclusion compared with the exclusion of medical injuries, and the impact of identifying multiple admissions.

METHODS

Analysis of data from the 1999-2000 New South Wales Inpatient Statistics Collection, Australia, including an internal linkage of the same dataset.

RESULTS

Approximately 27.5% of records with a non-injury primary diagnosis include a nature of injury diagnosis in a subsequent diagnostic field. This figure increased to more than half (53%) of discharges for medical injuries. The internal linkage showed that 6.5% of discharges were repeat admissions for the same International Classification of Diseases, 10th revision (ICD-10) injury code and that 13.8% were repeat admissions for any ICD-10 injury code. The proportions of repeat admissions varied according to the type and the mechanism of injury.

CONCLUSIONS

Selecting hospitalised injury cases from the principal diagnosis alone would underestimate medical injury cases as well as other injuries occurring in hospital. Repeat admissions should always be considered particularly in the case of thermal injuries, self harm, and medical injuries. Due to the limitations of data linkage, alternative methods need to be developed to identify repeat admissions. Other areas in which further research would be beneficial to a more uniform reporting of injury hospitalisations include better identification of injuries occurring in hospital, a review of ICD-10 injury codes, and the development an ICD-10 based severity measure which can be readily used with hospital discharge data.