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Chen Q, Huang G, Li T, Zhang Q, He P, Yang J, Li Y, Du D. Insights into epidemiological trends of severe chest injuries: an analysis of age, period, and cohort from 1990 to 2019 using the Global Burden of Disease study 2019. Scand J Trauma Resusc Emerg Med 2024; 32:89. [PMID: 39285499 PMCID: PMC11403847 DOI: 10.1186/s13049-024-01258-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 08/30/2024] [Indexed: 09/20/2024] Open
Abstract
BACKGROUND This study assessed the global trends and burden of severe chest injury, including rib fractures, lung contusions, and heart injuries from 1990 to 2019. Herein, we predicted the burden patterns and temporal trends of severe chest injuries to provide epidemiological evidence globally and in China. METHODS In our analysis, the age-standardized incidence rate (ASIR), prevalence rate (ASPR), and years lived with disability rate (ASYR) of severe chest injury were analyzed by gender, age, sociodemographic index, and geographical region between 1990 and 2019 using data from the Global Burden of Disease study 2019. Trends were depicted by calculating the estimated annual percentage changes (EAPCs). The impact of age, period, and cohort factors was assessed using an Age-Period-Cohort model. Autoregressive integrated moving average (ARIMA) model was employed to predict severe chest injury trends from 2020 to 2050. RESULTS In 2019, the global number of severe chest injury cases reached 7.95 million, with the highest incidence rate observed in Central Europe (209.61). Afghanistan had the highest ASIRs at 277.52, while North Korea had the lowest ASIRs at 41.02. From 1990 to 2019, the Syrian Arab Republic saw significant increases in ASIR, ASPR, and ASYR, with EAPCs of 10.4%, 9.31%, and 10.3%, respectively. Burundi experienced a decrease in ASIR with an EAPC of - 6.85% (95% confidence interval [CI] - 11.11, - 2.37), while Liberia's ASPR and ASYR declined with EAPCs of - 3.22% (95% CI - 4.73, - 1.69) and - 5.67% (95% CI - 8.00, - 3.28), respectively. Falls and road injuries remained the most common causes. The relative risk of severe chest injury by age, period, and cohort demonstrated a complex effect globally and in China. The ARIMA model forecasted a steady increase in global numbers from 2020 to 2050, while in China, it forecasted an increase in incidence, a decrease in ASIR and ASYR, and an increase in ASPR. CONCLUSIONS This study provides a groundbreaking analysis of global severe chest injury, shedding light on its measures and impact. These findings highlight the need for timely, specialized care and addressing regional disparities to mitigate the severe chest injury burden.
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Affiliation(s)
- Qingsong Chen
- School of Microelectronics and Communication Engineering of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 174, Zhengjie street, Shapingba District, 400044, and No. 1, Jiangkang Road, YuzhongDistrict, 400014, Chongqing, China
- Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China
| | - Guangbin Huang
- Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China
| | - Tao Li
- Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China
| | - Qi Zhang
- Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China
| | - Ping He
- Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China
| | - Jun Yang
- Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China
| | - Yongming Li
- School of Microelectronics and Communication Engineering of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 174, Zhengjie street, Shapingba District, 400044, and No. 1, Jiangkang Road, YuzhongDistrict, 400014, Chongqing, China.
- Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China.
| | - Dingyuan Du
- School of Microelectronics and Communication Engineering of Chongqing University, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 174, Zhengjie street, Shapingba District, 400044, and No. 1, Jiangkang Road, YuzhongDistrict, 400014, Chongqing, China.
- Department of Traumatology, National Regional Trauma Medical Center, Chongqing University Central Hospital (Chongqing Emergency Medical Center), No. 1, Jiangkang Road, Yuzhong District, 400014, Chongqing, China.
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Yousefi MR, Karajizadeh M, Ghasemian M, Paydar S. Comparing NEWS2, TRISS, and RTS in predicting mortality rate in trauma patients based on prehospital data set: a diagnostic study. BMC Emerg Med 2024; 24:163. [PMID: 39251893 PMCID: PMC11382384 DOI: 10.1186/s12873-024-01084-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 09/02/2024] [Indexed: 09/11/2024] Open
Abstract
BACKGROUND In the recent years, National Early Warning Score2 (NEWS2) is utilized to predict early on, the worsening of clinical status in patients. To this date the predictive accuracy of National Early Warning Score (NEWS2), Revised Trauma Score (RTS), and Trauma and injury severity score (TRISS) regarding the trauma patients' mortality rate have not been compared. Therefore, the objective of this study is comparing NEWS2, TRISS, and RTS in predicting mortality rate in trauma patients based on prehospital data set. METHODS This cross-sectional retrospective diagnostic study performed on 6905 trauma patients, of which 4191 were found eligible, referred to the largest trauma center in southern Iran, Shiraz, during 2022-2023 based on their prehospital data set in order to compare the prognostic power of NEWS2, RTS, and TRISS in predicting in-hospital mortality rate. Patients are divided into deceased and survived groups. Demographic data, vital signs, and GCS were obtained from the patients and scoring systems were calculated and compared between the two groups. TRISS and ISS are calculated with in-hospital data set; others are based on prehospital data set. RESULTS A total of 129 patients have deceased. Age, cause of injury, length of hospital stay, SBP, RR, HR, temperature, SpO2, and GCS were associated with mortality (p-value < 0.001). TRISS and RTS had the highest sensitivity and specificity respectively (77.52, CI 95% [69.3-84.4] and 93.99, CI 95% [93.2-94.7]). TRISS had the highest area under the ROC curve (0.934) followed by NEWS2 (0.879), GCS (0.815), RTS (0.812), and ISS (0.774). TRISS and NEWS were superior to RTS, GCS, and ISS (p-value < 0.0001). CONCLUSION This novel study compares the accuracy of NEWS2, TRISS, and RTS scoring systems in predicting mortality rate based on prehospital data. The findings suggest that all the scoring systems can predict mortality, with TRISS being the most accurate of them, followed by NEWS2. Considering the time consumption and ease of use, NEWS2 seems to be accurate and quick in predicting mortality based on prehospital data set.
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Affiliation(s)
| | - Mehrdad Karajizadeh
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mehdi Ghasemian
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Paydar
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Kuipers MF, Laurila R, Remy ML, van Oudheusden M, Hazlett N, Lipsky S, Reisner LL, McCall D, de Groot NMS, Brundel BJJM. Exploring Diet-Based Treatments for Atrial Fibrillation: Patient Empowerment and Citizen Science as a Model for Quality-of-Life-Centered Solutions. Nutrients 2024; 16:2672. [PMID: 39203809 PMCID: PMC11357055 DOI: 10.3390/nu16162672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 07/18/2024] [Accepted: 07/24/2024] [Indexed: 09/03/2024] Open
Abstract
Atrial fibrillation (AF) is the most common heart rhythm disorder in the Western world. Between the years 2010 and 2019, the global prevalence of AF rose from 33.5 million to 59 million, highlighting the importance of developing equitable treatments for patients. The disease is associated with symptoms such as palpitations, dizziness, fatigue, shortness of breath, and cognitive dysfunction. In addition, AF increases the risk of developing a stroke and heart failure. Despite new insights into risk factors that can lead to the development of AF, the success of current treatments is suboptimal. Numerous risk factors, such as hypertension, diabetes, and obesity, have been associated with the development and progression of AF. As these can be lifestyle-related risk factors, lifestyle modification may be a solution to reduce AF-related symptoms as well as episodes. Research results show that certain dietary changes can reduce AF and numerous risk factors for AF. Increasing attention is being given to Mediterranean and whole, plant-based eating patterns, which emphasize eating grains, legumes, vegetables, fruits, and nuts, while excluding most-or all-animal products. Hence, what are the beneficial aspects of a Mediterranean and plant-based diet which consists mainly of unprocessed foods? In the current review, we discuss the outcomes of diet-based treatments. Moreover, other diet-related treatments, brought up by patient initiatives, are highlighted. These patient-initiated studies include L-glutamine and electrolytes as options to manage AF. Also, we highlight the emerging importance of valuing patient needs and a quality-of-life-centered approach to medicine. As indicated by recent studies and patient experiences, citizen science can create inclusive solutions that lead to patient empowerment and a holistic approach for AF management.
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Affiliation(s)
- Myrthe F. Kuipers
- Department of Marketing, Economics and Business Administration, Amsterdam Business School, University of Amsterdam, 1018 TV Amsterdam, The Netherlands;
| | - Ronja Laurila
- Atrial Fibrillation Innovation Platform, 1000 CE Amsterdam, The Netherlands;
| | - Maurice L. Remy
- Athena Institute, Faculty of Science, VU University Amsterdam, 1081 BT Amsterdam, The Netherlands; (M.L.R.); (M.v.O.)
| | - Michiel van Oudheusden
- Athena Institute, Faculty of Science, VU University Amsterdam, 1081 BT Amsterdam, The Netherlands; (M.L.R.); (M.v.O.)
| | - Nedra Hazlett
- Allegheny Health Network, Pittsburgh, PA 15222, USA;
- Plant-Based, Pittsburgh, PA 15222, USA;
| | | | | | - Debbe McCall
- Journal of Atrial Fibrillation and Electrophysiology, Overland Park, KS 66209, USA;
| | | | - Bianca J. J. M. Brundel
- Department of Physiology, Amsterdam UMC, Location Vrije Universiteit, Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias, 1081 HZ Amsterdam, The Netherlands
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Gołuchowska A, Sobieszek K. Musculoskeletal system injuries in the Polish Territorial Defence Forces. BMJ Mil Health 2024; 170:315-319. [PMID: 36446419 DOI: 10.1136/military-2022-002166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 11/08/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Musculoskeletal system injuries (MSIs) are the major health problem of soldiers. The aim of this study was to assess the types of MSIs that occurred most frequently among soldiers and which parts of the body they generally affected. METHODS The study included 140 Territorial Army soldiers, both men and women, serving in the Polish Territorial Defence Forces (TDF). Times and frequency of MSIs were assessed using an original questionnaire available via a web-based platform, the TDF Information Portal and the Yammer network. RESULTS Among the participants, 42% reported MSIs, most often a single one (19%), incurred while doing military service. Damaged muscles and ligaments were the most common injuries in both groups (p>0.05). The knee joint was the main location of injuries for both sexes (24% in men vs 50% in women, p>0.05). Other parts of the body often affected by injuries were the shoulder joint (24%, p>0.05), head, spine, wrist, fingers, ankle and feet (19% each) in the male soldiers and the ankle (24%), spine (14%), head, chest, shoulder joint and foot (10% each) in the female soldiers. Injuries reoccurred with similar frequency in the female and male soldiers (43% vs 40%, p>0.05) and had the same location in both groups (43% vs 40%, respectively, p>0.05). Difficult terrain, too intensive military training and heavy loads were the main risk factors for MSIs in both groups (p>0.05). CONCLUSIONS More than half of all the participants (19% of the men and 33% of the women) reported at least one injury incurred during military service. Over 40% of all the study subjects had reinjuries. The males and females were similar in terms of the most common type and location of MSI. Occurrence of MSIs rarely required interruption in the military training/service.
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Affiliation(s)
| | - K Sobieszek
- Master's Degree in Physiotherapy, graduate of long-cycle programme in Physiotherapy, Faculty of Health Sciences, Medical University of Lodz, Poland; female soldier of the Polish Territorial Defence Forces, Medical University of Lodz, Lodz, Poland
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Kenyon RM, Leighton JL. Control of Haemorrhage in Orthopaedic Trauma. J Clin Med 2024; 13:4260. [PMID: 39064300 PMCID: PMC11277702 DOI: 10.3390/jcm13144260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/26/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
This paper aims to outline current practices and examine promising new advancements in the modern management of haemorrhage in orthopaedic trauma. Many prehospital and perioperative haemorrhage control strategies and techniques have been available to clinicians for multiple decades, yet our understanding and utilisation of these practices continues to be refined and optimised. There is a particular focus in this article on issues related to resuscitation and coagulation in trauma. We examine the complex mechanisms that lead to coagulopathy in trauma patients as well as the transformative effect tranexamic acid has had in limiting blood loss. We also explore some emerging technologies such as endovascular interventions and clot-stabilising dressings and devices that are likely to have a significant impact going forward.
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Hosseinpour H, Anand T, Hejazi O, Colosimo C, Bhogadi SK, Spencer A, Nelson A, Ditillo M, Magnotti LJ, Joseph B. The Role of Whole Blood Hemostatic Resuscitation in Bleeding Geriatric Trauma Patients. J Surg Res 2024; 299:26-33. [PMID: 38692185 DOI: 10.1016/j.jss.2024.03.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/17/2024] [Accepted: 03/21/2024] [Indexed: 05/03/2024]
Abstract
INTRODUCTION Whole blood (WB) has recently gained increased popularity as an adjunct to the resuscitation of hemorrhaging civilian trauma patients. We aimed to assess the nationwide outcomes of using WB as an adjunct to component therapy (CT) versus CT alone in resuscitating geriatric trauma patients. METHODS We performed a 5-y (2017-2021) retrospective analysis of the Trauma Quality Improvement Program. We included geriatric (age, ≥65 y) trauma patients presenting with hemorrhagic shock (shock index >1) and requiring at least 4 units of packed red blood cells in 4 h. Patients with severe head injuries (head Abbreviated Injury Scale ≥3) and transferred patients were excluded. Patients were stratified into WB-CT versus CT only. Primary outcomes were 6-h, 24-h, and in-hospital mortality. Secondary outcomes were major complications. Multivariable regression analysis was performed, adjusting for potential confounding factors. RESULTS A total of 1194 patients were identified, of which 141 (12%) received WB. The mean ± standard deviation age was 74 ± 7 y, 67.5% were male, and 83.4% had penetrating injuries. The median [interquartile range] Injury Severity Score was 19 [13-29], with no difference among study groups (P = 0.059). Overall, 6-h, 24-h, and in-hospital mortality were 16%, 23.1%, and 43.6%, respectively. On multivariable regression analysis, WB was independently associated with reduced 24-h (odds ratio, 0.62 [0.41-0.94]; P = 0.024), and in-hospital mortality (odds ratio, 0.60 [0.40-0.90]; P = 0.013), but not with major complications (odds ratio, 0.78 [0.53-1.15]; P = 0.207). CONCLUSIONS Transfusion of WB as an adjunct to CT is associated with improved early and overall mortality in geriatric trauma patients presenting with severe hemorrhage. The findings from this study are clinically important, as this is an essential first step in prioritizing the selection of WB resuscitation for geriatric trauma patients presenting with hemorrhagic shock.
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Affiliation(s)
- Hamidreza Hosseinpour
- Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona
| | - Tanya Anand
- Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona
| | - Omar Hejazi
- Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona
| | - Christina Colosimo
- Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona
| | - Sai Krishna Bhogadi
- Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona
| | - Audrey Spencer
- Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona
| | - Adam Nelson
- Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona
| | - Michael Ditillo
- Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona
| | - Louis J Magnotti
- Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona
| | - Bellal Joseph
- Division of Trauma, Critical Care, Burns, and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona.
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Seif M, Edalat S, Majidpour Azad Shirazi A, Alipouri S, Bayati M. Prediction of the burden of road traffic injuries in Iran by 2030: Prevalence, death, and disability-adjusted life years. Chin J Traumatol 2024; 27:242-248. [PMID: 38503589 PMCID: PMC11357753 DOI: 10.1016/j.cjtee.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 01/14/2024] [Accepted: 02/10/2024] [Indexed: 03/21/2024] Open
Abstract
PURPOSE Road traffic accidents pose a global challenge with substantial human and economic costs. Iran experiences a high incidence of road traffic injuries, leading to a significant burden on society. This study aims to predict the future burden of road traffic injuries in Iran until 2030, providing valuable insights for policy-making and interventions to improve road safety and reduce the associated human and economic costs. METHODS This analytical study utilized time series models, specifically autoregressive integrated moving average (ARIMA) and artificial neural networks (ANNs), to predict the burden of road traffic accidents by analyzing past data to identify patterns and trends in Iran until 2030. The required data related to prevalence, death, and disability-adjusted life years (DALYs) rates were collected from the Institute for Health Metrics and Evaluation database and analyzed using R software and relevant modeling and statistical analysis packages. RESULTS Both prediction models, ARIMA and ANNs indicate that the prevalence rates (per 100,000) of all road traffic injuries, except for motorcyclist road injuries which have an almost flat trend, remaining at around 430, increase by 2030. Based on estimations of both models, the rates of death and DALYs due to motor vehicle and pedestrian road traffic injuries decrease. For motor vehicle road injuries, estimated trends decrease to approximately 520 DALYs and 10 deaths. Also, for pedestrian road injuries these rates reached approximately 300 DALYs and 6 deaths, according to the models. For cyclists and other road traffic injuries, the predicted DALY rates by the ANN model increase to almost 50 and 8, while predictions conducted by the ARIMA model show a static trend, remaining at 40 and approximately 6.5. Moreover, these rates for the prediction of death rate by the ANN model increased to 0.6 and 0.1, while predictions conducted by the ARIMA model show a static trend, remaining at 0.43 and 0.07. According to the ANN model, the predicted rates of DALY and death for motorcyclists decrease to 100 and approximately 2.7, respectively. On the other hand, predictions made by the ARIMA model show a static trend, with rates remaining at 200 and approximately 3.2, respectively. CONCLUSION The prevalence of road traffic injuries is predicted to increase, while the death and DALY rates of road traffic injuries show different patterns. Effective intervention programs and safety measures are necessary to prevent and reduce road traffic accidents. Different interventions should be designed and implemented specifically for different groups of pedestrians, cyclists, motorcyclists, and motor vehicle drivers.
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Affiliation(s)
- Mozhgan Seif
- Non-communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sedigheh Edalat
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Majidpour Azad Shirazi
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Somayeh Alipouri
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Metsemakers WJ, Moriarty TF, Morgenstern M, Marais L, Onsea J, O'Toole RV, Depypere M, Obremskey WT, Verhofstad MHJ, McNally M, Morshed S, Wouthuyzen-Bakker M, Zalavras C. The global burden of fracture-related infection: can we do better? THE LANCET. INFECTIOUS DISEASES 2024; 24:e386-e393. [PMID: 38042164 DOI: 10.1016/s1473-3099(23)00503-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 12/04/2023]
Abstract
Fracture-related infection is a major complication related to musculoskeletal injuries that not only has important clinical consequences, but also a substantial socioeconomic impact. Although fracture-related infection is one of the oldest disease entities known to mankind, it has only recently been defined and, therefore, its global burden is still largely unknown. In this Personal View, we describe the origin of the term fracture-related infection, present the available data on its global impact, and discuss important aspects regarding its prevention and management that could lead to improved outcomes in both high-resource and low-resource settings. We also highlight the need for health-care systems to be adequately compensated for the high cost of human resources (trained staff) and well-equipped facilities required to adequately care for these complex patients. Our aim is to increase awareness among clinicians and policy makers that fracture-related infection is a disease entity that deserves prioritisation in terms of research, with the goal to standardise treatment and improve patient outcomes on a global scale.
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Affiliation(s)
- Willem-Jan Metsemakers
- Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
| | - T Fintan Moriarty
- AO Research Institute Davos, Davos, Switzerland; Center for Musculoskeletal Infections, Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland
| | - Mario Morgenstern
- Center for Musculoskeletal Infections, Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland
| | - Leonard Marais
- Department of Orthopaedics, School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Jolien Onsea
- Department of Trauma Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Robert V O'Toole
- Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Melissa Depypere
- Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - William T Obremskey
- Department of Orthopaedic Surgery and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael H J Verhofstad
- Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - Martin McNally
- The Bone Infection Unit, Oxford University Hospitals, Oxford, UK
| | - Saam Morshed
- Department of Orthopaedic Surgery and Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Marjan Wouthuyzen-Bakker
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Charalampos Zalavras
- Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Nikbakht HA, Farajpour F, Farhadi Z, Hashemi SN, Jahani MA. Analyzing the trend of mortality due to traffic and nontraffic accidents: a study in the north of Iran. Ann Med Surg (Lond) 2024; 86:3242-3248. [PMID: 38846822 PMCID: PMC11152805 DOI: 10.1097/ms9.0000000000002043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/28/2024] [Indexed: 06/09/2024] Open
Abstract
Background Examining the raw and standardized mortality rates is the primary strategy for improving life expectancy and human health in society through identifying risk factors and dealing with the factors that cause them. Objectives This study examined the trend of mortalities due to traffic and nontraffic accidents. Methods This cross-sectional study examines the registered mortalities during the years 2016-2022 in the form of a census in the health department's death registration and classification system. Mortality was analyzed as raw and standardized mortality in each 100 000 population. Results Out of 18 265 deaths during 2016-2022, 1305 (7.15%) were related to accidents and incidents. The age-standardized total mortality rate in the first year was 32.9, and in the final year of the study, it was 33.3 per 100 000 people; although there are fluctuations, this trend is upward (P.trend=0.021). Also, the age-standardized traffic death rate in the first year is 19, and in the final year is 12 per 100 000 people; this decreasing trend was not statistically significant (P.trend=0.061). The incidence of age-standardized intentional nontraffic deaths was 1.7 in the first year of the study interval and 9.8 in the last year in 100 000 people, which showed an upward trend (P.trend<0.001). Conclusion In light of the generally increasing trend of accidents, especially nontraffic accidents, universal and well-rounded measures are necessary for safety matters and reducing mortality.
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Affiliation(s)
| | - Fatemeh Farajpour
- Student Research Committee, Babol University of Medical Sciences, Babol
| | - Zeynab Farhadi
- Social Determinants of Health Research Center, Health Research Institute
| | - Seyedeh N. Hashemi
- Doctorate of Medicine Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
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Ohm E, Madsen C, Gravseth HM, Brage S, Grøholt EK, Alver K, Holvik K. Post-injury long-term sickness absence and risk of disability pension: The role of socioeconomic status. Injury 2024; 55:111480. [PMID: 38452702 DOI: 10.1016/j.injury.2024.111480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/02/2024] [Accepted: 02/25/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Previous research has identified low socioeconomic status (SES) as a risk factor for long-term sickness absence (LTSA) and disability pension (DP) following trauma. However, most studies lack information on medical diagnoses, limiting our understanding of the underlying factors. To address this gap, we retrieved information about diagnostic causes for receipt of welfare benefits to explore the role of SES in the transition from post-injury LTSA to permanent DP among the working population in Norway. MATERIALS AND METHODS We conducted a population-based cohort study of all Norwegian residents aged 25-59 years registered with a spell of LTSA due to injury commencing in the period 2000-2003. This cohort was followed through 2014 by linking information on receipt of welfare benefits with sociodemographic data from administrative registers. SES was defined as a composite measure of educational attainment and income level. We used flexible parametric survival models to estimate hazard ratios (HR) with 95 % confidence intervals (CI) for all-cause and diagnosis-specific DP according to SES, adjusting for sex, age, marital status, immigrant status and healthcare region of residence. RESULTS Of 53,937 adults with post-injury LTSA, 9,665 (18 %) transferred to DP during follow-up. The crude risk of DP was highest for LTSA spells due to poisoning and head injuries. Overall, individuals in the lowest SES category had twice the risk of DP compared to those in the highest SES category (HR = 2.25, 95 % CI 2.13-2.38). The difference by SES was greatest for LTSA due to poisoning and smallest for LTSA due to head injuries. A majority (75 %) of DP recipients had a non-injury diagnosis as the primary cause of DP. The socioeconomic gradient was more pronounced for non-injury causes of DP (HR = 2.47, 95 % CI 2.31-2.63) than for injury causes (HR = 1.73, 95 % CI 1.56-1.92) and was especially steep for DP due to musculoskeletal diseases and mental and behavioural disorders. CONCLUSIONS The relationship between SES and DP varied by both the type of injury that caused LTSA and the diagnosis used to grant DP, highlighting the importance of taking diagnostic information into account when investigating long-term consequences of injuries.
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Affiliation(s)
- Eyvind Ohm
- Department of Health and Inequality, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway.
| | - Christian Madsen
- Department of Disease Burden, Norwegian Institute of Public Health, Zander Kaaesgt. 7 5015 Bergen, Norway
| | - Hans Magne Gravseth
- Department of Occupational Health Surveillance, National Institute of Occupational Health, PO Box 5330 Majorstuen 0304 Oslo, Norway
| | - Søren Brage
- Retired medical doctor with a PhD in epidemiology/social medicine. Before retirement SB held a position in the Norwegian Labour and Welfare Administration, leading the unit responsible for medical coding of welfare benefits from 1998 to 2015
| | - Else Karin Grøholt
- Department of Health and Inequality, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway
| | - Kari Alver
- Department of Health and Inequality, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway
| | - Kristin Holvik
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, PO Box 222 Skøyen 0213 Oslo, Norway
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11
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Zhang LY, Zhang HY. Torso hemorrhage: noncompressible? never say never. Eur J Med Res 2024; 29:153. [PMID: 38448977 PMCID: PMC10919054 DOI: 10.1186/s40001-024-01760-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 02/29/2024] [Indexed: 03/08/2024] Open
Abstract
Since limb bleeding has been well managed by extremity tourniquets, the management of exsanguinating torso hemorrhage (TH) has become a hot issue both in military and civilian medicine. Conventional hemostatic techniques are ineffective for managing traumatic bleeding of organs and vessels within the torso due to the anatomical features. The designation of noncompressible torso hemorrhage (NCTH) marks a significant step in investigating the injury mechanisms and developing effective methods for bleeding control. Special tourniquets such as abdominal aortic and junctional tourniquet and SAM junctional tourniquet designed for NCTH have been approved by FDA for clinical use. Combat ready clamp and junctional emergency treatment tool also exhibit potential for external NCTH control. In addition, resuscitative endovascular balloon occlusion of the aorta (REBOA) further provides an endovascular solution to alleviate the challenges of NCTH treatment. Notably, NCTH cognitive surveys have revealed that medical staff have deficiencies in understanding relevant concepts and treatment abilities. The stereotypical interpretation of NCTH naming, particularly the term noncompressible, is the root cause of this issue. This review discusses the dynamic relationship between TH and NCTH by tracing the development of external NCTH control techniques. The authors propose to further subdivide the existing NCTH into compressible torso hemorrhage and NCTH' (noncompressible but REBOA controllable) based on whether hemostasis is available via external compression. Finally, due to the irreplaceability of special tourniquets during the prehospital stage, the authors emphasize the importance of a package program to improve the efficacy and safety of external NCTH control. This program includes the promotion of tourniquet redesign and hemostatic strategies, personnel reeducation, and complications prevention.
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Affiliation(s)
- Lian-Yang Zhang
- Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Hua-Yu Zhang
- Department of Trauma Surgery, War Trauma Medical Center, State Key Laboratory of Trauma, Burn and Combined Injury, Daping Hospital, Army Medical University, Chongqing, 400042, China.
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12
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Lule H, Mugerwa M, SSebuufu R, Kyamanywa P, Posti JP, Wilson ML. Rural trauma team development training amongst medical trainees and traffic law enforcement professionals in a low-income country: a protocol for a prospective multicenter interrupted time series. Int J Surg Protoc 2024; 28:12-19. [PMID: 38433864 PMCID: PMC10905493 DOI: 10.1097/sp9.0000000000000013] [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: 08/25/2023] [Accepted: 09/28/2023] [Indexed: 03/05/2024] Open
Abstract
Background Road traffic injuries and their resulting mortality disproportionately affect rural communities in low-middle-income countries (LMICs) due to limited human and infrastructural resources for postcrash care. Evidence from high-income countries show that trauma team development training could improve the efficiency, care, and outcome of injuries. A paucity of studies have evaluated the feasibility and applicability of this concept in resource constrained settings. The aim of this study protocol is to establish the feasibility of rural trauma team development and training in a cohort of medical trainees and traffic law enforcement professionals in Uganda. Methods Muticenter interrupted time series of prospective interventional trainings, using the rural trauma team development course (RTTDC) model of the American College of Surgeons. A team of surgeon consultants will execute the training. A prospective cohort of participants will complete a before and after training validated trauma related multiple choice questionnaire during September 2019-November 2023. The difference in mean prepost training percentage multiple choice questionnaire scores will be compared using ANOVA-test at 95% CI. Time series regression models will be used to test for autocorrelations in performance. Acceptability and relevance of the training will be assessed using 3 and 5-point-Likert scales. All analyses will be performed using Stata 15.0. Ethical approval was obtained from Research and Ethics Committee of Mbarara University of Science and Technology (Ref: MUREC 1/7, 05/05-19) and Uganda National Council for Science and Technology (Ref: SS 5082). Retrospective registration was accomplished with Research Registry (UIN: researchregistry9490).
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Affiliation(s)
- Herman Lule
- Department of Surgery, Kiryandongo Regional Referral Hospital, Kigumba, Uganda
- Department of Clinical Neurosciences, Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre
| | - Michael Mugerwa
- Department of Clinical Neurosciences, Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre
| | | | - Patrick Kyamanywa
- Mother Kevin Postgraduate Medical School, Uganda Martyr’s University, Nkozi, Uganda
| | - Jussi P. Posti
- Department of Neurosurgery and Turku Brain Injury Centre, Neurocentre, Turku University Hospital and University of Turku, Turku, Finland
| | - Michael L. Wilson
- Heidelberg Institute of Global Health (HIGH), University Hospital and University of Heidelberg, Heidelberg, Germany
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13
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Paleczny S, Osagie N, Sethi J. Validity and reliability International Classification of Diseases-10 codes for all forms of injury: A systematic review. PLoS One 2024; 19:e0298411. [PMID: 38421992 PMCID: PMC10903801 DOI: 10.1371/journal.pone.0298411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Intentional and unintentional injuries are a leading cause of death and disability globally. International Classification of Diseases (ICD), Tenth Revision (ICD-10) codes are used to classify injuries in administrative health data and are widely used for health care planning and delivery, research, and policy. However, a systematic review of their overall validity and reliability has not yet been done. OBJECTIVE To conduct a systematic review of the validity and reliability of external cause injury ICD-10 codes. METHODS MEDLINE, EMBASE, COCHRANE, and SCOPUS were searched (inception to April 2023) for validity and/or reliability studies of ICD-10 external cause injury codes in all countries for all ages. We examined all available data for external cause injuries and injuries related to specific body regions. Validity was defined by sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Reliability was defined by inter-rater reliability (IRR), measured by Krippendorff's alpha, Cohen's Kappa, and/or Fleiss' kappa. RESULTS Twenty-seven published studies from 2006 to 2023 were included. Across all injuries, the mean outcome values and ranges were sensitivity: 61.6% (35.5%-96.0%), specificity: 91.6% (85.8%-100%), PPV: 74.9% (58.6%-96.5%), NPV: 80.2% (44.6%-94.4%), Cohen's kappa: 0.672 (0.480-0.928), Krippendorff's alpha: 0.453, and Fleiss' kappa: 0.630. Poisoning and hand and wrist injuries had higher mean sensitivity (84.4% and 96.0%, respectively), while self-harm and spinal cord injuries were lower (35.5% and 36.4%, respectively). Transport and pedestrian injuries and hand and wrist injuries had high PPVs (96.5% and 92.0%, respectively). Specificity and NPV were generally high, except for abuse (NPV 44.6%). CONCLUSIONS AND SIGNIFICANCE The validity and reliability of ICD-10 external cause injury codes vary based on the injury types coded and the outcomes examined, and overall, they only perform moderately well. Future work, potentially utilizing artificial intelligence, may improve the validity and reliability of ICD codes used to document injuries.
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Affiliation(s)
- Sarah Paleczny
- Injury Prevention Research Office, Division of Neurosurgery, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Nosakhare Osagie
- Injury Prevention Research Office, Division of Neurosurgery, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Jai Sethi
- Injury Prevention Research Office, Division of Neurosurgery, St. Michael’s Hospital, Toronto, Ontario, Canada
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Wah W, Berecki-Gisolf J, Walker-Bone K. In-hospital complications of work-related musculoskeletal injuries. Injury 2024; 55:111211. [PMID: 37984014 DOI: 10.1016/j.injury.2023.111211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/07/2023] [Accepted: 11/12/2023] [Indexed: 11/22/2023]
Abstract
BACKGROUND, OBJECTIVES Work-related musculoskeletal (MSK) injuries are a major contributor to morbidity worldwide and frequently result in hospitalisation. Hospital complications are common, costly, and largely preventable, but relevant data is required to address this. This study aimed to identify the incidence and factors associated with in-hospital complications of work-related MSK injuries. METHODS This study is based on work-related MSK hospital admission data from Victorian Admitted Episodes Database, 2016-2022. Complications were identified based on ICD-10-AM coding using CHADx (Classification of Hospital Acquired Diagnoses). Negative binomial and logistic regression analyses were performed to identify factors related to in-hospital complications. RESULTS In-hospital complications occurred in 6.3 % of work-related MSK injury admissions. In the adjusted models, ages ≥45 years, female sex, and area-level disadvantage were associated with in-hospital complications. Stay at public (vs private) hospitals, comorbidity, emergency admissions, and general anaesthesia were also associated. Complication rates were higher in hospitalised workers with direct head, neck, and trunk injuries and cumulative MSK disorders than those with direct extremities injuries and acute MSK conditions. The most common complications were cardiovascular, gastrointestinal complications and adverse drug events. CONCLUSION This study identified patient, injury and hospital-related characteristics associated with in-hospital complications of work-related MSK injuries for informing prevention strategies and risk estimation by hospital staff and workers' compensation schemes. The results demonstrate a sizable rate of complications given the relatively young and healthy study population.
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Affiliation(s)
- Win Wah
- Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, 553St Kilda road, Melbourne, Victoria 3004, Australia.
| | - Janneke Berecki-Gisolf
- Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, 553St Kilda road, Melbourne, Victoria 3004, Australia; Victorian Injury Surveillance Unit, Monash University Accident Research Centre, Monash University, 21 Alliance Ln, Clayton, Melbourne, Victoria 3168, Australia
| | - Karen Walker-Bone
- Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, 553St Kilda road, Melbourne, Victoria 3004, Australia
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15
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Zeng HJ, Liu JJ, Yang YC. Clinical observation of gastrointestinal function recovery in patients after hepatobiliary surgery. World J Gastrointest Surg 2024; 16:76-84. [PMID: 38328324 PMCID: PMC10845271 DOI: 10.4240/wjgs.v16.i1.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/21/2023] [Accepted: 12/28/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The liver is an important metabolic and digestive organ in the human body, capable of producing bile, clotting factors, and vitamins. AIM To investigate the recovery of gastrointestinal function in patients after hepatobiliary surgery and identify effective rehabilitation measures. METHODS A total of 200 patients who underwent hepatobiliary surgery in our hospital in 2022 were selected as the study subjects. They were divided into a control group and a study group based on the extent of the surgery, with 100 patients in each group. The control group received routine treatment, while the study group received targeted interventions, including early enteral nutrition support, drinking water before gas discharge, and large bowel enema, to promote postoperative gastrointestinal function recovery. The recovery of gastrointestinal function was compared between the two groups. RESULTS Compared with the control group, patients in the study group had better recovery of bowel sounds and less accumulation of fluids in the liver bed and gallbladder fossa (P < 0.05). They also had shorter time to gas discharge and first meal (P < 0.05), higher overall effective rate of gastrointestinal function recovery (P < 0.05), and lower incidence of postoperative complications (P < 0.05). CONCLUSION Targeted nursing interventions (early nutritional support, drinking water before gas discharge, and enema) can effectively promote gastrointestinal function recovery in patients undergoing hepatobiliary surgery and reduce the incidence of complications, which is worthy of promotion.
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Affiliation(s)
- Hua-Jun Zeng
- Department of General Practice, Nanyang First People's Hospital, Nanyang 473000, Henan Province, China
| | - Jing-Jing Liu
- Department of Anesthesiology, Chinese People’s Armed Police Force Hospital of Beijing, Beijing 100027, China
| | - Ying-Chun Yang
- Department of Anesthesiology, Beijing Fengtai Hospital, Beijing 100071, China
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16
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Irumba C, Baragaine J, Obore S, Mwanje H, Nteziyaremye J. An intricate vagina penetrating injury with a 22 cm cassava stick in situ for 6 months: a case report. J Med Case Rep 2024; 18:30. [PMID: 38267997 PMCID: PMC10809435 DOI: 10.1186/s13256-023-04339-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/26/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Trauma remains one of the major causes of morbidity and mortality and a threat to attainment of sustainable development goal 11. Genital urinary trauma is reported in about 10% of patients presenting with trauma worldwide, and in about 6.6% of patients in Sub-Saharan Africa. If not careful enough, one may miss the foreign body in the vagina and this may be associated with morbidity, and although rare, mortality. CASE PRESENTATION We report a case of a 7-year-old Black Ugandan that had suffered vagina trauma 6 months prior to presentation at our facility and presented with chronic vagina pus discharge for 6 months. Prior examinations had failed to recognize the foreign body and so did the two abdominal pelvic ultrasound scans. During examination under anesthesia, we were able to locate the cassava stick that had caused penetrating vagina injury and we were able to dislodge it. It was a blunt cassava stick with length of 22 cm and diameter of 2 cm. Although it had gone through the peritoneal cavity, we did not do a laparotomy. CONCLUSION This case emphasizes the need for a thorough vaginal exam including the need to do it under anesthesia with good lighting even when ultrasound scan findings are normal. It presents an opportunity for one to manage penetrating peritoneal injury without a laparotomy in highly selected cases. Gynecologists should be keen as well to rule out child molestation.
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Affiliation(s)
- Charles Irumba
- Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Urogynaecology, Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda
| | - Justus Baragaine
- Department of Obstetrics and Gynaecology, College of Health Sciences, Makerere University, Kampala, Uganda
- Department of Urogynaecology, Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda
| | - Susan Obore
- Department of Urogynaecology, Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda
| | - Haruna Mwanje
- Department of Urogynaecology, Mulago Specialized Women and Neonatal Hospital, Kampala, Uganda
| | - Julius Nteziyaremye
- Department of Obstetrics and Gynaecology, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
- Department of Obstetrics and Gynaecology, Mbale Regional Referral Hospital, Mbale, Uganda.
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17
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Dandona R, Pandey A, Kumar GA, Arora M, Dandona L. Review of the India Adolescent Health Strategy in the context of disease burden among adolescents. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 20:100283. [PMID: 38234699 PMCID: PMC10794100 DOI: 10.1016/j.lansea.2023.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 08/24/2023] [Accepted: 09/07/2023] [Indexed: 01/19/2024]
Abstract
Background A nuanced understanding of the health needs of adolescents in the context of the India Adolescent Health Strategy (IAHS) is needed to inform policy interventions for improving the health and well-being of adolescents in India. Methods Using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, we identified the top ten causes of years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) disaggregated by sex and age group (10-14 and 15-19 years) for India and its states in 2019. To inform the IAHS of refinement or expansion in focus needed to improve adolescent health in India, we reviewed the extent to which the top 10 causes of disease burden are addressed in the IAHS, and the availability of and age- and sex-disaggregation in the service utilisation data for adolescents captured in the Adolescent Friendly Health Clinic monitoring information system (AFHC MIS) and Health Management Information System (HMIS). We also reviewed the availability of and age-and sex-disaggregation in the data capture at the population level for the IAHS outcome indicators in the data sources identified in the IAHS operational framework. Findings Females in the 10-14 and 15-19 years age groups suffered 6.75 million and 9.25 million DALYs, respectively, 39.1% and 44.2% of which were YLLs; the corresponding DALYs for males were 6.71 million and 9.65 million (42.3% and 41.1% YLLs), respectively. Within the 6 thematic areas of the IAHS, most strategies and indicators identified are for sexual and reproductive health followed by nutrition, and broadly these conditions accounted for YLDs and not YLLs in adolescents. Significant gaps in the IAHS in comparison to the disease burden for fatal diseases and conditions were seen across injuries, communicable diseases, and non-communicable diseases. Injuries accounted for 65.9% and 45.3% of YLLs in males and females aged 15-19 years, and 40.8% in males aged 10-14 years. Specifically, road injuries (15.3%, 95% UI 11.0-18.0) and self-harm (11.3%, 95% UI 8.7-14.2) accounted for most of the injury deaths in 15-19 years whereas drowning (7.7% 95% UI 5.8-9.6) and road injuries (6.9%, 95% UI 4.7-8.6) accounted for the most injury deaths in 10-14 years males. However, only self-harm and gender-based violence are specifically addressed in the IAHS with non-specific interventions for other injuries. Diarrhoea, lower respiratory infections, malaria, encephalitis, tuberculosis, typhoid, cirrhosis, and hepatitis are the other disease conditions accounting for YLLs and DALYs in adolescents but these are neither addressed in the IAHS nor in service provision under the AFHC MIS. There is no age- or sex-disaggregation in the cause of death data captured in the HMIS to allow an understanding of mortality in adolescents. For the IAHS outcome indicators at the population level, data capture for the 10-14 years irrespective of sex was largely missing from the population surveys and none of the surveys captured data for either females or males aged 15-19 years for physical inactivity and mental health indicators. Interpretation The considerable differences seen in the IAHS thematic focus as compared with the leading causes of fatal and non-fatal disease burden in adolescents in India, and in the availability of population-level data to monitor the outcome indicators of the IAHS can pose substantial limitations for improving adolescent health in India. The findings in this paper can be utilized by decision makers to refine action aimed at improving adolescent health and well-being. Funding Bill & Melinda Gates Foundation.
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Affiliation(s)
- Rakhi Dandona
- Public Health Foundation of India, New Delhi, India
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
| | | | - G Anil Kumar
- Public Health Foundation of India, New Delhi, India
| | - Monika Arora
- Public Health Foundation of India, New Delhi, India
| | - Lalit Dandona
- Public Health Foundation of India, New Delhi, India
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA
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18
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Tunesi S, Tambuzzi S, Decarli A, Cattaneo C, Russo AG. Trends in mortality from non-natural causes in children and adolescents (0-19 years) in Europe from 2000 to 2018. BMC Public Health 2023; 23:2223. [PMID: 37950237 PMCID: PMC10638782 DOI: 10.1186/s12889-023-17040-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Non-natural mortality in children and adolescents is a global public health problem that varies widely from country to country. Data on child and adolescent maltreatment are not readily available, and mortality due to violent causes is also underestimated. METHODS Injury-related mortality rates (overall and by specific causes) from 2000 to 2018 in selected European countries were analysed to observe mortality patterns in children and adolescents using data from the Eurostat database. Age-standardized mortality rates per 100,000 person-years were calculated for each country. Joinpoint regression analysis with a significance level of 0.05 and 95% confidence intervals was performed for mortality trends. RESULTS Children and adolescent mortality from non-natural causes decreased significantly in Europe from 10.48 around 2005 to 5.91 around 2015. The Eastern countries (Romania, Bulgaria, Poland, Slovakia, Czech Republic) had higher rates; while Spain, Denmark, Italy, and the United Kingdom had the lowest. Rates for European Country declined by 5.10% per year over the entire period. Larger downward trends were observed in Ireland, Spain and Portugal; smaller downward trends were observed for Eastern countries (Bulgaria, Czech Republic, Poland, Slovakia) and Finland. Among specific causes of death, the largest decreases were observed for accidental causes (-5.9%) and traffic accidents (-6.8%). CONCLUSIONS Mortality among children and adolescents due to non-natural causes has decreased significantly over the past two decades. Accidental events and transport accidents recorded the greatest decline in mortality rates, although there are still some European countries where the number of deaths among children and adolescents from non-natural causes is high. Social, cultural, and health-related reasons may explain the observed differences between countries.
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Affiliation(s)
- Sara Tunesi
- Epidemiology Unit, Agency for Health Protection of Milan, Via Conca del Naviglio, 45, 20123, Milano, (MI), Italy
| | - Stefano Tambuzzi
- Bureau of Legal Medicine and Insurance, Department of Biomedical Science for Health, University of Milan, Milan, Italy
| | - Adriano Decarli
- Epidemiology Unit, Agency for Health Protection of Milan, Via Conca del Naviglio, 45, 20123, Milano, (MI), Italy
| | - Cristina Cattaneo
- Bureau of Legal Medicine and Insurance, Department of Biomedical Science for Health, University of Milan, Milan, Italy
| | - Antonio Giampiero Russo
- Epidemiology Unit, Agency for Health Protection of Milan, Via Conca del Naviglio, 45, 20123, Milano, (MI), Italy.
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Gerard J, Van Gent JM, Cardenas J, Gage C, Meyer DE, Cox C, Wade CE, Cotton BA. Hypofibrinogenemia following injury in 186 children and adolescents: identification of the phenotype, current outcomes, and potential for intervention. Trauma Surg Acute Care Open 2023; 8:e001108. [PMID: 38020863 PMCID: PMC10649809 DOI: 10.1136/tsaco-2023-001108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives Recent studies evaluating fibrinogen replacement in trauma, along with newly available fibrinogen-based products, has led to an increase in debate on where products such as cryoprecipitate belong in our resuscitation strategies. We set out to define the phenotype and outcomes of those with hypofibrinogenemia and evaluate whether fibrinogen replacement should have a role in the initial administration of massive transfusion. Methods All patients <18 years of age presenting to our trauma center 11/17-4/21 were reviewed. We then evaluated all patients who received emergency-release and massive transfusion protocol (MTP) products. Patients were defined as hypofibrinogenemic (HYPOFIB) if admission fibrinogen <150 or rapid thrombelastography (r-TEG) angle <60 degrees. Our analysis sought to define risk factors for presenting with HYPOFIB, the impact on outcomes, and whether early replacement improved mortality. Results 4169 patients were entered into the trauma registry, with 926 level 1 trauma activations, of which 186 patients received emergency-release blood products during this time; 1%, 3%, and 10% were HYPOFIB, respectively. Of the 186 patients of interest, 18 were HYPOFIB and 168 were non-HYPOFIB. The HYPOFIB patients were significantly younger, had lower field and arrival Glasgow Coma Scale, had higher head Abbreviated Injury Scale, arrived with worse global coagulopathy, and died from brain injury. Non-HYPOFIB patients were more likely to have (+)focused assessment for the sonography of trauma on arrival, sustained severe abdominal injuries, and die from hemorrhage. 12% of patients who received early cryoprecipitate (0-2 hours) had higher mortality by univariate analysis (55% vs 31%, p=0.045), but no difference on multivariate analysis (OR 0.36, 95% CI 0.07 to 1.81, p=0.221). Those receiving early cryoprecipitate who survived after pediatric intensive care unit (PICU) admission had lower PICU fibrinogen and r-TEG alpha-angle values. Conclusion In pediatric trauma, patients with hypofibrinogenemia on admission are most likely younger and to have sustained severe brain injury, with an associated mortality of over 80%. Given the absence of bleeding-related deaths in HYPOFIB patients, this study does not provide evidence for the empiric use of cryoprecipitate in the initial administration of a massive transfusion protocol. Level of Evidence Level III - Therapeutic/Care Management.
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Affiliation(s)
- Justin Gerard
- Department of Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jan-Michael Van Gent
- Department of Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Jessica Cardenas
- Department of Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Christian Gage
- Department of Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - David E Meyer
- Department of Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Charles Cox
- Department of Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Charles E Wade
- Surgery/Center for Injury Research, The University of Texas Health Science Center McGovern School of Medicine, Houston, Texas, USA
| | - Bryan A Cotton
- Department of Surgery, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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Rogers E, Pothugunta S, Kosmider V, Stokes N, Bonomini L, Briggs GD, Lewis DP, Balogh ZJ. The Diagnostic, Therapeutic and Prognostic Relevance of Neutrophil Extracellular Traps in Polytrauma. Biomolecules 2023; 13:1625. [PMID: 38002307 PMCID: PMC10669581 DOI: 10.3390/biom13111625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/02/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Neutrophil extracellular traps (NETs) represent a recently discovered polymorphonuclear leukocyte-associated ancient defence mechanism, and they have also been identified as part of polytrauma patients' sterile inflammatory response. This systematic review aimed to determine the clinical significance of NETs in polytrauma, focusing on potential prognostic, diagnostic and therapeutic relevance. The methodology covered all major databases and all study types, but was restricted to polytraumatised humans. Fourteen studies met the inclusion criteria, reporting on 1967 patients. Ten samples were taken from plasma and four from whole blood. There was no standardisation of methodology of NET detection among plasma studies; however, of all the papers that included a healthy control NET, proxies were increased. Polytrauma patients were consistently reported to have higher concentrations of NET markers in peripheral blood than those in healthy controls, but their diagnostic, therapeutic and prognostic utility is equivocal due to the diverse study population and methodology. After 20 years since the discovery of NETs, their natural history and potential clinical utility in polytrauma is undetermined, requiring further standardisation and research.
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Affiliation(s)
- Emily Rogers
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia (S.P.)
| | - Shevani Pothugunta
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia (S.P.)
| | - Veronika Kosmider
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia (S.P.)
| | - Natasha Stokes
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia (S.P.)
| | - Layla Bonomini
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia (S.P.)
| | - Gabrielle D. Briggs
- Discipline of Surgery, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia; (G.D.B.)
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, NSW 2308, Australia
| | - Daniel P. Lewis
- Discipline of Surgery, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia; (G.D.B.)
- Department of Traumatology, John Hunter Hospital, Newcastle, NSW 2308, Australia
| | - Zsolt J. Balogh
- Discipline of Surgery, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia; (G.D.B.)
- Injury and Trauma Research Program, Hunter Medical Research Institute, Newcastle, NSW 2308, Australia
- Department of Traumatology, John Hunter Hospital, Newcastle, NSW 2308, Australia
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Fleury MJJ, Nicolleau C, Bouhours G, Conté M, Martin L, Lasocki S, Léger M. Evaluating cognitive aids in hospital management of severe trauma patients: a prospective randomised high-fidelity simulation trial. Br J Anaesth 2023; 131:e150-e152. [PMID: 37741721 DOI: 10.1016/j.bja.2023.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 09/25/2023] Open
Affiliation(s)
- Maxime J J Fleury
- Department of Anaesthesiology and Intensive Care, Angers University Hospital Centre, Angers, France
| | - Claire Nicolleau
- Department of Anaesthesiology and Intensive Care, Angers University Hospital Centre, Angers, France
| | - Guillaume Bouhours
- Department of Anaesthesiology and Intensive Care, Angers University Hospital Centre, Angers, France
| | - Mathieu Conté
- Department of Anaesthesiology and Intensive Care, Angers University Hospital Centre, Angers, France
| | - Ludovic Martin
- Department of Dermatology, Angers University Hospital Centre, Angers, France
| | - Sigismond Lasocki
- Department of Anaesthesiology and Intensive Care, Angers University Hospital Centre, Angers, France
| | - Maxime Léger
- Department of Anaesthesiology and Intensive Care, Angers University Hospital Centre, Angers, France; Department of Anaesthesia and Perioperative Care, UCSF, San Francisco, CA, USA.
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Zaki HA, Hamdi AH, Elgassim M, Albaroudi B, Fadul KY, Abdelrahman A, Basharat K, Al-Marri NDR, Elmegabar B, Elsayed WAE. Unmasking the Underlying Causes: A Cross-Sectional Analysis of Mortality From Intentional and Unintentional Injuries in the United Arab Emirates. Cureus 2023; 15:e46567. [PMID: 37933336 PMCID: PMC10625665 DOI: 10.7759/cureus.46567] [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] [Accepted: 10/05/2023] [Indexed: 11/08/2023] Open
Abstract
The United Arab Emirates (UAE) has experienced substantial development in infrastructure and transportation in the last few decades. Although available evidence suggests that the incidence of injuries has considerably increased in the previous few years, there is a scarcity of literature that comprehensively analyzed the mortality due to different types of injuries in the UAE. Therefore, the current study was designed to report mortality due to various intentional and unintentional injuries in the UAE. Secondary data was obtained from the World Health Organization (WHO) mortality database. We targeted injuries-specific mortality datasets. We applied a filter (UAE) to retrieve mortality data from unintentional and intentional injuries in the UAE. The latest data in the WHO mortality database was for 2020-21. A total of 10,357 death records from the UAE were present in the WHO mortality database. The percentage of injury-specific deaths out of total deaths was 8.69% (n=900). Injury-specific mortality rate per 100,000 population was 9.09. The percentage of injury-specific deaths was higher for males (87.3%, n=786) and the age group 25-34 years (n=323, 35.9%). Of the 900 injury-specific deaths, 449 (49.9%) were due to unintentional injuries, 216 (24.0%) were due to unintentional injuries, while the remaining (26.1%, n=235) deaths occurred due to Ill-defined injuries. More than half (53.7%, n=241) of unintentional injuries were because of road traffic injuries (RTIs) followed by fall (14.7%, n=66), exposure to mechanical forces (6.5%, n=29), drowning (6.0%, n=27) fire (1.1%, n=5), poisonings (1.1%, n=5), natural disasters (n=1, 0.2%) and other unintentional injuries (16.7%, n=75). More than three-quarters (83.3%, n=180) of intentional injuries were because of self-inflicted injuries while the remaining (16.7%, n=36) intentional injuries-specific deaths occurred due to violence. Many deaths in the UAE occur due to unintentional and intentional injuries. RTIs and falls are the leading causes of unintentional injury-specific deaths, while self-inflicted injuries and violence are the leading causes of intentional injury-specific deaths.
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Affiliation(s)
- Hany A Zaki
- Emergency Medicine, Hamad Medical Corporation, Doha, QAT
| | | | | | | | - Khalid Y Fadul
- Emergency Medicine, Hamad Medical Corporation, Doha, QAT
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He C, Yin P, Chen R, Gao Y, Liu W, Schneider A, Bell ML, Kan H, Zhou M. Cause-specific accidental deaths and burdens related to ambient heat in a warming climate: A nationwide study of China. ENVIRONMENT INTERNATIONAL 2023; 180:108231. [PMID: 37778287 DOI: 10.1016/j.envint.2023.108231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/14/2023] [Accepted: 09/23/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Future warming is projected to increase the heat-related mortality burden, especially for vulnerable populations. However, most previous studies focused on non-accidental morbidity or mortality, with far less research on heat-related accidental events. METHODS We collected individual accidental death records among all residents in Chinese mainland from June to August during 2013-2019. Accidental deaths were further divided into several subtypes by different causes. We used an individual-level, time-stratified, case-crossover study design to estimate the association between daily mean temperature and accidental deaths, and estimate its variation in seven geo-climatic zones, age (5-64, 65-74, ≥75), and sex (male, female). We then estimated the temperature-related excess accidental deaths under global warming scenarios of 1.5, 2, and 3℃. FINDINGS A total of 711,929 accidental death records were included in our study. We found that higher temperatures were associated with increased risks of deaths from the total accidental events and four main subtypes, including traffic, falls, drowning, and unintentional injuries. We also found that younger individuals (ages 5-64) and males faced a higher risk of heat-related mortality due to total accidents, traffic incidents, and drowning. For future climate scenarios, even under the 1.5℃ climate change scenario, 6,939 (95% eCI (empirical Confidence Interval): 6,818-7,067) excess accidental deaths per year are attributed to higher summertime daily temperature over mainland China, and the number of accidental deaths would increase by 16.71% and 33.59% under the 2℃ and 3℃ climate change scenarios, respectively. For residents living in southern coastal and northwest inland regions, the projected increase in accidental death is higher. CONCLUSIONS This nationwide study confirms that higher summer temperatures are linked to an increased risk of accidental deaths. Younger age groups and males face a higher risk. This indicates that current estimates of the health effects of climate change might be underestimated, particularly for younger populations.
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Affiliation(s)
- Cheng He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China; Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Peng Yin
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Wei Liu
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | | | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
| | - Maigeng Zhou
- National Center for Chronic Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
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Gupta P, Dar PMUD, Gupta S, Jain S, Kumar S, Gupta A, Sagar S. Analysis and approach to renal trauma: A five-year experience at a level I trauma centre in north India. Chin J Traumatol 2023:S1008-1275(23)00093-7. [PMID: 37838577 DOI: 10.1016/j.cjtee.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/18/2023] [Accepted: 08/03/2023] [Indexed: 10/16/2023] Open
Abstract
PURPOSE Renal trauma constitutes 0.5% - 5% of all trauma patients, and 10% - 20% of abdominal trauma. It is the most commonly injured organ in the genitourinary tract. Road traffic crash (RTC) is the most common cause. In recent years due to the advances in radiological imaging and endovascular techniques, there has been an increase in the nonoperative management of renal trauma. We investigated a large trauma cohort at a level I trauma centre to evaluate patients' demographics with renal trauma, their management, and the outcomes. METHODS This was a retrospective analysis of the prospectively collected data of renal trauma patients managed from January 2016 to December 2020. Patients who visited the level I trauma centre in north India with renal trauma were included in this study. Patients who were dead on arrival in the emergency department were excluded. Demographics, mechanism of injury, presence of hemorrhagic shock, associated injuries, complications, length of hospital stay (LOS), discharge, and mortality were recorded. The data were entered in Microsoft Excel 365 and analysed using SPSS version 21. RESULTS This study collected data from 303 renal trauma patients. Males constituted 86.5% of the patients. Most patients were young, aged from 20 - 40 years. Blunt renal trauma was the predominant mode of injury (n = 270, 89.1%). RTCs (n = 190, 62.7%) and falls from height (n = 65, 21.4%) were the 2 most common mechanisms of injury. Focused assessment with sonography in trauma was positive in 68.4% of patients. Grade III (grading by the American Association for the Surgery of Trauma) renal trauma (30.4%) was the most common grade in our study. The liver (n = 104, 34.3%) and splenic trauma (n = 96, 31.7%) were the most commonly associated injuries. Of the 303 patients, 260 (85.8%) were managed nonoperatively. The mean (SD) of the patients' LOS was 12.5 (6.5) days. There were 25 (8.3%) mortalities during the study period and all of them had associated other injuries. The comparison of LOS of isolated renal trauma group and renal trauma with associated injuries group was not statistically significant (p = 0.322). All the patients who died during the study period had renal trauma with associated other organ injuries. None of the patients with isolated renal trauma died during the study. The outcome comparison between both groups was not statistically significant (p = 0.110). CONCLUSION Renal trauma predominantly occurs in young males, especially due to RTCs followed by fall from height. Focused assessment with sonography in trauma is not reliable in detecting renal injuries, other diagnostic tools such as contrast enhanced computed tomography torso should be considered in diagnosing and grading these injuries. Renal trauma usually does not occur in isolation. Majority are associated with other abdominal and extra abdominal injuries. Most of the times these injuries can be managed nonoperatively, which can achieve a low mortality. The patients who required surgery had high mortality as compared to patients who managed nonoperatively. These patients who required surgery had either severe renal or extra renal trauma and were in hemorrhagic shock. Renal trauma from this large cohort may contribute to improving the quality of care for patients with renal trauma by obtaining knowledge about the patient's characteristics, management, and outcomes.
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Affiliation(s)
- Piyush Gupta
- Department of General Surgery, Indian Naval Hospital Ship, Kalyani, vizag, Visakhapatnam, Andhra Pradesh, 530005, India
| | - Parvez Mohi Ud Din Dar
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Vijaypur, Jammu, 184120, India
| | - Sahil Gupta
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Siddhart Jain
- Department of Urology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Subodh Kumar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Amit Gupta
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Sushma Sagar
- Division of Trauma Surgery and Critical Care, Jai Prakash Narayan Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, 110029, India
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Sharma D, Prinja S, Aggarwal AK, Rajsekar K, Bahuguna P. Development of the Indian Reference Case for undertaking economic evaluation for health technology assessment. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 16:100241. [PMID: 37694178 PMCID: PMC10485782 DOI: 10.1016/j.lansea.2023.100241] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 02/24/2023] [Accepted: 06/02/2023] [Indexed: 09/12/2023]
Abstract
Background Health technology assessment (HTA) is globally recognised as an important tool to guide evidence-based decision-making. However, heterogeneity in methods limits the use of any such evidence. The current research was undertaken to develop a set of standards for conduct of economic evaluations for HTA in India, referred to as the Indian Reference Case. Methods Development of the reference case comprised of a four-step process: (i) review of existing international HTA guidelines; (ii) systematic review of economic evaluations for three countries to assess adherence with pre-existing country-specific HTA guidelines; (iii) empirical analysis to assess the impact of alternate assumptions for key principles of economic evaluation on the results of cost-effectiveness analysis; (iv) stakeholder consultations to assess appropriateness of the recommendations. Based on the inferences drawn from the first three processes, a preliminary draft of the reference case was developed, which was finalised based on stakeholder consultations. Findings The Indian Reference Case provides twelve recommendations on eleven key principles of economic evaluation: decision problem, comparator, perspective, source of effectiveness evidence, measure of costs, health outcomes, time-horizon, discounting, heterogeneity, uncertainty analysis and equity analysis, and for presentation of results. The recommendations are user-friendly and have scope to allow for context-specific flexibility. Interpretation The Indian Reference Case is expected to provide guidance in planning, conducting, and reporting of economic evaluations. It is anticipated that adherence to the Reference Case would increase the quality and policy utilisation of future evaluations. However, with advancement in the field of health economics efforts aimed at refining the Indian Reference Case would be needed. Funding This research received no specific grant from any funding agency, commercial, or not-for-profit sectors. The research was undertaken as part of doctoral thesis of Sharma D, who received scholarship from the Indian Council of Medical Research (ICMR), New Delhi, India.
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Affiliation(s)
- Deepshikha Sharma
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Shankar Prinja
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Arun K. Aggarwal
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Kavitha Rajsekar
- Department of Health Research, Ministry of Health and Family Welfare, New Delhi, India
| | - Pankaj Bahuguna
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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An SJ, Kumwenda K, Peiffer S, Davis D, Gallaher J, Charles A. Pediatric Traumatic Brain Injury in Malawi: A Propensity-Weighted Analysis of Outcomes and Trends Over Time. World Neurosurg 2023; 176:e704-e710. [PMID: 37295467 DOI: 10.1016/j.wneu.2023.05.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/26/2023] [Accepted: 05/27/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Pediatric injuries contribute to substantial mortality and morbidity worldwide, particularly in sub-Saharan Africa. We aim to identify predictors of mortality and time trends for pediatric traumatic brain injuries (TBIs) in Malawi. METHODS We performed a propensity-matched analysis of data from the trauma registry at Kamuzu Central Hospital in Malawi from 2008 to 2021. All children ≤16 years of age were included. Demographic and clinical data were collected. Outcomes were compared between patients with and without head injuries. RESULTS A cohort of 54,878 patients was included, with 1755 having TBI. The mean ages of patients with and without TBI were 7.8 ± 7.8 years and 7.1 ± 4.5 years, respectively. The most common mechanism for patients with and without TBI was road traffic injury and falls, respectively (48.2% vs. 47.8%, P < 0.01). The crude mortality rate for the TBI cohort was 20.9% compared to 2.0% in the non-TBI cohort (P < 0.01). After propensity matching, patients with TBI had 4.7 higher odds of mortality (95% confidence interval 1.9-11.8). Over time, patients with TBI had an increasing predicted probability of mortality for all age categories, with the most significant increase among children younger than 1 year. CONCLUSIONS TBI confers a greater than 4-fold higher likelihood of mortality in this pediatric trauma population in a low-resource setting. These trends have worsened over time.
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Affiliation(s)
- Selena J An
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kellar Kumwenda
- Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Sarah Peiffer
- Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Dylane Davis
- University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, North Carolina, USA
| | - Jared Gallaher
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Anthony Charles
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi.
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Hetaimish BM, Abualross O, Alesawi A, Namenkani M, Alramadhani A, Samargandi R. The Current State of Undergraduate Trauma and Orthopedics Training in Saudi Arabia: A Survey-Based Study of Sixth-Year Medical Students' and Interns' Learning Experience and Subjective Clinical Competence. Cureus 2023; 15:e39974. [PMID: 37416005 PMCID: PMC10321025 DOI: 10.7759/cureus.39974] [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] [Accepted: 06/03/2023] [Indexed: 07/08/2023] Open
Abstract
Background and objective Students frequently complain about the lack of practical skill learning and the poor quality of the medical school curriculum. In light of this, the purpose of this study was to assess the learning experience and subjective clinical competence of final-year medical students and interns in the field of orthopedics in Saudi Arabia (SA). Methods A cross-sectional observational descriptive study utilizing an electronically validated survey was conducted, which included the following six main sections: introduction, demographics, self-assessment of competency regarding certain orthopedic skills, clinical experience in orthopedics, orthopedics curriculum assessment, and choice of future career specialty. Results The total number of participants was 794. Among them, 33% (n=160) and 37.1% (180) had attended no "trauma meetings" or "operating room (OR)" sessions respectively, and only 21.9% (n=106) had attended more than five clinics. Subjective competence in history taking was highest (mean: 8.925 ±1.299) among students who had received more than four weeks of orthopedic rotation and attended more than six clinics. The students who had completed more than four weeks of orthopedic rotation and more than six bedside sessions scored the highest in terms of subjective competence in handling orthopedic patients in primary care settings (mean: 8.014 ±1.931). Conclusion The survey indicates that the amount of orthopedic training provided by institutions varies, with some students receiving less training than recommended. However, longer rotations lead to greater perceived orthopedic competence. Students and interns with more exposure to orthopedics through curriculum and elective rotations demonstrated a greater interest in pursuing orthopedics as a future career.
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Affiliation(s)
- Bandar M Hetaimish
- Orthopedic Surgery, Faculty of Medicine, University of Jeddah, Jeddah, SAU
| | - Osamah Abualross
- Medicine, Faculty of Medicine, University of Jeddah, Jeddah, SAU
| | | | | | | | - Ramy Samargandi
- Orthopedic Surgery, CHRU de Tours, Tours, FRA
- Orthopedic Surgery, Faculty of Medicine, University of Jeddah, Jeddah, SAU
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Berheto TM, Sengoelge M, Tadesse S, Workie SB, Tessema G, Memirie ST, Mohammed S, Getnet F, Walker A, Naghavi M, Misganaw A. Neglected burden of injuries in Ethiopia, from 1990 to 2019: a systematic analysis of the global burden of diseases study 2019. Front Public Health 2023; 11:1149966. [PMID: 37333551 PMCID: PMC10274142 DOI: 10.3389/fpubh.2023.1149966] [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: 02/28/2023] [Accepted: 05/08/2023] [Indexed: 06/20/2023] Open
Abstract
Background The 2030 agenda for sustainable development goals has given injury prevention new attention, including halving road traffic injuries. This study compiled the best available evidence on injury from the global burden of diseases study for Ethiopia from 1990 to 2019. Methods Injury data on incidence, prevalence, mortality, disability-adjusted life years lost, years lived with disability, and years of life lost were extracted from the 2019 global burden of diseases study for regions and chartered cities in Ethiopia from 1990 to 2019. Rates were estimated per 100,000 population. Results In 2019, the age-standardized rate of incidence was 7,118 (95% UI: 6,621-7,678), prevalence was 21,735 (95% UI: 19,251-26,302), death was 72 (95% UI: 61-83), disability-adjusted life years lost was 3,265 (95% UI: 2,826-3,783), years of live lost was 2,417 (95% UI: 2,043-2,860), and years lived with disability was 848 [95% UI: (620-1,153)]. Since 1990, there has been a reduction in the age-standardized rate of incidence by 76% (95% UI: 74-78), death by 70% (95% UI: 65-75), and prevalence by 13% (95% UI: 3-18), with noticeable inter-regional variations. Transport injuries, conflict and terrorism, interpersonal violence, self-harm, falls, poisoning, and exposure to mechanical forces were the leading causes of injury-related deaths and long-term disabilities. Since 1990, there has been a decline in the prevalence of transport injuries by 32% (95% UI: 31-33), exposure to mechanical forces by 12% (95% UI: 10-14), and interpersonal violence by 7.4% (95% UI: 5-10). However, there was an increment in falls by 8.4% (95% UI: 7-11) and conflict and terrorism by 1.5% (95% UI: 38-27). Conclusion Even though the burden of injuries has steadily decreased at national and sub-national levels in Ethiopia over the past 30 years, it still remains to be an area of public health priority. Therefore, injury prevention and control strategies should consider regional disparities in the burden of injuries, promoting transportation safety, developing democratic culture and negotiation skills to solve disputes, using early security-interventions when conflict arises, ensuring workplace safety and improving psychological wellbeing of citizens.
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Affiliation(s)
- Tezera Moshago Berheto
- National Data Management and Analytics Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mathilde Sengoelge
- Department of Global Public Health, Karolinska Institutet (KI), Stockholm, Sweden
| | - Sebsibe Tadesse
- National Data Management and Analytics Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Shimelash Bitew Workie
- National Data Management and Analytics Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Gizachew Tessema
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | | | - Shikur Mohammed
- National Data Management and Analytics Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Fentabil Getnet
- National Data Management and Analytics Center for Health, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Ally Walker
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
| | - Mohsen Naghavi
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
| | - Awoke Misganaw
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, United States
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Transfusion Management in Trauma: What is Current Best Practice? CURRENT SURGERY REPORTS 2023. [DOI: 10.1007/s40137-023-00352-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Moradi-Lakeh M, Toumi A, Khalifa SE, Doctor HV, Alyafei S, Al Hamad SK, Al-Thani M, Rashidian A. Core health indicators in countries with high proportion of expatriates: Case study of Qatar. Front Public Health 2023; 11:1035686. [PMID: 36825143 PMCID: PMC9941695 DOI: 10.3389/fpubh.2023.1035686] [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: 09/03/2022] [Accepted: 01/13/2023] [Indexed: 02/10/2023] Open
Abstract
Background Population size and structure have a huge impact on health indicators. In countries with a high proportion of expatriates, there are some limitations in estimating, aggregating and reporting of the health indicators, and corrections may be required in the established estimation methodologies. We review the case of Qatar to see how its specific population characteristics affect its health indicators. Methods We used routinely collected data and reviewed and calculated a selected list of health indicators for Qatari and non-Qatari populations residing in Qatar. Mortality and cancer incidence rates, stratified by nationality, were used for this purpose. Also, a direct method was used to estimate completeness of the death registry, compared to the mortuary data. Results Age and sex distribution of Qatari and non-Qatari populations are completely different. Compared to the mortuary data, completeness of death registration for the total population was estimated at 98.9 and 94.3%, with and without considering overseas deaths, respectively. Both estimates were considerably higher than estimates from the indirect methods. Mortality patterns were different even after standardization of age and stratification of sex groups; male age-standardized mortality rates were 502.7 and 242.3 per 100,000 individuals, respectively for Qataris and non-Qataris. The rates were closer in female populations (315.6 and 291.5, respectively). The leading types of cancer incidents were different in Qataris and non-Qataris. Conclusions Expatriates are a dynamic population with high-turnover, different from Qatari population in their age-sex structure and health status. They are more likely to be young or middle-aged and are less affected by age related diseases and cancers. Also, they might be at higher risks for specific diseases or injuries. Aggregating indicators of Qatari and non-Qatari populations might be mis-leading for policy making purposes, and common estimation correction approaches cannot alleviate the limitations. High-proportion of expatriate population also imposes significant errors to some of the key demographic estimates (such as completeness of death registry). We recommend a standardized approach to consider nationality in addition to age and sex distributions for analysis of health data in countries with a high proportion of expatriates.
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Affiliation(s)
- Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran,Optimax Access LLC, Mission Viejo, CA, United States,*Correspondence: Maziar Moradi-Lakeh ✉ ; ✉
| | - Amine Toumi
- Public Health Department, Ministry of Public Health, Doha, Qatar
| | | | - Henry Victor Doctor
- Department of Science, Information and Dissemination, Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
| | - Salah Alyafei
- Public Health Department, Ministry of Public Health, Doha, Qatar
| | | | | | - Arash Rashidian
- Department of Science, Information and Dissemination, Regional Office for the Eastern Mediterranean, World Health Organization, Cairo, Egypt
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Pagnotta VF, King N, Donnelly PD, Thompson W, Walsh SD, Molcho M, Ng K, Malinowska-Cieślik M, Pickett W. Access to medical care and its association with physical injury in adolescents: a cross-national analysis. Inj Prev 2023; 29:42-49. [PMID: 36167714 DOI: 10.1136/ip-2022-044701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/27/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND Strong variations in injury rates have been documented cross-nationally. Historically, these have been attributed to contextual determinants, both social and physical. We explored an alternative, yet understudied, explanation for variations in adolescent injury reporting-that varying access to medical care is, in part, responsible for cross-national differences. METHODS Age-specific and gender-specific rates of medically treated injury (any, serious, by type) were estimated by country using the 2013/2014 Health Behaviour in School-aged Children study (n=209 223). Available indicators of access to medical care included: (1) the Healthcare Access and Quality Index (HAQ; 39 countries); (2) the Universal Health Service Coverage Index (UHC; 37 countries) and (3) hospitals per 100 000 (30 countries) then physicians per 100 000 (36 countries). Ecological analyses were used to relate injury rates and indicators of access to medical care, and the proportion of between-country variation in reported injuries attributable to each indicator. RESULTS Adolescent injury risks were substantial and varied by country and sociodemographically. There was little correlation observed between national level injury rates and the HAQ and UHC indices, but modest associations between serious injury and physicians and hospitals per 100 000. Individual indicators explained up to 9.1% of the total intercountry variation in medically treated injuries and 24.6% of the variation in serious injuries. CONCLUSIONS Cross-national variations in reported adolescent serious injury may, in part, be attributable to national differences in access to healthcare services. Interpretation of cross-national patterns of injury and their potential aetiology should therefore consider access to medical care as a plausible explanation.
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Affiliation(s)
- Valerie F Pagnotta
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Nathan King
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| | | | - Wendy Thompson
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Sophie D Walsh
- Department of Criminology, Bar-Ilan University, Ramat Gan, Israel
| | - Michal Molcho
- Department of Children's Studies, School of Education, University of Galway, Galway, Ireland
| | - Kwok Ng
- Faculty of Education, University of Turku, Turku, Finland.,Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.,School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.,Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Marta Malinowska-Cieślik
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University, Medical College, Krakow, Poland
| | - William Pickett
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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Franklin RC, Franklin JL, Swinbourne JM, Manson E, Loughnan G, Markovic T, Hocking S. Understanding the confluence of injury and obesity in a Grade 2 obesity and above population. Aust N Z J Public Health 2023; 47:100008. [PMID: 36640630 DOI: 10.1016/j.anzjph.2022.100008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 08/01/2022] [Accepted: 08/01/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Obesity and injury are major inter-related public health challenges. The objective of this study was to explore the perceptions of injury in people with severe obesity. METHODS A cross-sectional design was employed to capture injury perception and lifestyle habits via questionnaires. Weight (kg) and height (m) were measured by clinicians for patients attending a weight loss group program. Univariate, chi-square, ANOVA and ordinal regression analyses were undertaken. RESULTS There were 292 participants (67.1% female), mean age 49.3 years and Body Mass Index 47.2 kg/m2 (range 30.7-91.9 kg/m2). Concern about having an injury was found in 83%, and 74.2% thought that weight would increase the likelihood of injury. A greater concern of being injured at baseline was associated with less weight loss at eight weeks (F=3.567; p=0.03). Depression, anxiety and sleepiness score were higher in those who reported greater 'Concern about having an injury'. CONCLUSIONS People with obesity fear injury and falling, which limits their willingness to exercise. Anxiety symptoms appear to exacerbate this connection. IMPLICATIONS FOR PUBLIC HEALTH In individuals with obesity, anxiety, sleepiness and depression are associated with a fear of being injured. Addressing fear and reducing anxiety may decrease barriers to participating in physical activity.
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Affiliation(s)
- Richard C Franklin
- Public Health and Tropical Medicine, CPHMVS, James Cook University, Queensland, Australia.
| | - Janet L Franklin
- Metabolism & Obesity Service, Royal Prince Alfred Hospital, New South Wales, Australia
| | - Jessica M Swinbourne
- Metabolism & Obesity Service, Royal Prince Alfred Hospital, New South Wales, Australia
| | - Elisia Manson
- Metabolism & Obesity Service, Royal Prince Alfred Hospital, New South Wales, Australia
| | - Georgina Loughnan
- Metabolism & Obesity Service, Royal Prince Alfred Hospital, New South Wales, Australia
| | - Tania Markovic
- Metabolism & Obesity Service, Royal Prince Alfred Hospital, New South Wales, Australia; The Boden Initiative, Obesity Group, Charles Perkins Centre, Univerity of Sydney, New south Wales, Australia
| | - Samantha Hocking
- Metabolism & Obesity Service, Royal Prince Alfred Hospital, New South Wales, Australia; The Boden Initiative, Obesity Group, Charles Perkins Centre, Univerity of Sydney, New south Wales, Australia
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Wang C, Toigo S, Zutrauen S, McFaull SR, Thompson W. Injuries among Canadian children and youth: an analysis using the 2019 Canadian Health Survey on Children and Youth. Health Promot Chronic Dis Prev Can 2023; 43:98-102. [PMID: 36794826 PMCID: PMC10026611 DOI: 10.24095/hpcdp.43.2.05] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
This work provides an overview of injury patterns in Canadian children and youth aged 1 to 17 years. Self-reported data from the 2019 Canadian Health Survey on Children and Youth were used to calculate estimates for the percentage of Canadian children and youth who experienced a head injury or concussion, broken bone or fracture, or serious cut or puncture within the last 12 months, overall and by sex and age group. Head injuries and concussions (4.0%) were the most commonly reported, but the least likely to be seen by a medical professional. Injuries most frequently occurred while engaging in sports, physical activity or playing.
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Affiliation(s)
- Chinchin Wang
- Public Health Agency of Canada, Ottawa, Ontario, Canada
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Landolt J, Olumbe A, Thompson M. Comparing drowning (unintentional and intentional) and immersion deaths, Gold Coast, Queensland, Australia: a 6-year retrospective study. AUST J FORENSIC SCI 2022. [DOI: 10.1080/00450618.2022.2152095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Jairus Landolt
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
- Haskayne School of Business, University of Calgary, Calgary, Alberta, Canada
| | - Alex Olumbe
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
- Forensic and Scientific Services, Health Support Queensland, Brisbane, Queensland, Australia
| | - Melissa Thompson
- School of Medicine and Dentistry, Griffith University, Southport, Queensland, Australia
- Forensic and Scientific Services, Health Support Queensland, Brisbane, Queensland, Australia
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Xu Y, Chen M, Yang R, Wumaierjiang M, Huang S. Global, Regional, and National Burden of Road Injuries from 1990 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16479. [PMID: 36554366 PMCID: PMC9779128 DOI: 10.3390/ijerph192416479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Understanding occurrence can help formulate effective preventative laws and regulations. However, the most recent global burden and road injuries (RIs) trends have not been reported. This study reports the burden of RIs globally from 1990 to 2019. (2) Methods: RIs data were downloaded from the Global Burden of Disease 2019. Incidence, deaths, and disability-adjusted life years (DALYs) described the trend and burden of RIs. We calculated age-standardized rates (ASRs) and estimated annual percentage change (EAPC) for the above indexes to evaluate the temporal trend of RIs. We evaluated the social-demographic index (SDI) with epidemiological RI parameters and reported proportions of age-standardized rates due to RI. (3) Results: In 2019, the global incidence of RIs reached 103.2 million. The EAPC of RI incidence increased, whereas deaths and DALYs decreased. Age-standardized incident rate (ASIR) was highest in low-middle SDI regions, age-standardized death rate (ASDR) was high in middle SDI regions, and age-standardized DALYs increased in low SDI regions. The highest accident rates were found in those aged 20-24 years old. Cyclist injuries were the leading RIs (34%), though pedestrian and motor vehicle accidents were the leading cause of death (37.4%, 37.6%) and DALYs (35.7%, 32.3%), respectively. (4) Conclusions: Over the past 30 years, RIs incidence increased annually, though death and DALY rates decreased. RIs places a considerable burden on public health in low SDI countries. Data should be used to develop and implement effective measures to reduce the burden of RIs.
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Affiliation(s)
- Yifan Xu
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
| | - Meikai Chen
- Department of Intensive Care Unit, The Affiliated Drum Tower Hospital, Medical School, Nanjing University, Nanjing 210093, China
| | - Ruitong Yang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
| | - Muhemaiti Wumaierjiang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
| | - Shengli Huang
- Department of Orthopedics, The Second Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710049, China
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Nsengiyumva B, Henry MB, Kuntz HM, Estes MK, Randall MM, Guptill M. Chest trauma epidemiology and emergency department management in a tertiary teaching hospital in Kigali, Rwanda. Afr J Emerg Med 2022; 12:428-431. [PMID: 36277235 PMCID: PMC9579306 DOI: 10.1016/j.afjem.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 09/24/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Chest trauma is a major contributor to injury morbidity and mortality, and understanding trends is a crucial part of addressing this burden in low- and middle-income countries. This study reports the characteristics and emergency department (ED) management of chest trauma patients presenting to Rwanda's national teaching hospital in Kigali. Methods This descriptive analysis included a convenience sample of patients presenting to a single tertiary hospital ED with chest trauma from June to December 2017. Demographic data were collected as well as injury mechanism, thoracic and associated injuries, types of imaging obtained, and treatments performed. Chart review was conducted seven days post-admission to follow up on outcomes and additional diagnoses and interventions. Incidences were calculated with Microsoft Excel. Results Among the 62 patients included in this study, 74% were male, and mean age was 35 years. Most patients were injured in road traffic crashes (RTCs) (68%). Common chest injuries included lung contusions (79% of cases), rib fractures (44%), and pneumothoraces (37%). Head trauma was a frequent concurrent extra-thoracic injury (61%). Diagnostic imaging primarily included E-FAST ultrasound (92%) and chest x-ray (98%). The most common therapies included painkillers (100%), intravenous fluids (89%), and non-invasive oxygen (63%), while 29% underwent invasive intervention in the form of thoracostomy. The majority of patients were admitted (81%). Pneumonia was the most common complication to occur in the first seven days (32% of admitted patients). Ultimately, 40% of patients were discharged home within seven days of presentation, 50% remained hospitalized, and 5% died. Conclusion This study on the epidemiology of chest trauma in Rwanda can guide injury prevention and medical training priorities. Efforts should target prevention in young males and those involved in RTCs. ED physicians in Rwanda need to be prepared to diagnose and treat a variety of chest injuries with invasive and noninvasive means.
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Affiliation(s)
- Bernard Nsengiyumva
- Department of Accident and Emergency (Head of Department), University Teaching Hospital of Butare, Huye, Rwanda,Department of Anesthesia, Emergency Medicine and Critical Care, University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda,Corresponding author at:
| | - Michael B. Henry
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States,Department of Emergency Medicine, Maricopa Medical Center, Creighton University Arizona Health Education Alliance, Phoenix, Arizona, United States
| | - Heather M. Kuntz
- Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, United States
| | - Molly K. Estes
- Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, United States
| | - Melanie M. Randall
- Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, United States
| | - Mindi Guptill
- Department of Emergency Medicine, Loma Linda University School of Medicine, Loma Linda, California, United States
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37
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Mortality from fall: A descriptive analysis of a multicenter Indian trauma registry. Injury 2022; 53:3956-3961. [PMID: 36244832 DOI: 10.1016/j.injury.2022.09.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 09/21/2022] [Accepted: 09/25/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Fall is the second most common mechanism of trauma worldwide after road traffic injuries. Data on fall predominantly comes from the high-income countries (HICs) and mostly includes injuries in children and elderly. There are very few studies from low- and middle-income countries(LMICs) that describe fall related injuries other than fragility fractures in elderly. This study describes the profile of poly-trauma patients admitted with a history of 'fall' and assesses the variables associated with mortality. METHOD We analyzed data from the 'Towards Improved Trauma Care Outcome' (TITCO) database which prospectively collected data of poly-trauma patients admitted to four major tertiary care hospitals of India between 2013 to 2015. Patients across all age groups admitted to hospital with the history of 'fall'; were included in our study. Single bone fractures were excluded. The Kaplan Meier survival analysis was used to estimate the survival probability in different age groups. RESULTS A total of 3686 patients were included in our study. The median age of the patients was 28 years (IQR: 9, 47) with the majority being males (73.6%). Almost one-third of the patients were within the age group of 0-14 (30.4%). Most of the patients (79.9%) had a diagnosis of traumatic brain injury (TBI). The overall in-hospital mortality was 18% (664), but higher at 39.0% among patients over 65 years of age. Probability of survival decreased with increase of age. CONCLUSION Falling from height is a common injury mechanism in India, occurring more in young males and usually associated with TBI. Isolated TBI and TBI associated with other injuries are the main contributors of mortality in fall injuries. Mortality from these injuries increased with age and ISS.
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Rooholamini A, Gandomkar R, Basiri K, Jalili M, Jafarian A. Identifying Situational Awareness Behaviors in Trauma Teams; a Nominal Group Technique Study. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2022; 10:e88. [PMID: 36590653 PMCID: PMC9795274 DOI: 10.22037/aaem.v10i1.1826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Introduction Situational awareness (SA), as a nontechnical human factor, is critical to the success of a trauma team. This study aimed to identify representatives of behaviors supporting (desirable) and diminishing (undesirable) SA for trauma teams while performing the initial assessment of multi-trauma patients. Methods This Nominal Group Technique Study was conducted on twenty attending physicians from various specialties affiliated with Tehran University of Medical Sciences, who were invited to a nominal group technique meeting in 2020. Participants were asked to write down their proposed behaviors in silence. Subsequently, each participant shared their list with the group in a round-robin format, and clarifications were made through discussion. After categorizing the ideas, we asked participants to rate each behavior's importance on a five-point Likert scale. The consensus was defined as ≥70% agreement on a rating of 4 and 5. Results The final SA behaviors for the trauma team consisted of 29 (22 desirable and 7 undesirable) behaviors arranged in seven dimensions: resource allocation, anticipate and plan, avoid fixation errors, call for help if needed, prioritize attention, reassess patient, and shared mental model. The most important desirable and undesirable behaviors were identified in resource allocation (n=8) and avoid fixation errors (n=7) dimensions, respectively. Resource allocation behaviors consist of 'checking necessary equipment', 'allocating an alternative person(s) to do the required task if needed', 'assigning tasks to the right person(s)', and 'Addressing each team member with a requested task'. Avoid fixation errors behaviors were 'insisting on performing the procedure', 'making decisions without considering all available information', and 'emphasizing others' expertise in the diagnostic process'. Conclusion The proposed team SA behaviors may be used in assessing the trauma team performance and training program to promote trauma team SA.
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Affiliation(s)
- Azadeh Rooholamini
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Roghayeh Gandomkar
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding author: Roghayeh Gandomkar; Third floor, No. 57, Hojatdoust St., Keshavarz Blvd., Tehran, Iran. Postal Code: 141669591
| | - Kamal Basiri
- Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Jalili
- Health Professions Education Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Emergency Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Jafarian
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Department of General Surgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.,Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Kim EK, Suri D, Mahajan A, Bhandarkar P, Khajanchi M, Gadgil A, Ranganathan K, Gerdin Warnberg M, Roy N, Raykar NP. Patterns of Head and Neck Injuries in Urban India: A Multicenter Study. OTO Open 2022; 6:2473974X221128217. [PMID: 36247657 PMCID: PMC9558877 DOI: 10.1177/2473974x221128217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/04/2022] [Indexed: 11/05/2022] Open
Abstract
Objective The pattern of head and neck injuries has been well studied in high-income
countries, but the data are limited in low- and middle-income countries,
which are disproportionately affected by trauma. We examined a prospective
multicenter database to describe patterns and outcomes of head and neck
injuries in urban India. Study Design Retrospective review of trauma registry. Setting Four tertiary public hospitals in Mumbai, Delhi, Kolkata. Methods We identified patients with isolated head and neck injuries using
International Classification of Diseases, 10th Revision
(ICD-10) codes and excluded those with traumatic brain
and/or ophthalmic injuries and injuries in other body regions. Results Our cohort included 171 patients. Most were males (80.7%) and adults aged 18
to 55 years (60.2%). Falls (36.8%) and road traffic accidents (36.3%) were
the 2 predominant mechanisms of injury. Overall, 35.7% required intensive
care unit (ICU) admission, and 11.7% died. More than 20% of patients were
diagnosed with “unspecified injury of neck.” Those with the diagnosis had a
higher ICU admission rate (51.4% vs 31.3%, P = .025) and
mortality rate (27.0% vs 7.5%, P = .001) than those without
the diagnosis. Conclusion Isolated head and neck injuries are not highly prevalent among Indian trauma
patients admitted to urban tertiary hospitals but are associated with high
mortality. Over a fifth of patients were diagnosed with “unspecified injury
of neck,” which is associated with more severe clinical outcomes. Exactly
what this diagnosis entails and encompasses remains unclear.
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Affiliation(s)
- Eric K. Kim
- University of California San Francisco,
School of Medicine, San Francisco, California, USA,Program in Global Surgery and Social
Change, Harvard Medical School, Boston, Massachusetts, USA,Eric K. Kim, School of Medicine, University
of California San Francisco, 513 Parnassus Ave, Suite S-245, San Francisco, CA
94143-0454, USA.
| | - Deepak Suri
- Harvard School of Dental Medicine,
Boston, Massachusetts, USA
| | | | - Prashant Bhandarkar
- Tata Institute of Social Sciences
School of Health Systems Studies, Deonar, Maharashtra, India
| | - Monty Khajanchi
- Department of Surgery, King Edward
Memorial Hospital, Mumbai, Maharashtra, India
| | - Anita Gadgil
- World Health Organization Collaborating
Centre for Research in Surgical Care Delivery in Low-and-Middle Income Countries,
Mumbai, India
| | - Kavitha Ranganathan
- Program in Global Surgery and Social
Change, Harvard Medical School, Boston, Massachusetts, USA,Division of Plastic Surgery, Brigham
and Women's Hospital, Boston, Massachusetts, USA
| | | | - Nobhojit Roy
- World Health Organization Collaborating
Centre for Research in Surgical Care Delivery in Low-and-Middle Income Countries,
Mumbai, India,Department of Global Public Health,
Karolinska Institutet, Stockholm, Sweden
| | - Nakul P. Raykar
- Program in Global Surgery and Social
Change, Harvard Medical School, Boston, Massachusetts, USA,Division of Trauma, Emergency
Surgery, Surgical Critical Care, Department of Surgery, Brigham and Women's
Hospital, Boston, Massachusetts, USA,Center for Surgery and Public Health,
Brigham and Women's Hospital, Boston, Massachusetts, USA
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Disadvantaged by More Than Distance: A Systematic Literature Review of Injury in Rural Australia. SAFETY 2022. [DOI: 10.3390/safety8030066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rural populations experience injury-related mortality and morbidity rates 1.5 times greater than metropolitan residents. Motivated by a call for stronger epidemiological evidence around rural injuries to inform prevention, a systematic review of peer-reviewed literature published between January 2010 and March 2021 was undertaken to explore the epidemiology of rural injury and associated risk factors in Australia. A subsequent aim was to explore definitions of rurality used in injury prevention studies. There were 151 papers included in the review, utilizing 23 unique definitions to describe rurality. People living in rural areas were more likely to be injured, for injuries to be more severe, and for injuries to have greater resulting morbidity than people in metropolitan areas. The increase in severity reflects the mechanism of rural injury, with rural injury events more likely to involve a higher energy exchange. Risk-taking behavior and alcohol consumption were significant risk factors for rural injury, along with rural cluster demographics such as age, sex, high socio-economic disadvantage, and health-related comorbidities. As injury in rural populations is multifactorial and nonhomogeneous, a wide variety of evidence-based strategies are needed. This requires funding, political leadership for policy formation and development, and implementation of evidence-based prevention interventions.
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Charalampous P, Pallari E, Gorasso V, von der Lippe E, Devleesschauwer B, Pires SM, Plass D, Idavain J, Ngwa CH, Noguer I, Padron-Monedero A, Sarmiento R, Majdan M, Ádám B, AlKerwi A, Cilovic-Lagarija S, Clarsen B, Corso B, Cuschieri S, Dopelt K, Economou M, Fischer F, Freitas A, García-González JM, Gazzelloni F, Gkitakou A, Gulmez H, Hynds P, Isola G, Jakobsen LS, Kabir Z, Kissimova-Skarbek K, Knudsen AK, Konar NM, Ladeira C, Lassen B, Liew A, Majer M, Mechili EA, Mereke A, Monasta L, Mondello S, Morgado JN, Nena E, Ng ESW, Niranjan V, Nola IA, O'Caoimh R, Petrou P, Pinheiro V, Ortiz MR, Riva S, Samouda H, Santos JV, Santoso CMA, Milicevic MS, Skempes D, Sousa AC, Speybroeck N, Tozija F, Unim B, Uysal HB, Vaccaro FG, Varga O, Vasic M, Violante FS, Wyper GMA, Polinder S, Haagsma JA. Methodological considerations in injury burden of disease studies across Europe: a systematic literature review. BMC Public Health 2022; 22:1564. [PMID: 35978333 PMCID: PMC9382747 DOI: 10.1186/s12889-022-13925-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
Background Calculating the disease burden due to injury is complex, as it requires many methodological choices. Until now, an overview of the methodological design choices that have been made in burden of disease (BoD) studies in injury populations is not available. The aim of this systematic literature review was to identify existing injury BoD studies undertaken across Europe and to comprehensively review the methodological design choices and assumption parameters that have been made to calculate years of life lost (YLL) and years lived with disability (YLD) in these studies. Methods We searched EMBASE, MEDLINE, Cochrane Central, Google Scholar, and Web of Science, and the grey literature supplemented by handsearching, for BoD studies. We included injury BoD studies that quantified the BoD expressed in YLL, YLD, and disability-adjusted life years (DALY) in countries within the European Region between early-1990 and mid-2021. Results We retrieved 2,914 results of which 48 performed an injury-specific BoD assessment. Single-country independent and Global Burden of Disease (GBD)-linked injury BoD studies were performed in 11 European countries. Approximately 79% of injury BoD studies reported the BoD by external cause-of-injury. Most independent studies used the incidence-based approach to calculate YLDs. About half of the injury disease burden studies applied disability weights (DWs) developed by the GBD study. Almost all independent injury studies have determined YLL using national life tables. Conclusions Considerable methodological variation across independent injury BoD assessments was observed; differences were mainly apparent in the design choices and assumption parameters towards injury YLD calculations, implementation of DWs, and the choice of life table for YLL calculations. Development and use of guidelines for performing and reporting of injury BoD studies is crucial to enhance transparency and comparability of injury BoD estimates across Europe and beyond. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13925-z.
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Affiliation(s)
- Periklis Charalampous
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - Elena Pallari
- Health Innovation Network, Minerva House, Montague Close, London, UK
| | - Vanessa Gorasso
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.,Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Brecht Devleesschauwer
- Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium.,Department of Translational Physiology, Infectiology and Public Health, Ghent University, Merelbeke, Belgium
| | - Sara M Pires
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Dietrich Plass
- Department for Exposure Assessment, and Environmental Health Indicators, German Environment Agency, Berlin, Germany
| | - Jane Idavain
- Department of Health Statistics, National Institute for Health Development, Tallinn, Estonia
| | - Che Henry Ngwa
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Isabel Noguer
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | | | - Rodrigo Sarmiento
- National School of Public Health, Carlos III Institute of Health, Madrid, Spain.,Medicine School, University of Applied and Environmental Sciences, Bogota, Colombia
| | - Marek Majdan
- Department of Public Health, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.,Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Ala'a AlKerwi
- Directorate of Health, Service Epidemiology and Statistics, Luxembourg, Luxembourg
| | | | - Benjamin Clarsen
- Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway.,Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Barbara Corso
- Institute of Neuroscience, National Research Council, Rome, Italy
| | - Sarah Cuschieri
- Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel.,Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Mary Economou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Florian Fischer
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Alberto Freitas
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | | | | | - Artemis Gkitakou
- Department of Internal Medicine and Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Hakan Gulmez
- Department of Family Medicine, Faculty of Medicine, İzmir Democracy University, Izmir, Turkey
| | - Paul Hynds
- Environmental Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Lea S Jakobsen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Zubair Kabir
- Public Health & Epidemiology, School of Public Health, University College Cork, Cork, Ireland
| | - Katarzyna Kissimova-Skarbek
- Department of Health Economics and Social Security, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Ann Kristin Knudsen
- Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Naime Meriç Konar
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey
| | - Carina Ladeira
- H&TRC - Health & Technology Research Center, Escola Superior de Tecnologia da Saúde (ESTeSL), Instituto Politécnico de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Brian Lassen
- National Food Institute, Technical University of Denmark, Lyngby, Denmark
| | - Aaron Liew
- Clinical Sciences Institute, School of Medicine, National University of Ireland, Galway, Galway City, Ireland
| | - Marjeta Majer
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Enkeleint A Mechili
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece.,Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania
| | - Alibek Mereke
- Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Lorenzo Monasta
- Institute of Maternal, Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Stefania Mondello
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Joana Nazaré Morgado
- Environmental Health and Nutrition Laboratory, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Evangelia Nena
- Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Vikram Niranjan
- School of Public Health, Physiotherapy and Sport Sciences, University College Dublin, Dublin, Ireland
| | - Iskra Alexandra Nola
- Andrija Štampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Rónán O'Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, Grenville Place, Cork City, Ireland
| | - Panagiotis Petrou
- Pharmacoepidemiology-Pharmacovigilance, Pharmacy School, School of Sciences and Engineering, University of Nicosia, Nicosia, Cyprus
| | - Vera Pinheiro
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Silvia Riva
- Department of Psychology and Pedagogic Science, St Mary's University, London, UK
| | - Hanen Samouda
- Population Health Department, Luxembourg Institute of Health, Nutrition and Health Research Group, Luxembourg, Luxembourg
| | - João Vasco Santos
- CINTESIS - Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal.,Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, Lisbon, Portugal
| | | | | | | | - Ana Catarina Sousa
- Department of Biology, School of Science and Technology, University of Évora, Évora, Portugal.,Comprehensive Health Research Centre (CHRC), University of Évora, Évora, Portugal
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université Catholique de Louvain, Brussels, Belgium
| | - Fimka Tozija
- Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia.,Faculty of Medicine, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Brigid Unim
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Aging, Istituto Superiore Di Sanità, Rome, Italy
| | - Hilal Bektaş Uysal
- Department of Internal Medicine, Adnan Menderes University School of Medicine, Aydin, Turkey
| | | | - Orsolya Varga
- Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Milena Vasic
- Faculty of Dentistry Pancevo, University Business Academy in Novi Sad, Pancevo, Serbia.,Institute of Public Health of Serbia Dr Milan Jovanović Batut, Belgrade, Serbia
| | - Francesco Saverio Violante
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Grant M A Wyper
- Place and Wellbeing Directorate, Public Health Scotland, Glasgow, Scotland, UK
| | - Suzanne Polinder
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Juanita A Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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42
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Chen SK, Hsu LM, Chiu NC, Saleh W, Pai CW, Chen PL. Injury in Children with Developmental Disorders: A 1:1 Nested Case-Control Study Using Multiple Datasets in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9814. [PMID: 36011448 PMCID: PMC9407707 DOI: 10.3390/ijerph19169814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Although past studies have identified predictors related to child injuries with developmental disorders, national-level research in Asia is limited. The objective of this study was to explore the risk factors for child injuries with developmental disorders in Taiwan using a national-level integrated database for the period between 2004-2015 (The Maternal and Child Health Database, National Health Insurance Research Database, Census Registry, and Indigenous Household Registration). Children younger than 12 years old who had records of visiting the ER or being hospitalized due to injury or without injury were included in this study. A 1:1 nested case-control study (injury vs. noninjury) to examine the risk factors for child injury with developmental disorder was performed. A total of 2,167,930 children were enrolled. The risk factors were associated with repeated ER visits or hospitalization: being indigenous (adjusted odds ratio [AOR]: 1.51; CI: 1.45-1.57); having a developmental disorder (AOR: 1.74; CI: 1.70-1.78); and having parents with illicit drug use (AOR: 1.48; CI: 1.32-1.66), alcohol abuse (AOR: 1.21; CI: 1.07-1.37), or a history of mental illness (AOR: 1.43; CI: 1.41-1.46). Being indigenous, having developmental disorders, and having parents with history of illicit drug use, alcohol abuse, or mental illness were predictors related to injuries in children.
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Affiliation(s)
- Shang-Ku Chen
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
| | - Li-Min Hsu
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
- Department of Surgery and Traumatology, National Taiwan University Hospital, Taipei 100, Taiwan
| | - Nan-Chang Chiu
- Department of Pediatrics, MacKay Memorial Hospital, Taipei 104, Taiwan
| | - Wafaa Saleh
- Transport Research Institute, Edinburgh Napier University, Edinburgh EH11 4DY, UK
| | - Chih-Wei Pai
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
| | - Ping-Ling Chen
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei 110, Taiwan
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43
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Peden AE, Cullen P, Francis KL, Moeller H, Peden MM, Ye P, Tian M, Zou Z, Sawyer SM, Aali A, Abbasi-Kangevari Z, Abbasi-Kangevari M, Abdelmasseh M, Abdoun M, Abd-Rabu R, Abdulah DM, Abebe G, Abebe AM, Abedi A, Abidi H, Aboagye RG, Abubaker Ali H, Abu-Gharbieh E, Adane DE, Adane TD, Addo IY, Adewole OG, Adhikari S, Adnan M, Adnani QES, Afolabi AAB, Afzal S, Afzal MS, Aghdam ZB, Ahinkorah BO, Ahmad AR, Ahmad T, Ahmad S, Ahmadi A, Ahmed H, Ahmed MB, Ahmed A, Ahmed A, Ahmed JQ, Ahmed Rashid T, Aithala JP, Aji B, Akhlaghdoust M, Alahdab F, Alanezi FM, Alemayehu A, Al Hamad H, Ali SS, Ali L, Alimohamadi Y, Alipour V, Aljunid SM, Almidani L, Almustanyir S, Altirkawi KA, Alvis-Zakzuk NJ, Ameyaw EK, Amin TT, Amir-Behghadami M, Amiri S, Amiri H, Anagaw TF, Andrei T, Andrei CL, Anvari D, Anwar SL, Anyasodor AE, Arabloo J, Arab-Zozani M, Arja A, Arulappan J, Arumugam A, Aryannejad A, Asgary S, Ashraf T, Athari SS, Atreya A, Attia S, Aujayeb A, Awedew AF, Azadnajafabad S, Azangou-Khyavy M, Azari S, Azari Jafari A, Azizi H, Azzam AY, Badiye AD, Baghcheghi N, Bagherieh S, Baig AA, Bakkannavar SM, Balta AB, Banach M, Banik PC, Bansal H, Bardhan M, Barone-Adesi F, Barrow A, Bashiri A, Baskaran P, Basu S, Bayileyegn NS, Bekel AA, Bekele AB, Bendak S, Bensenor IM, Berhie AY, Bhagat DS, Bhagavathula AS, Bhardwaj P, Bhardwaj N, Bhaskar S, Bhat AN, Bhattacharyya K, Bhutta ZA, Bibi S, Bintoro BS, Bitaraf S, Bodicha BBA, Boloor A, Bouaoud S, Brown J, Burkart K, Butt NS, Butt MH, Cámera LA, Campuzano Rincon JC, Cao C, Carvalho AF, Carvalho M, Chakraborty PA, Chandrasekar EK, Chang JC, Charalampous P, Charan J, Chattu VK, Chekole BM, Chitheer A, Cho DY, Chopra H, Christopher DJ, Chukwu IS, Cruz-Martins N, Dadras O, Dahlawi SMA, Dai X, Damiani G, Darmstadt GL, Darvishi Cheshmeh Soltani R, Darwesh AM, Das S, Dastiridou A, Debela SA, Dehghan A, Demeke GM, Demetriades AK, Demissie S, Dessalegn FN, Desta AA, Dianatinasab M, Diao N, Dias da Silva D, Diaz D, Digesa LE, Diress M, Djalalinia S, Doan LP, Dodangeh M, Doku PN, Dongarwar D, Dsouza HL, Eini E, Ekholuenetale M, Ekundayo TC, Elagali AEM, Elbahnasawy MA, Elhabashy HR, Elhadi M, El Sayed Zaki M, Enyew DB, Erkhembayar R, Eskandarieh S, Etaee F, Fagbamigbe AF, Faris PS, Farmany A, Faro A, Farzadfar F, Fatehizadeh A, Fereshtehnejad SM, Feroze AH, Fetensa G, Feyisa BR, Filip I, Fischer F, Foroutan B, Foroutan M, Fowobaje KR, Franklin RC, Fukumoto T, Gaal PA, Gadanya MA, Galali Y, Galehdar N, Ganesan B, Garg T, Gebrehiwot MGD, Gebremariam YH, Gela YY, Gerema U, Ghafourifard M, Ghamari SH, Ghanbari R, Ghasemi Nour M, Gholamalizadeh M, Gholami A, Gholamrezanezhad A, Ghozy S, Gilani SA, Gill TK, Giné-Vázquez I, Girma ZA, Glasbey JC, Glozah FN, Golechha M, Goleij P, Grivna M, Guadie HA, Gunawardane DA, Guo Y, Gupta VB, Gupta S, Gupta B, Gupta VK, Haj-Mirzaian A, Halwani R, Hamadeh RR, Hameed S, Hanif A, Hargono A, Harlianto NI, Harorani M, Hasaballah AI, Hasan SMM, Hassan A, Hassanipour S, Hassankhani H, Havmoeller RJ, Hay SI, Heidari M, Hendrie D, Heyi DZ, Hiraike Y, Holla R, Horita N, Hossain SJ, Hossain MBH, Hosseini Shabanan S, Hosseinzadeh M, Hostiuc S, Hoveidaei AH, Hsiao AK, Hussain S, Hussein A, Ibitoye SE, Ilesanmi OS, Ilic IM, Ilic MD, Immurana M, Inbaraj LR, Islam SMS, Islam RM, Islam MM, Ismail NE, J LM, Jahrami H, Jakovljevic M, Janodia MD, Javaheri T, Jayapal SK, Jayarajah UU, Jayaraman S, Jeganathan J, Jemal B, Jha RP, Jonas JB, Joo T, Joseph N, Jozwiak JJ, Jürisson M, Kabir A, Kadashetti V, Kadir DH, Kalankesh LR, Kalankesh LR, Kalhor R, Kamal VK, Kamath R, Kandel H, Kantar RS, Kapoor N, Karami H, Karaye IM, Karkhah S, Katoto PDMC, Kauppila JH, Kayode GA, Keikavoosi-Arani L, Keskin C, Khader YS, Khajuria H, Khammarnia M, Khan EA, Khan MN, Khan M, Khan YH, Khan IA, Khan A, Khan MAB, Khanali J, Khatatbeh MM, Khayat Kashani HR, Khubchandani J, Kifle ZD, Kim J, Kim YJ, Kisa S, Kisa A, Kneib CJ, Kompani F, Koohestani HR, Koul PA, Koulmane Laxminarayana SL, Koyanagi A, Krishan K, Krishnamoorthy V, Kucuk Bicer B, Kumar N, Kumar N, Kumar N, Kumar M, Kurmi OP, Laflamme L, Lám J, Landires I, Larijani B, Lasrado S, Lauriola P, La Vecchia C, Lee SWH, Lee YH, Lee SW, Lee WC, Legesse SM, Li S, Lim SS, Lorenzovici L, Luke AO, Madadizadeh F, Madureira-Carvalho ÁM, Magdy Abd El Razek M, Mahjoub S, Mahmoodpoor A, Mahmoudi R, Mahmoudimanesh M, Majeed A, Makki A, Malakan Rad E, Malekpour MR, Malik AA, Mallhi TH, Malta DC, Mansouri B, Mansournia MA, Mathews E, Maulud SQ, Mazingi D, Mehrabi Nasab E, Mendoza-Cano O, Menezes RG, Mengistu DA, Mentis AFA, Meretoja A, Mesregah MK, Mestrovic T, Micheletti Gomide Nogueira de Sá AC, Miller TR, Mirghaderi SP, Mirica A, Mirmoeeni S, Mirrakhimov EM, Mirza M, Misra S, Mithra P, Mittal C, Moberg ME, Mohammadi M, Mohammadi S, Mohammadi E, Mohammadpourhodki R, Mohammed S, Mohammed TA, Mohseni M, Mokdad AH, Momtazmanesh S, Monasta L, Moni MA, Moreira RS, Morrison SD, Mostafavi E, Mousavi Isfahani H, Mubarik S, Muccioli L, Mukherjee S, Mulita F, Mustafa G, Nagarajan AJ, Naimzada MD, Nangia V, Nassereldine H, Natto ZS, Nayak BP, Negoi I, Nejadghaderi SA, Nepal S, Neupane Kandel S, Noroozi N, Nuñez-Samudio V, Nzoputam OJ, Nzoputam CI, Ochir C, Odhiambo JN, Odukoya OO, Okati-Aliabad H, Okonji OC, Olagunju AT, Omar Bali A, Omer E, Otoiu A, Otstavnov SS, Otstavnov N, Oumer B, Owolabi MO, P A M, Padron-Monedero A, Padubidri JR, Pahlevan Fallahy MT, Palicz T, Panda-Jonas S, Pandi-Perumal SR, Pardhan S, Park EK, Patel SK, Pathan AR, Pati S, Paudel U, Pawar S, Pedersini P, Peres MFP, Petcu IR, Phillips MR, Pillay JD, Piracha ZZ, Poursadeqiyan M, Pourtaheri N, Qattea I, Radfar A, Rafiee A, Raghav PR, Rahim F, Rahman MA, Rahman FS, Rahman M, Rahmani AM, Rahmani S, Raj Moolambally S, Ramazanu S, Ramezanzadeh K, Rana J, Rao CR, Rao SJ, Rashedi V, Rashidi MM, Rastogi P, Rasul A, Rawaf S, Rawaf DL, Rawal L, Rawassizadeh R, Rezaei N, Rezaei N, Rezaeian M, Rezapour A, Riad A, Riaz M, Rickard J, Rodriguez JAB, Roever L, Ronfani L, Roy B, S M, Saad AMA, Sabour S, Sabzmakan L, Saddik B, Sadeghi M, Saeb MR, Saeed U, Saeedi Moghaddam S, Safi SZ, Sahiledengle B, Sahoo H, Sahraian MA, Saki M, Salamati P, Salehi S, Salem MR, Samy AM, Sanabria J, Santric-Milicevic MM, Saqib MAN, Sarikhani Y, Sarveazad A, Sathian B, Satpathy M, Saya GK, Schneider IJC, Schwebel DC, Seddighi H, Senthilkumaran S, Seylani A, Shabaninejad H, Shafeghat M, Shah PA, Shahabi S, Shahbandi A, Shahraki-Sanavi F, Shaikh MA, Shaker E, Shams-Beyranvand M, Shanawaz M, Shannawaz M, Sharew MMS, Sharma N, Shashamo BB, Shayan M, Sheikhi RA, Shen J, Shetty BSK, Shetty PH, Shin JI, Shitaye NA, Shivakumar KM, Shobeiri P, Shorofi SA, Shrestha S, Siabani S, Sidemo NB, Simegn W, Sinaei E, Singh P, Sinto R, Siraj MS, Skryabin VY, Skryabina AA, Sleet DA, S N C, Socea B, Solmi M, Solomon Y, Song Y, Sousa RARC, Soyiri IN, Stokes MA, Suleman M, Suliankatchi Abdulkader R, Sun J, Szócska M, Tabarés-Seisdedos R, Tabatabaei SM, Tabish M, Taheri E, Taheri Soodejani M, Tampa M, Tan KK, Tarigan IU, Tariqujjaman M, Tat NY, Tat VY, Tavakoli A, Tefera BN, Tefera YM, Temesgen G, Temsah MH, Thangaraju P, Thapar R, Thomas NK, Ticoalu JHV, Tincho MB, Tiyuri A, Togtmol M, Tovani-Palone MR, Tran MTN, Ullah S, Ullah S, Ullah I, Umakanthan S, Unnikrishnan B, Upadhyay E, Valadan Tahbaz S, Valdez PR, Vasankari TJ, Vaziri S, Veroux M, Vervoort D, Violante FS, Vlassov V, Vu LG, Waheed Y, Wang Y, Wang YP, Wang C, Wiangkham T, Wickramasinghe ND, Woday AT, Wu AM, Yahya GAT, Yahyazadeh Jabbari SH, Yang L, Yaya S, Yigit A, Yiğit V, Yisihak E, Yonemoto N, You Y, Younis MZ, Yu C, Yunusa I, Yusefi H, Zahir M, Zaman SB, Zare I, Zarea K, Zastrozhin MS, Zhang ZJ, Zhang Y, Ziapour A, Zodpey S, Zoladl M, Patton GC, Ivers RQ. Adolescent transport and unintentional injuries: a systematic analysis using the Global Burden of Disease Study 2019. Lancet Public Health 2022; 7:e657-e669. [PMID: 35779567 PMCID: PMC9329128 DOI: 10.1016/s2468-2667(22)00134-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Globally, transport and unintentional injuries persist as leading preventable causes of mortality and morbidity for adolescents. We sought to report comprehensive trends in injury-related mortality and morbidity for adolescents aged 10-24 years during the past three decades. METHODS Using the Global Burden of Disease, Injuries, and Risk Factors 2019 Study, we analysed mortality and disability-adjusted life-years (DALYs) attributed to transport and unintentional injuries for adolescents in 204 countries. Burden is reported in absolute numbers and age-standardised rates per 100 000 population by sex, age group (10-14, 15-19, and 20-24 years), and sociodemographic index (SDI) with 95% uncertainty intervals (UIs). We report percentage changes in deaths and DALYs between 1990 and 2019. FINDINGS In 2019, 369 061 deaths (of which 214 337 [58%] were transport related) and 31·1 million DALYs (of which 16·2 million [52%] were transport related) among adolescents aged 10-24 years were caused by transport and unintentional injuries combined. If compared with other causes, transport and unintentional injuries combined accounted for 25% of deaths and 14% of DALYs in 2019, and showed little improvement from 1990 when such injuries accounted for 26% of adolescent deaths and 17% of adolescent DALYs. Throughout adolescence, transport and unintentional injury fatality rates increased by age group. The unintentional injury burden was higher among males than females for all injury types, except for injuries related to fire, heat, and hot substances, or to adverse effects of medical treatment. From 1990 to 2019, global mortality rates declined by 34·4% (from 17·5 to 11·5 per 100 000) for transport injuries, and by 47·7% (from 15·9 to 8·3 per 100 000) for unintentional injuries. However, in low-SDI nations the absolute number of deaths increased (by 80·5% to 42 774 for transport injuries and by 39·4% to 31 961 for unintentional injuries). In the high-SDI quintile in 2010-19, the rate per 100 000 of transport injury DALYs was reduced by 16·7%, from 838 in 2010 to 699 in 2019. This was a substantially slower pace of reduction compared with the 48·5% reduction between 1990 and 2010, from 1626 per 100 000 in 1990 to 838 per 100 000 in 2010. Between 2010 and 2019, the rate of unintentional injury DALYs per 100 000 also remained largely unchanged in high-SDI countries (555 in 2010 vs 554 in 2019; 0·2% reduction). The number and rate of adolescent deaths and DALYs owing to environmental heat and cold exposure increased for the high-SDI quintile during 2010-19. INTERPRETATION As other causes of mortality are addressed, inadequate progress in reducing transport and unintentional injury mortality as a proportion of adolescent deaths becomes apparent. The relative shift in the burden of injury from high-SDI countries to low and low-middle-SDI countries necessitates focused action, including global donor, government, and industry investment in injury prevention. The persisting burden of DALYs related to transport and unintentional injuries indicates a need to prioritise innovative measures for the primary prevention of adolescent injury. FUNDING Bill & Melinda Gates Foundation.
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44
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Williams BM, Mulima G, Charles A. Chest Trauma Management in Low- and Middle-Income Countries. Thorac Surg Clin 2022; 32:329-336. [PMID: 35961741 DOI: 10.1016/j.thorsurg.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Trauma is a leading cause of death and disability worldwide and disproportionately affects those in low- and middle-income countries (LMICs). Globally, two-thirds of injured patients sustain trauma to the thoracic cavity. Further research, capacity building, and increased awareness are needed to limit the high thoracic trauma-associated morbidity and mortality in LMICs.
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Affiliation(s)
| | | | - Anthony Charles
- Department of Surgery, University of North Carolina-Chapel Hill; Kamuzu Central Hospital, Lilongwe, Malawi.
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45
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Nour S, Imani R, Sharifi AM. Angiogenic Effect of a Nanoniosomal Deferoxamine-Loaded Poly(vinyl alcohol)-Egg White Film as a Promising Wound Dressing. ACS Biomater Sci Eng 2022; 8:3485-3497. [PMID: 35786844 DOI: 10.1021/acsbiomaterials.2c00046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Owing to the noticeable increase in the number of patients with impaired wound healing capabilities, developing bioactive wound dressings with supportive physicomechanical and biological properties for clinical wound management has attracted much more attention nowadays. In this regard, engineered dressings with angiogenesis potential are vital for accelerated tissue regeneration. In the current study, nanoniosomal deferoxamine (DFO)-loaded transparent films of egg white-poly(vinyl alcohol) (PVA/EW/ND) were successfully fabricated at three different PVA/EW ratios (1:0, 1:1, and 1:1.5 wt/wt %) through the thin film hydration and solvent casting methods. The developed films' characterizations were carried out using scanning electron microscopy, Fourier transform infrared spectroscopy analysis, uniaxial tensile strength, water uptake, water vapor transmission rate, in vitro degradation, and drug release. The results demonstrated that the various weight ratios of PVA/EW have a significant effect on the microscopic morphology, equilibrium swelling, degradation, and mechanical properties of the films. The drug release profile exhibited a sustained release of DFO with controlled burst-lag phases resembling the Korsmeyer-Peppas pattern. The cytotoxicity and adhesion analysis using human dermal fibroblasts displays the biocompatibility of the developed PVA/EW/ND films and the formation of cellular colonies on the surface. The in vitro angiogenic capability of the developed films evaluated by the scratch wound assay and microbead-assisted tube formation study showed a significant increase in the rate of migration of human umbilical vein endothelial cells and in the number of tube-like structures. Therefore, the achieved results suggest that the presented PVA/EW/ND film has promising potential for effective wound healing applications.
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Affiliation(s)
- Shirin Nour
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran 15916-34311, Iran
| | - Rana Imani
- Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran 15916-34311, Iran
| | - Ali Mohammad Sharifi
- Stem Cell and Regenerative Medicine Research Center, Iran University of Medical Sciences, Tehran 14496-14535, Iran.,Razi Drug Research Center, Department of Pharmacology, Iran University of Medical Sciences, Tehran 14496-14535, Iran.,Tissue Engineering Group (NOCERAL), Department of Orthopedics Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
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46
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Oliveira CCMD, Santos JLGD, Novaes HMD. Evaluation of mobile emergency service with the use of mixed method. CAD SAUDE PUBLICA 2022; 38:e00096221. [PMID: 35703593 DOI: 10.1590/0102-311xen096221] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 01/13/2022] [Indexed: 11/22/2022] Open
Abstract
This is an evaluative study, with sequential explanatory mixed methods, aimed at evaluating the performance of the Brazilian Mobile Emergency Medical Service (SAMU) in the Grande ABC region, located in the state of São Paulo, Brazil. In the quantitative approach, an analysis of interrupted time series was performed to evaluate the immediate and gradual effects of the SAMU on hospital mortality due to acute myocardial infarction. The qualitative approach was conducted via semi-structured interviews and a thematic analysis was applied for the interpretation of the results, exploring the attitudes and values of the interviewees regarding the performance of SAMU in the Grande ABC region. Interrupted time series analysis showed a -0.04% reduction in the underlying mortality rate since SAMU implementation (95%CI: -0.0816; -0.0162; p-value = 0.0040) and a reduction in the mortality level, -2.89 (95%CI: -4.3293; -1.4623; p-value = 0.0001), both with statistical significance. To improve the robustness of the results, a control region was used, showing a statistically significant difference in the post-intervention result of -0.0639 (95%CI: -0.1060; -0.0219; p-value = 0.0001). The interviews revealed that the SAMU has the potential to intervene in the prognosis of transported cases, however, challenges related to the availability of beds, expansion of telemedicine, and continuous training of professionals for qualified emergency care in the event of a heart attack must be overcome. The results indicate that the studied intervention is part of a set of factors that, together, generate more conditions to achieve a better result.
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47
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Park JH, Song KJ, Shin SD, Hong KJ, Ro YS, Jeong J, Choi YH. Epidemiology and outcomes of severe injury patients: Nationwide community-based study in Korea. Injury 2022; 53:1935-1946. [PMID: 35369987 DOI: 10.1016/j.injury.2022.03.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 02/22/2022] [Accepted: 03/05/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The aim of this study was to estimate the annual incidence of various severe injuries, case fatality rates, and case disability rates for patients in Korea. MATERIALS AND METHODS This community-based observational study involved all residents in Korea between Jan. 1, 2018, and Dec. 31, 2018. Nationwide data were retrieved from the patient care report of the National Fire Agency and hospital medical records review of the Korea Disease Control and Prevention Agency. Severe injury was defined as any injury that resulted in emergency medical service (EMS) use and any field-based physiologic abnormality: systolic blood pressure ≤90 mm Hg, respiratory rate <10 or >29 per min, or AVPU scale nonalert. Crude and adjusted incidence rates were calculated without any exclusion. Outcomes including the Glasgow Outcome Scale (GOS) at hospital discharge were assessed according to a medical review. Case-fatality and case-disability rates were calculated after excluding patients with unknown vital status. RESULTS During the one-year period, 36,363 severe injuries occurred, yielding a crude annual incidence rate of 70.9 per 100,000 population; 57.8% were traumatic injuries, and 42.2% were nontraumatic injuries. The adjusted annual incidence rates were 61.7/100,000 for all severe injuries, 35.3/100,000 for traumatic injuries, and 26.4/100,000 for nontraumatic injuries. The case-fatality rate was 24.3% for all severe injuries, 27.0% for traumatic injuries, and 21.0% for nontraumatic injuries. The case-disability rate of GOS 3,4 was 6.0%, and the case-disability rate of GOS 2-4 was 16.4% for all severe injury patients. CONCLUSIONS This nationwide community-based study revealed incidence rates and outcomes of severe injury patients in Korea.
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Affiliation(s)
- Jeong Ho Park
- Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, 20 Boramae-Ro 5 gil, Dongjak-gu, Seoul 07061, Republic of Korea
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul National University Boramae Medical Center, Republic of Korea.
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, 20 Boramae-Ro 5 gil, Dongjak-gu, Seoul 07061, Republic of Korea
| | - Ki Jeong Hong
- Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, 20 Boramae-Ro 5 gil, Dongjak-gu, Seoul 07061, Republic of Korea
| | - Young Sun Ro
- Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, 20 Boramae-Ro 5 gil, Dongjak-gu, Seoul 07061, Republic of Korea
| | - Joo Jeong
- Department of Emergency Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Young Ho Choi
- Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, 20 Boramae-Ro 5 gil, Dongjak-gu, Seoul 07061, Republic of Korea
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48
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Gianfredi V, Ferrara P, Pennisi F, Casu G, Amerio A, Odone A, Nucci D, Dinu M. Association between Daily Pattern of Physical Activity and Depression: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116505. [PMID: 35682090 PMCID: PMC9180107 DOI: 10.3390/ijerph19116505] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 01/27/2023]
Abstract
Recent research suggested that daily pattern of physical activity (PA) may have an important association with depression, but findings are limited and contradictory. Our aim was to conduct a systematic review of the literature to summarize the literature evidence on the association between timing of PA and depression. A comprehensive search of PubMed/Medline and Scopus databases has been performed, and a total of five manuscripts have been thoroughly reviewed. The performed descriptive analysis shows lower levels of PA among individuals with depression or depressive symptoms, although evidence on the 24 h pattern of PA and depression is limited. An interesting finding is the association between lower PA during the morning, higher PA late in the evening (night), and depression or depressive symptoms. However, definitive conclusions could not be drawn due to the observational nature of the studies, their limited number, the high heterogeneity in the sample populations, and the studies’ differing outcome definitions and exposure assessments. Future studies considering not only the level of PA but also its daily variability might be important to further explore this novel area of research.
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Affiliation(s)
- Vincenza Gianfredi
- Department of Biomedical Sciences for Health, University of Milan, Via Pascal 36, 20133 Milan, Italy;
- CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Pietro Ferrara
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (P.F.); (A.O.)
- Center for Public Health Research, University of Milan-Bicocca, 20900 Monza, Italy
| | - Flavia Pennisi
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (F.P.); (G.C.)
| | - Giulia Casu
- School of Medicine, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy; (F.P.); (G.C.)
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, 16146 Genoa, Italy;
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Department of Psychiatry, Tufts University, Boston, MA 02155, USA
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (P.F.); (A.O.)
| | - Daniele Nucci
- Nutritional Support Unit, Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy
- Correspondence:
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, 50121 Florence, Italy;
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49
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Haagsma JA, Charalampous P, Ariani F, Gallay A, Moesgaard Iburg K, Nena E, Ngwa CH, Rommel A, Zelviene A, Abegaz KH, Al Hamad H, Albano L, Liliana Andrei C, Andrei T, Antonazzo IC, Aremu O, Arumugam A, Atreya A, Aujayeb A, Ayuso-Mateos JL, Engelbert Bain L, Banach M, Winfried Bärnighausen T, Barone-Adesi F, Beghi M, Bennett DA, Bhagavathula AS, Carvalho F, Castelpietra G, Caterina L, Chandan JS, Couto RAS, Cruz-Martins N, Damiani G, Dastiridou A, Demetriades AK, Dias-da-Silva D, Francis Fagbamigbe A, Fereshtehnejad SM, Fernandes E, Ferrara P, Fischer F, Fra.Paleo U, Ghirini S, Glasbey JC, Glavan IR, Gomes NGM, Grivna M, Harlianto NI, Haro JM, Hasan MT, Hostiuc S, Iavicoli I, Ilic MD, Ilic IM, Jakovljevic M, Jonas JB, Jerzy Jozwiak J, Jürisson M, Kauppila JH, Kayode GA, Khan MAB, Kisa A, Kisa S, Koyanagi A, Kumar M, Kurmi OP, La-Vecchia C, Lamnisos D, Lasrado S, Lauriola P, Linn S, Loureiro JA, Lunevicius R, Madureira-Carvalho A, Mechili EA, Majeed A, Menezes RG, Mentis AFA, Meretoja A, Mestrovic T, Miazgowski T, Miazgowski B, Mirica A, Molokhia M, Mohammed S, Monasta L, Mulita F, David Naimzada M, Negoi I, Neupane S, Oancea B, Orru H, Otoiu A, Otstavnov N, Otstavnov SS, Padron-Monedero A, Panda-Jonas S, Pardhan S, Patel J, Pedersini P, Pinheiro M, Rakovac I, Rao CR, Rawaf S, Rawaf DL, Rodrigues V, Ronfani L, Sagoe D, Sanmarchi F, Santric-Milicevic MM, Sathian B, Sheikh A, Shiri R, Shivalli S, Dora Sigfusdottir I, Sigurvinsdottir R, Yurievich Skryabin V, Aleksandrovna Skryabina A, Smarandache CG, Socea B, Sousa RARC, Steiropoulos P, Tabarés-Seisdedos R, Roberto Tovani-Palone M, Tozija F, Van de Velde S, Juhani Vasankari T, Veroux M, Violante FS, Vlassov V, Wang Y, Yadollahpour A, Yaya S, Sergeevich Zastrozhin M, Zastrozhina A, Polinder S, Majdan M. The burden of injury in Central, Eastern, and Western European sub-region: a systematic analysis from the Global Burden of Disease 2019 Study. Arch Public Health 2022; 80:142. [PMID: 35590340 PMCID: PMC9121595 DOI: 10.1186/s13690-022-00891-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/02/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were to: 1) compare GBD 2019 estimates on injury mortality and DALYs across European sub-regions and countries by cause-of-injury category and sex; 2) examine changes in injury DALY rates over a 20 year-period by cause-of-injury category, sub-region and country; and 3) assess inequalities in injury mortality and DALY rates across the countries. METHODS We performed a secondary database descriptive study using the GBD 2019 results on injuries in 44 European countries from 2000 to 2019. Inequality in DALY rates between these countries was assessed by calculating the DALY rate ratio between the highest-ranking country and lowest-ranking country in each year. RESULTS In 2019, in Eastern Europe 80 [95% uncertainty interval (UI): 71 to 89] people per 100,000 died from injuries; twice as high compared to Central Europe (38 injury deaths per 100,000; 95% UI 34 to 42) and three times as high compared to Western Europe (27 injury deaths per 100,000; 95%UI 25 to 28). The injury DALY rates showed less pronounced differences between Eastern (5129 DALYs per 100,000; 95% UI: 4547 to 5864), Central (2940 DALYs per 100,000; 95% UI: 2452 to 3546) and Western Europe (1782 DALYs per 100,000; 95% UI: 1523 to 2115). Injury DALY rate was lowest in Italy (1489 DALYs per 100,000) and highest in Ukraine (5553 DALYs per 100,000). The difference in injury DALY rates by country was larger for males compared to females. The DALY rate ratio was highest in 2005, with DALY rate in the lowest-ranking country (Russian Federation) 6.0 times higher compared to the highest-ranking country (Malta). After 2005, the DALY rate ratio between the lowest- and the highest-ranking country gradually decreased to 3.7 in 2019. CONCLUSIONS Injury mortality and DALY rates were highest in Eastern Europe and lowest in Western Europe, although differences in injury DALY rates declined rapidly, particularly in the past decade. The injury DALY rate ratio of highest- and lowest-ranking country declined from 2005 onwards, indicating declining inequalities in injuries between European countries.
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Affiliation(s)
- Juanita A. Haagsma
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Periklis Charalampous
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Filippo Ariani
- Epidemiology Unit, Central Tuscany Local Health Authority, Florence, Italy
| | - Anne Gallay
- grid.493975.50000 0004 5948 8741Department of Non-Communicable Diseases and Injuries, Santé Publique France, Saint-Maurice, France
| | - Kim Moesgaard Iburg
- grid.7048.b0000 0001 1956 2722Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Evangelia Nena
- grid.12284.3d0000 0001 2170 8022Laboratory of Social Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Che Henry Ngwa
- grid.8761.80000 0000 9919 9582School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden ,grid.22903.3a0000 0004 1936 9801Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Alexander Rommel
- grid.13652.330000 0001 0940 3744Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Ausra Zelviene
- Institute of Hygiene, Health Information Center, Kaunas, Lithuania
| | - Kedir Hussein Abegaz
- grid.412132.70000 0004 0596 0713Department of Biostatistics, Near East University, Nicosia, Cyprus ,Department of Biostatistics and Health Informatics, Madda Walabu University, Bale Robe, Ethiopia
| | - Hanadi Al Hamad
- grid.413548.f0000 0004 0571 546XGeriatrics and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar
| | - Luciana Albano
- grid.9841.40000 0001 2200 8888Department of Experimental Medicine, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Catalina Liliana Andrei
- grid.8194.40000 0000 9828 7548Cardiology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Tudorel Andrei
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Ippazio Cosimo Antonazzo
- grid.7563.70000 0001 2174 1754Research Center On Public Health, University of Milan-Bicocca, Monza, Italy
| | - Olatunde Aremu
- grid.19822.300000 0001 2180 2449Department of Public Health, Birmingham City University, Birmingham, UK
| | - Ashokan Arumugam
- grid.412789.10000 0004 4686 5317Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alok Atreya
- grid.429382.60000 0001 0680 7778Department of Forensic Medicine, Lumbini Medical College, Palpa, Nepal
| | - Avinash Aujayeb
- grid.451090.90000 0001 0642 1330Northumbria Healthcare NHS Foundation Trust, Cramlington, UK
| | - Jose Luis Ayuso-Mateos
- grid.411251.20000 0004 1767 647XHospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain ,grid.413448.e0000 0000 9314 1427Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain
| | - Luchuo Engelbert Bain
- grid.36511.300000 0004 0420 4262Lincoln International Institute for Rural Health (LIIRH), University of Lincoln, Lincoln, UK ,Global South Health Services and Research, GSHS, Amsterdam, The Netherlands
| | - Maciej Banach
- grid.8267.b0000 0001 2165 3025Department of Hypertension, Medical University of Lodz, Lodz, Poland ,grid.415071.60000 0004 0575 4012Polish Mothers’ Memorial Hospital Research Institute, Lodz, Poland
| | - Till Winfried Bärnighausen
- grid.7700.00000 0001 2190 4373Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany ,grid.38142.3c000000041936754XT.H. Chan School of Public Health, Harvard University, Boston, MA USA
| | - Francesco Barone-Adesi
- grid.16563.370000000121663741Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | | | - Derrick A. Bennett
- grid.4991.50000 0004 1936 8948Clinical Trials Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Akshaya S. Bhagavathula
- grid.43519.3a0000 0001 2193 6666Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates ,grid.4491.80000 0004 1937 116XDepartment of Social and Clinical Pharmacy, Charles University, Hradec Kralova, Prague, Czech Republic
| | - Félix Carvalho
- grid.5808.50000 0001 1503 7226Research Unit On Applied Molecular Biosciences (UCIBIO), University of Porto, Porto, Portugal
| | - Giulio Castelpietra
- Outpatient and Inpatient Care Service, Central Health Directorate, Friuli Venezia Giulia Region, Trieste, Italy
| | - Ledda Caterina
- grid.8158.40000 0004 1757 1969Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Joht Singh Chandan
- grid.6572.60000 0004 1936 7486Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Rosa A. S. Couto
- grid.5808.50000 0001 1503 7226Department of Chemical Sciences, University of Porto, Porto, Portugal
| | - Natália Cruz-Martins
- grid.5808.50000 0001 1503 7226Faculty of Medicine, University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Institute for Research & Innovation in Health (i3S), University of Porto, Porto, Portugal ,Institute of Research and Advanced, Training in Health Sciences and Technologies (INFACTS), Gandra, Portugal
| | - Giovanni Damiani
- grid.4708.b0000 0004 1757 2822Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy ,grid.67105.350000 0001 2164 3847Department of Dermatology, Case Western Reserve University, Cleveland, OH USA
| | - Anna Dastiridou
- grid.411299.6Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece
| | - Andreas K. Demetriades
- grid.418716.d0000 0001 0709 1919Edinburgh Spinal Surgery Outcome Studies Group, Department of Neurosurgery, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Diana Dias-da-Silva
- grid.5808.50000 0001 1503 7226Laboratory of Toxicology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - Adeniyi Francis Fagbamigbe
- grid.9582.60000 0004 1794 5983Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Seyed-Mohammad Fereshtehnejad
- grid.28046.380000 0001 2182 2255Division of Neurology, Department of Medicine, University of Ottawa, Ottawa, ON Canada ,grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Department of Neurobiology, Karolinska Institute, Stockholm, Sweden
| | - Eduarda Fernandes
- grid.5808.50000 0001 1503 7226Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal
| | - Pietro Ferrara
- grid.7563.70000 0001 2174 1754Research Center On Public Health, University of Milan-Bicocca, Monza, Italy
| | - Florian Fischer
- grid.6363.00000 0001 2218 4662Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Urbano Fra.Paleo
- grid.8393.10000000119412521Research Institute for Sustainable Land Development (Interra), University of Extremadura, Caceres, Spain
| | - Silvia Ghirini
- grid.416651.10000 0000 9120 6856National Center On Addictions and Doping, Istituto Superiore Di Sanità, Rome, Italy
| | - James C. Glasbey
- grid.6572.60000 0004 1936 7486NIHR Global Health Research Unit On Global Surgery, University of Birmingham, Birmingham, UK
| | - Ionela-Roxana Glavan
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Nelson G. M. Gomes
- grid.5808.50000 0001 1503 7226Associated Laboratory for Green Chemistry (LAQV), University of Porto, Porto, Portugal ,grid.5808.50000 0001 1503 7226Department of Chemistry, University of Porto, Porto, Portugal
| | - Michal Grivna
- grid.43519.3a0000 0001 2193 6666Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Netanja I. Harlianto
- grid.7692.a0000000090126352Department of Orthopedics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Josep Maria Haro
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain ,Research and Development Unit, San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain
| | - M. Tasdik Hasan
- grid.414142.60000 0004 0600 7174International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh ,grid.10025.360000 0004 1936 8470Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Sorin Hostiuc
- grid.8194.40000 0000 9828 7548Department of Legal Medicine and Bioethics, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania ,Clinical Legal Medicine Department, National Institute of Legal Medicine Mina Minovici, Bucharest, Romania
| | - Ivo Iavicoli
- grid.4691.a0000 0001 0790 385XDepartment of Public Health, University of Naples Federico II, Naples, Italy
| | - Milena D. Ilic
- grid.413004.20000 0000 8615 0106Department of Epidemiology, University of Kragujevac, Kragujevac, Serbia
| | - Irena M. Ilic
- grid.7149.b0000 0001 2166 9385Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Mihajlo Jakovljevic
- grid.448878.f0000 0001 2288 8774N. A. Semashko Department of Public Health and Healthcare, I. M. Sechenov First Moscow State Medical University, Moscow, Russia ,grid.413004.20000 0000 8615 0106Department of Global Health, Economics and Policy, University of Kragujevac, Kragujevac, Serbia
| | - Jost B. Jonas
- grid.7700.00000 0001 2190 4373Department of Ophthalmology, Heidelberg University, Mannheim, Germany ,grid.414373.60000 0004 1758 1243Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing, China
| | - Jacek Jerzy Jozwiak
- grid.107891.60000 0001 1010 7301Department of Family Medicine and Public Health, University of Opole, Opole, Poland
| | - Mikk Jürisson
- grid.10939.320000 0001 0943 7661Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Joonas H. Kauppila
- grid.4714.60000 0004 1937 0626Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden ,grid.10858.340000 0001 0941 4873Surgery Research Unit, University of Oulu, Oulu, Finland
| | - Gbenga A. Kayode
- grid.421160.0International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria ,grid.5477.10000000120346234Julius Centre for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
| | - Moien A. B. Khan
- grid.43519.3a0000 0001 2193 6666Department of Family Medicine, United Arab Emirates University, Al-Ain, United Arab Emirates ,grid.451052.70000 0004 0581 2008Primary Care Department, NHS North West London, London, England
| | - Adnan Kisa
- grid.457625.70000 0004 0383 3497School of Health Sciences, Kristiania University College, Oslo, Norway ,grid.265219.b0000 0001 2217 8588Department of Global Community Health and Behavioral Sciences, Tulane University, New Orleans, LA USA
| | - Sezer Kisa
- grid.412414.60000 0000 9151 4445Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Ai Koyanagi
- Biomedical Research Networking Center for Mental Health Network (CiberSAM), San Juan de Dios Sanitary Park, Sant Boi de Llobregat, Spain ,grid.425902.80000 0000 9601 989XCatalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
| | - Manasi Kumar
- grid.10604.330000 0001 2019 0495Department of Psychiatry, University of Nairobi, Nairobi, Kenya ,grid.83440.3b0000000121901201Division of Psychology and Language Sciences, University College London, London, UK
| | - Om P. Kurmi
- grid.25073.330000 0004 1936 8227Division of Respirology, Department of Medicine, McMaster University, Hamilton, Canada ,grid.8096.70000000106754565Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Carlo La-Vecchia
- grid.4708.b0000 0004 1757 2822Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Demetris Lamnisos
- grid.440838.30000 0001 0642 7601Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Savita Lasrado
- grid.414767.70000 0004 1765 9143Department of Otorhinolaryngology, Father Muller Medical College, Mangalore, India
| | - Paolo Lauriola
- grid.5326.20000 0001 1940 4177Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Shai Linn
- grid.18098.380000 0004 1937 0562School of Public Health, University of Haifa, Haifa, Israel
| | - Joana A. Loureiro
- grid.5808.50000 0001 1503 7226Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), University of Porto, Porto, Portugal
| | - Raimundas Lunevicius
- grid.10025.360000 0004 1936 8470Department of General Surgery, School of Medicine, Liverpool University Hospitals NHS Foundation Trust, University of Liverpool, Liverpool, UK
| | - Aurea Madureira-Carvalho
- Institute of Research and Advanced, Training in Health Sciences and Technologies (INFACTS), Gandra, Portugal ,grid.5808.50000 0001 1503 7226Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade Do Porto, Porto, Portugal
| | - Enkeleint A. Mechili
- grid.8127.c0000 0004 0576 3437Clinic of Social and Family Medicine, School of Medicine, University of Crete, Crete, Greece ,Department of Healthcare, Faculty of Public Health, University of Vlora, Vlora, Albania
| | - Azeem Majeed
- grid.7445.20000 0001 2113 8111Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Ritesh G. Menezes
- grid.411975.f0000 0004 0607 035XForensic Medicine Division, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Alexios-Fotios A. Mentis
- grid.418497.7Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece ,grid.411299.6Department of Neurology, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | - Atte Meretoja
- grid.1008.90000 0001 2179 088XSchool of Health Sciences, University of Melbourne, Melbourne, VIC Australia ,grid.15485.3d0000 0000 9950 5666Neurology Unit, Helsinki University Hospital, Helsinki, Finland
| | - Tomislav Mestrovic
- Clinical Microbiology and Parasitology Unit, Dr Zora Profozic Polyclinic, Zagreb, Croatia ,grid.502995.20000 0004 4651 2415University Centre Varazdin, University North, Varazdin, Croatia
| | - Tomasz Miazgowski
- grid.107950.a0000 0001 1411 4349Department of Propedeutics of Internal Diseases & Arterial Hypertension, Pomeranian Medical University, Szczecin, Poland
| | - Bartosz Miazgowski
- grid.107950.a0000 0001 1411 4349Center for Innovation in Medical Education, Pomeranian Medical University, Szczecin, Poland
| | - Andreea Mirica
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Mariam Molokhia
- grid.13097.3c0000 0001 2322 6764Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Shafiu Mohammed
- grid.7700.00000 0001 2190 4373Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany ,grid.411225.10000 0004 1937 1493Health Systems and Policy Research Unit, Ahmadu Bello University, Zaria, Nigeria
| | - Lorenzo Monasta
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Francesk Mulita
- grid.412458.eDepartment of General Surgery, University General Hospital of Patras, Patras, Greece
| | - Mukhammad David Naimzada
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia ,grid.411191.d0000 0000 9146 0440Experimental Surgery and Oncology Laboratory, Kursk State Medical University, Kursk, Russia
| | - Ionut Negoi
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania ,Department of General Surgery, Emergency Hospital of Bucharest, Bucharest, Romania
| | - Subas Neupane
- grid.502801.e0000 0001 2314 6254Faculty of Social Sciences, Unit of Health Sciences, Tampere University, Tampere, Finland ,grid.502801.e0000 0001 2314 6254Gerontology Research Center, Tampere University, Tampere, Finland
| | - Bogdan Oancea
- grid.5100.40000 0001 2322 497XAdministrative and Economic Sciences Department, University of Bucharest, Bucharest, Romania
| | - Hans Orru
- grid.10939.320000 0001 0943 7661Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia ,grid.12650.300000 0001 1034 3451Department of Public Health and Clinical Medicine, Sustainable Health, Umea University, Umea, Sweden
| | - Adrian Otoiu
- grid.432032.40000 0004 0416 9364Department of Statistics and Econometrics, Bucharest University of Economic Studies, Bucharest, Romania
| | - Nikita Otstavnov
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia
| | - Stanislav S. Otstavnov
- grid.18763.3b0000000092721542Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudny, Russia ,grid.410682.90000 0004 0578 2005Department of Project Management, National Research University Higher School of Economics, Moscow, Russia
| | - Alicia Padron-Monedero
- grid.512889.f0000 0004 1768 0241National School of Public Health, Institute of Health Carlos III, Madrid, Spain
| | - Songhomitra Panda-Jonas
- grid.7700.00000 0001 2190 4373Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | - Shahina Pardhan
- grid.5115.00000 0001 2299 5510Vision and Eye Research Institute, Anglia Ruskin University, Cambridge, UK
| | - Jay Patel
- grid.9909.90000 0004 1936 8403Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Paolo Pedersini
- grid.418563.d0000 0001 1090 9021IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Marina Pinheiro
- grid.5808.50000 0001 1503 7226Department of Chemistry, University of Porto, Porto, Portugal
| | - Ivo Rakovac
- World Health Organization (WHO) European Office for the Prevention and Control of Noncommunicable Diseases, Division of Country Health Programmes, WHO Regional Office for Europe, Moscow, Russian Federation
| | - Chythra R. Rao
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka India
| | - Salman Rawaf
- grid.7445.20000 0001 2113 8111Department of Primary Care and Public Health, Imperial College London, London, UK ,grid.271308.f0000 0004 5909 016XAcademic Public Health Department, Public Health England, London, UK
| | - David Laith Rawaf
- grid.7445.20000 0001 2113 8111World Health Organization (WHO) Collaborating Centre for Public Health Education and Training, Imperial College London, London, UK ,grid.439749.40000 0004 0612 2754University College London Hospitals, London, UK
| | | | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Burlo Garofolo Institute for Maternal and Child Health, Trieste, Italy
| | - Dominic Sagoe
- grid.7914.b0000 0004 1936 7443Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Francesco Sanmarchi
- grid.6292.f0000 0004 1757 1758Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Milena M. Santric-Milicevic
- grid.7149.b0000 0001 2166 9385Faculty of Medicine, University of Belgrade, Belgrade, Serbia ,grid.7149.b0000 0001 2166 9385School of Public Health and Health Management, University of Belgrade, Belgrade, Serbia
| | - Brijesh Sathian
- grid.413548.f0000 0004 0571 546XGeriatrics and Long Term Care Department, Hamad Medical Corporation, Doha, Qatar ,grid.17236.310000 0001 0728 4630Faculty of Health & Social Sciences, Bournemouth University, Bournemouth, UK
| | - Aziz Sheikh
- grid.4305.20000 0004 1936 7988Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK ,grid.38142.3c000000041936754XDivision of General Internal Medicine, Harvard University, Boston, MA USA
| | - Rahman Shiri
- grid.6975.d0000 0004 0410 5926Finnish Institute of Occupational Health, Helsinki, Finland
| | - Siddharudha Shivalli
- grid.8991.90000 0004 0425 469XDepartment of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Inga Dora Sigfusdottir
- grid.9580.40000 0004 0643 5232Department of Psychology, Reykjavik University, Reykjavik, Iceland ,Icelandic Centre for Social Research and Analysis (ICSRA), Reykjavik, Iceland ,grid.21729.3f0000000419368729Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY USA
| | - Rannveig Sigurvinsdottir
- grid.9580.40000 0004 0643 5232Department of Psychology, Reykjavik University, Reykjavik, Iceland
| | | | | | - Catalin-Gabriel Smarandache
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Socea
- grid.8194.40000 0000 9828 7548Department of General Surgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Raúl A. R. C. Sousa
- Professional Association of Licensed Optometry Professionals, Linda-a-Velha, Portugal
| | - Paschalis Steiropoulos
- grid.12284.3d0000 0001 2170 8022Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, Alexandroupolis, Greece
| | - Rafael Tabarés-Seisdedos
- grid.413448.e0000 0000 9314 1427Carlos III Health Institute, Biomedical Research Networking Center for Mental Health Network (CiberSAM), Madrid, Spain ,grid.5338.d0000 0001 2173 938XDepartment of Medicine, University of Valencia, Valencia, Spain
| | - Marcos Roberto Tovani-Palone
- grid.11899.380000 0004 1937 0722Department of Pathology and Legal Medicine, University of São Paulo, Ribeirão Preto, Brazil
| | - Fimka Tozija
- grid.7858.20000 0001 0708 5391Institute of Public Health of Republic of North Macedonia, Saints Cyril and Methodius University of Skopje, Skopje, North Macedonia
| | - Sarah Van de Velde
- grid.5284.b0000 0001 0790 3681Centre for Population, Family and Health, Department of Sociology, University of Antwerp, Antwerp, Belgium
| | | | - Massimiliano Veroux
- grid.8158.40000 0004 1757 1969Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Francesco S. Violante
- grid.6292.f0000 0004 1757 1758Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy ,grid.412311.4Occupational Health Unit, Sant’Orsola Malpighi Hospital, Bologna, Italy
| | - Vasiliy Vlassov
- grid.410682.90000 0004 0578 2005Department of Health Care Administration and Economics, National Research University Higher School of Economics, Moscow, Russia
| | - Yanzhong Wang
- grid.13097.3c0000 0001 2322 6764School of Population Health and Environmental Sciences, King’s College London, London, UK
| | - Ali Yadollahpour
- grid.11835.3e0000 0004 1936 9262Psychology Department, University of Sheffield, Sheffield, UK
| | - Sanni Yaya
- grid.28046.380000 0001 2182 2255School of International Development and Global Studies, University of Ottawa, Ottawa, ON Canada ,grid.4991.50000 0004 1936 8948The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Mikhail Sergeevich Zastrozhin
- Laboratory of Genetics and Genomics, Moscow Research and Practical Centre On Addictions, Moscow, Russia ,grid.465497.dAddictology Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Anasthasia Zastrozhina
- grid.465497.dPediatrics Department, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - Suzanne Polinder
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Marek Majdan
- grid.412903.d0000 0001 1212 1596Department of Public Health, Institute for Global Health and Epidemiology, Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovakia
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Chen Q, Tang B, Song J, Jiang Y, Zhao X, Ruan Y, Zhao F, Wu G, Chen T, He J. Dynamic Bayesian network for predicting physiological changes, organ dysfunctions and mortality risk in critical trauma patients. BMC Med Inform Decis Mak 2022; 22:119. [PMID: 35505328 PMCID: PMC9063308 DOI: 10.1186/s12911-022-01803-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Critical trauma patients are particularly prone to increased mortality risk; hence, an accurate prediction of their conditions enables early identification of patients' mortality status. Thus, we aimed to develop and validate a real-time prediction model for physiological changes, organ dysfunctions and mortality risk in critical trauma patients. METHODS We used Dynamic Bayesian Networks (DBNs) to model complicated relationships of physiological variables across time slices, accessing data of trauma patients from the Medical Information Mart for Intensive Care database (MIMIC-III) (n = 2915) and validated with patients' data from ICU admissions at the Changhai Hospital (ICU-CH) (n = 1909). The DBN model's evaluation included the predictive ability of physiological changes, organ dysfunctions and mortality risk. RESULTS Our DBN model included two static variables (age and sex) and 18 dynamic physiological variables. The differences in ratios between the real values and the 24- and 48-h predicted values of most physiological variables were within 5% in the two datasets. The accuracy of our DBN model for predicting renal, hepatic, cardiovascular and hematologic dysfunctions was more than 0.8.The calculated area under the curve (AUC) from receiver operating characteristic curves and 95% confidence interval for predicting the 24- and 48-h mortality risk were 0.977 (0.967-0.988) and 0.958 (0.945-0.971) in the MIMIC-III and 0.967 (0.947-0.987) and 0.946 (0.925-0.967) in ICU-CH. CONCLUSIONS A DBN is a promising method for predicting medical temporal data such as trauma patients' mortality risk, demonstrated by high AUC scores and validation by a real-life ICU scenario; thus, our DBN prediction model can be used as a real-time tool to predict physiological changes, organ dysfunctions and mortality risk during ICU admissions.
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Affiliation(s)
- Qi Chen
- Department of Health Statistics, Naval Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China
| | - Bihan Tang
- Institute of Military Health Management, Naval Medical University, Shanghai, China
| | - Jiaqi Song
- Department of Health Statistics, Naval Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China
| | - Ying Jiang
- Department of Pharmaceutical Administration and Regulation, Zhejiang Pharmaceutical College, Ningbo, China
| | - Xinxin Zhao
- School of Medicine, Tongji University, Shanghai, China
| | - Yiming Ruan
- Department of Health Statistics, Naval Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China
| | - Fangjie Zhao
- Institute of Military Health Management, Naval Medical University, Shanghai, China
| | - Guosheng Wu
- Department of Burn Surgery, Changhai Hospital, Naval Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China.
| | - Tao Chen
- Department of Cardiology, PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
| | - Jia He
- Department of Health Statistics, Naval Medical University, No. 800 Xiangyin Road, Shanghai, 200433, China. .,School of Medicine, Tongji University, Shanghai, China.
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