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Asadi F, Hosseini MA, Almasi S. Reliability of trauma coding with ICD-10. Chin J Traumatol 2022; 25:102-106. [PMID: 34419337 PMCID: PMC9039840 DOI: 10.1016/j.cjtee.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 04/28/2021] [Accepted: 06/29/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The reliability of trauma coding is essential in establishing the reliable trauma data and adopting efficient control and monitoring policies. The present study aimed to determine the reliability of trauma coding in educational hospitals affiliated to Shahid Beheshti University of Medical Sciences, Iran. METHODS In this descriptive cross-sectional study, 591 coded medical records with a trauma diagnosis in 2018 were selected and recoded by two coders. The reliability of trauma coding was calculated using Cohen's kappa. The data were recorded in a checklist, in which the validity of the content had been confirmed by experts. RESULTS The reliability of the coding related to the nature of trauma in research units was 0.75-0.77, indicating moderate reliability. Also, the reliability of the coding of external causes of trauma was 0.57-0.58, suggesting poor reliability. CONCLUSION The reliability of trauma coding both in terms of the nature of trauma and the external causes of trauma does not have a good status in the research units. This can be due to the complex coding of trauma, poor documentation of the cases, and not studying the entire case. Therefore, holding training courses for coders, offering training on the accurate documentation to other service providers, and periodically auditing the medical coding are recommended.
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Ahmadian L, Salehi F, Padidar S. International classification of external causes of injury: a study on its content coverage. BMC Med Inform Decis Mak 2021; 21:155. [PMID: 33985494 PMCID: PMC8117543 DOI: 10.1186/s12911-021-01515-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 05/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Injuries are a major health issue worldwide and their prevention requires access to accurate statistics in this regard. This can be achieved by classifying the collected data using the international classification systems. This study aimed at investigating the content coverage rate of the International Classification of External Causes of Injury (ICECI) regarding the external causes of injury in a hospital. METHODS This cross-sectional descriptive-analytical study was performed on 322 injured individuals visiting the emergency unit of a hospital which is the biggest truma center in the southeast of Iran. The required data were collected via a designed questionnaire by the researcher visiting the Emergency ward. The collected data were encoded based on the ICECI textbook by two encoders. Their agreement rate was calculated using the Kappa estimate of agreement. The content coverage of the classification system and the degree of completeness of the required data for encoding in the patients' records were measured. Data were analyzed by the SPSS software, ver 19. RESULTS The findings showed that 70% of the external causes of injury were covered by ICECI. Among the 322 cases, 138 (43%) had been referred due to a car crash. The injured were mostly drivers of land transport vehicles who had been unintentionally involved in a car crash. The least mechanism for injury was bite injury with 5 (2%). ICECI was capable of classifying 92% of the data related to the external causes of the injuries. The most un-covered data has belonged to the "activity when injured" axis (n = 18). Lack of precise data recording in the medical records resulted in missing data about at least one of the axis of the external causes in most records. CONCLUSION The findings of the present study showed that ICECI has good content coverage for encoding the external causes of injuries. Before implementing ICECI for encoding the external causes of injuries, it is required to train clinicians regarding how to document all aspects of an injury incidence.
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Affiliation(s)
- Leila Ahmadian
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Haftbagh Highway, Kerman, 7616911313, Iran
| | - Fatemeh Salehi
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Haftbagh Highway, Kerman, 7616911313, Iran. .,Health Human Resources Research Center, School of Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran. .,Emamreza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Shabnam Padidar
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Haftbagh Highway, Kerman, 7616911313, Iran. .,School of Management and Medical Information, Kerman University of Medical Sciences, Kerman, Iran.
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Brubacher JR, Shih Y, Weng JT, Verma R, Evans D, Grafstein E. Low-impact strategy for capturing better emergency department injury surveillance data. Inj Prev 2018; 25:507-513. [PMID: 30337353 DOI: 10.1136/injuryprev-2018-042958] [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: 08/07/2018] [Revised: 09/10/2018] [Accepted: 09/16/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Injury prevention should be informed by timely surveillance data. Unfortunately, most injury surveillance only captures patients with severe injuries and is not available in real time, hampering prevention efforts. We aimed to develop and pilot a simple injury surveillance strategy that can be integrated into routine emergency department (ED) workflow to collect more robust mechanism of injury information at time of visit for all injured ED patients with minimal impact on workflow. METHODS We reviewed ED injury surveillance systems and considered ED workflow. Forms were developed to collect injury-related information on ED patients and refined to address workload concerns raised by key stakeholders. Research assistants observed ED staff as they registered injured patients and noted the time required to collect data and any ambiguities or concerns encountered. Interobserver agreement was recorded. RESULTS Injury surveillance questions were based on a modification of the International Classification of External Causes of Injury. Research assistants observed 222 injured patients being admitted by registration clerks. The mean time required to complete the surveillance form was 64.9 s (95% CI 59.9 s to 69.9 s) for paper-based forms (120 cases) and 44.5 s (95% CI 41.7s to 47.4s) with direct electronic data entry (102 cases). Interobserver agreement (26 cases) was 100% for intent (kappa=1.0) of injury and 96% for mechanism of injury (kappa=0.74). CONCLUSIONS We report a simple injury surveillance strategy that ED staff can use to collect meaningful injury data in real time with minimal impact on workflow. This strategy can be adapted to enhance regional injury surveillance efforts.
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Affiliation(s)
- Jeffrey R Brubacher
- Department of Emergency Medicine, University of British Columbia, c/o Vancouver General Hospital Emergency Research Office, Vancouver, British Columbia, Canada
| | - Yuda Shih
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jian Ting Weng
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Rahul Verma
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - David Evans
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Eric Grafstein
- Department of Emergency Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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4
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de Putter CE, van Beeck EF, Polinder S, Panneman MJM, Burdorf A, Hovius SER, Selles RW. Healthcare costs and productivity costs of hand and wrist injuries by external cause: A population-based study in working-age adults in the period 2008-2012. Injury 2016; 47:1478-82. [PMID: 27198618 DOI: 10.1016/j.injury.2016.04.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/27/2016] [Accepted: 04/26/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND Hand and wrist injuries are very common at the Emergency Departments (ED), and among the most costly injury types in the working population. The purpose of this study was to explore the causes of non-trivial hand and wrist injuries (i.e., hand fractures, wrist fractures and complex soft-tissue injuries) in working-age adults in order to identify target areas for prevention. METHODS Data were extracted from the Dutch Injury Surveillance System, from the National Hospital Discharge Registry and from a patient follow-up survey in working-age adults (aged 20-64 years) in the period 2008-2012. An incidence-based cost model was used to estimate healthcare costs, and an absenteeism model for estimating the productivity costs. Total costs were calculated by external cause, subdivided in their main categories (home, sports, work, traffic and violence) and their most important subclasses. RESULTS Total costs of these injuries in The Netherlands were US $410 million per year, of which 75% (US $307 million) productivity costs. Males represented 66% (US $271 million) of the total costs. Within the male group, the group 35-49 years had the highest contribution to total costs (US $112 million), as well as the highest costs per case (US $10,675). Work-related injuries showed the highest costs per case (US $11,797), however, only 25% of the total costs were work-related. The top five causes in terms of total costs were: accidents at home (falls 23%, contact with an object 17%), traffic (cycling 9%) and work (industrial work 4%, and construction work 4%). CONCLUSION Hand and wrist injuries are a major cause of healthcare and productivity costs in working-age adults. To reduce the costs to society, prevention initiatives should be targeted at major contributing causes, that are mainly related to activities at home (falls, contact with an object) and accidents at the road (cycling).
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Affiliation(s)
- C E de Putter
- Department of Plastic-, Reconstructive- and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands.
| | - E F van Beeck
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
| | - S Polinder
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
| | | | - A Burdorf
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
| | - S E R Hovius
- Department of Plastic-, Reconstructive- and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands.
| | - R W Selles
- Department of Plastic-, Reconstructive- and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands; Department of Rehabilitation Medicine & Physical Therapy, Erasmus MC, Rotterdam, The Netherlands.
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5
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Momose Y, Suenaga T. Gender differences in the occurrence of nonfatalagricultural injuries among farmers in Fukuoka, Japan. J Rural Med 2015; 10:57-64. [PMID: 26705430 PMCID: PMC4689734 DOI: 10.2185/jrm.2897] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 05/29/2015] [Indexed: 11/27/2022] Open
Abstract
Background: The lack of information regarding nonfatal agricultural injuries
has been recognized as an obstacle for effective injury prevention. The aim of this study
was to describe gender differences in the pattern of nonfatal agricultural injuries
between the years 2008 and 2009. Methods: Farmers’ compensation injury claims were utilized to determine the
mechanisms involved (machinery, non-machinery, and traffic), types of accident, sources of
injury, kinds of injury, body parts affected place of injury, work being performed at the
time of injury, and length of hospitalization. Agricultural injuries were identified using
the International Classification of External Causes of Injury (ICECI). The Statistical
Analysis System (SAS) software was used for all statistical analyses. Study variables were
compared using the Mantel-Haenszel chi-square test. Results: A total of 2,729 (1,921 males) farmers’ compensation injury claims
were analyzed. There were approximately 9 times as many nonfatal agricultural machinery
injuries in males compared with females. The most common machinery injuries were cuts
resulting from a rotary blade (31%) for males and injuries caused by being struck by a
machine (24%) for females in the 65–89 years of age group. The male:female ratio of
non-machinery injuries averaged 2:1 (actual numbers of 1,293 and 676, respectively), but
the percentage was higher for females (83.7%) than males (67.3%). For both males and
females in the 65–89 years of age group, the main source of non-machinery injuries was
slopes, the main type of accident was falling/slipping, the leading kind of injury was
fracture, and the main work being performed was harvesting. Female farmers had a greater
risk of prolonged hospitalization (more than 30 days) compared with males (p <
0.05). Conclusions: Gender is an important factor to consider in the interpretation
of nonfatal agricultural injuries. A greater number of males had machinery injuries than
females; however, a higher percentage of females had non-machinery injuries than males.
Further research will be needed to understand the role of differential job tasks within
agriculture in explaining the difference in risk.
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Affiliation(s)
- Yoshito Momose
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Japan
| | - Takajiro Suenaga
- Department of Environmental Medicine, Faculty of Medicine, Kurume University, Japan
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Kim SJ, Shin SD, Lee EJ, Ro YS, Song KJ, Lee SC. Epidemiology and outcomes of out-of-hospital cardiac arrest according to suicide mechanism: a nationwide observation study. Clin Exp Emerg Med 2015; 2:95-103. [PMID: 27752579 PMCID: PMC5052863 DOI: 10.15441/ceem.15.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 04/15/2015] [Accepted: 04/19/2015] [Indexed: 11/23/2022] Open
Abstract
Objective Suicide remains a serious, preventable public health problem. This study aims to describe the epidemiological characteristics associated with various suicide methods and to investigate outcomes after suicide-associated sudden cardiac arrest (S-SCA), stratified by different suicide attempt methods. Methods An S-SCA database was constructed from ambulance run sheets and augmented by a review of hospital medical records from 2008 to 2010 in Korea. The cases with non-cardiac etiologies and suicide attempts were initially extracted. Suicide attempts were classified as hanging, poisoning, fall, and other. The primary end point was survival to discharge. Age- and sex-adjusted incidence rates were calculated for each suicide method. Adjusted odds ratios for outcome were calculated with adjustments for potential confounding variables. Results A total 5,743 patients were analyzed as S-SCAs. The most common method of suicide attempt was hanging (58.7%), followed by falls (17.6%), poisoning (17.5%), and others (5.8%). The survival to discharge rates were 2.1% (n=119) overall, 2.4% in hanging, 2.4% in poisoning and 0.5% in fall, respectively. The age- and sex-adjusted incidence rates (male/female) per million persons was 32.7 (35.8/29.7) in 2008, 41.8 (46.0/37.7) in 2009, and 43.0 (50.1/36.0) in 2010. Compared with hanging, adjusted odds ratios (95% confidence intervals) for survival to discharge was 1.05 (0.60 to 1.83) for poisoning and 0.08 (0.03 to 0.21) for falls. Conclusion In this nationwide S-SCA cohort study from 2008 to 2010, the standardized incidence rate increased annually. However, the rate of survival to discharge remains very low.
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Affiliation(s)
- Soo Jin Kim
- Seoul National University Graduate School of Medicine, Seoul, Korea; Seoul Metropolitan Fire Service Academy, Seoul, Korea
| | - Sang Do Shin
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eui Jung Lee
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Young Sun Ro
- Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - Kyoung Jun Song
- Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea
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7
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de Putter CE, van Beeck EF, Burdorf A, Borsboom GJJM, Toet H, Hovius SER, Selles RW. Increase in upper extremity fractures in young male soccer players in the Netherlands, 1998-2009. Scand J Med Sci Sports 2014; 25:462-6. [PMID: 24990273 DOI: 10.1111/sms.12287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2014] [Indexed: 11/27/2022]
Abstract
Young male soccer players have been identified as a target group for injury prevention, but studies addressing trends and determinants of injuries within this group are scarce. The goal of this study was to analyze age-specific trends in hospital-treated upper extremity fractures (UEF) among boys playing soccer in the Netherlands and to explore associated soccer-related factors. Data were obtained from a national database for the period 1998-2009. Rates were expressed as the annual number of UEF per 1000 soccer players. Poisson's regression was used to explore the association of UEF with the number of artificial turf fields and the number of injuries by physical contact. UEF rates increased significantly by 19.4% in boys 5-10 years, 73.2% in boys 11-14 years, and 38.8% in boys 15-18 years old. The number of injuries by physical contact showed a significant univariate association with UEF in boys 15-18 years old. The number of artificial turf fields showed a significant univariate association with UEF in all age groups, and remained significant for boys aged 15-18 years in a multivariate model. This study showed an increase of UEF rates in boys playing soccer, and an independent association between artificial turf fields and UEF in the oldest boys.
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Affiliation(s)
- C E de Putter
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands.,Department of Surgery, Reinier de Graaf Group, Delft, The Netherlands
| | - E F van Beeck
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - A Burdorf
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - G J J M Borsboom
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
| | - H Toet
- Consumer Safety Institute, Amsterdam, The Netherlands
| | - S E R Hovius
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - R W Selles
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands.,Department of Rehabilitation Medicine & Physical Therapy, Erasmus MC, Rotterdam, The Netherlands
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8
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Marsh SM, Jackson LL. A comparison of fatal occupational injury event characteristics from the Census of Fatal Occupational Injuries and the Vital Statistics Mortality System. JOURNAL OF SAFETY RESEARCH 2013; 46:119-125. [PMID: 23932693 DOI: 10.1016/j.jsr.2013.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 05/15/2013] [Accepted: 05/21/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES The aim of this study was to examine utility of appending International Classification of Diseases (ICD) codes from Vital Statistics Mortality (VSM) data to Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI), and compare occupational event characteristics based on ICD external cause and BLS Occupational Injury and Illness Classification System (OIICS) event codes. METHODS We linked VSM records with CFOI records for 2003 and 2004. RESULTS Ninety-five percent of approximately 11,000 CFOI cases were linked to VSM cases. Linked data suggest that CFOI OIICS event and VSM ICD codes identified similar leading events. However, VSM data were generally less specific. CONCLUSION Lack of detail inherent in ICD codes and death narratives limits specificity of injury characteristics in VSM data. Appending ICD codes to CFOI appears to offer little value. Research comparing work- and non-work-related events may be better served by having a defined framework to crosswalk both coding schemes to facilitate comparisons. IMPACT ON INDUSTRY Over the last two decades, both ICD and OIICS have been used to characterize occupational injury circumstances; however, this is the first study to use linked case comparisons of the OIICS and ICD codes at a detailed level. This study confirmed that multiple source data systems provide more detail surrounding an incident than a single source data system does. Our results suggest that OIICS-coded CFOI data are a better source for occupational injury research and prevention purposes. For future comparison studies requiring ICD, it would be advantageous to have a defined framework that could easily be used to map both coding schemes (OIICS and ICD).
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Affiliation(s)
- Suzanne M Marsh
- National Institute for Occupational Safety and Health, Division of Safety Research, Surveillance and Field Investigations Branch, Morgantown, WV 26505, USA.
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McKenzie K, Fingerhut L, Walker S, Harrison A, Harrison JE. Classifying external causes of injury: history, current approaches, and future directions. Epidemiol Rev 2011; 34:4-16. [PMID: 22045696 DOI: 10.1093/epirev/mxr014] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The International Classification of Diseases (ICD) is used to categorize diseases, injuries, and external causes of injury, and it is a key epidemiologic tool enabling storage and retrieval of data from health and vital records to produce core international mortality and morbidity statistics. The ICD is updated periodically to ensure the classification system remains current, and work is now under way to develop the next revision, ICD-11. It has been almost 20 years since the last ICD edition was published and over 60 years since the last substantial structural revision of the external causes chapter. Revision of such a critical tool requires transparency and documentation to ensure that changes made to the classification system are recorded comprehensively for future reference. In this paper, the authors provide a history of the development of external causes classification and outline the external cause structure. They discuss approaches to manage ICD-10 deficiencies and outline the ICD-11 revision approach regarding the development of, rationale for, and implications of proposed changes to the chapter. Through improved capture of external cause concepts in ICD-11, a stronger evidence base will be available to inform injury prevention, treatment, rehabilitation, and policy initiatives to ultimately contribute to a reduction in injury morbidity and mortality.
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Affiliation(s)
- Kirsten McKenzie
- National Centre for Health Information Research and Training, School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland, Australia 4059.
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10
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de Putter CE, van Beeck EF, Looman CWN, Toet H, Hovius SER, Selles RW. Trends in wrist fractures in children and adolescents, 1997-2009. J Hand Surg Am 2011; 36:1810-1815.e2. [PMID: 22036281 DOI: 10.1016/j.jhsa.2011.08.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 08/02/2011] [Accepted: 08/07/2011] [Indexed: 02/02/2023]
Abstract
PURPOSE Distal radius and carpal fractures in children and adolescents represent approximately 25% of all pediatric fractures. Incidence rates and causes of these fractures change over time owing to changes in activities and risk factors. The purpose of this study was to examine recent population-based trends in incidence and causes of wrist fractures in children and adolescents. METHODS We obtained data from the Dutch Injury Surveillance System of emergency department visits of 15 geographically distributed hospitals, and from the National Hospital Discharge Registry. This included a representative sample of outpatients and inpatients, respectively. We calculated incidence rates of wrist fractures per 100,000 person-years for each year between 1997 and 2009. Using Poisson's regression, we analyzed trends for children and adolescents 5 to 9, 10 to 14, and 15 to 19 years of age separately for boys and girls. RESULTS During the study period, incidence rates increased significantly in boys and girls 5 to 9 and 10 to 14 years of age, with the strongest increase in the age group 10 to 14 years. The observed increases were mainly due to increased incidence rates during soccer and gymnastics at school. CONCLUSIONS This population-based study revealed a substantial sports-related increase in the incidence rate of wrist fractures in boys and girls aged 5 to 9 and 10 to 14 years in the period 1997 to 2009. CLINICAL RELEVANCE With knowledge of the epidemiology of wrist fractures, prevention programs can be improved. From this study, we know that the incidence rate of wrist fractures in childhood is increasing, mainly as a result of soccer and gymnastics at school. Future sport injury research and surveillance data are necessary to develop new prevention programs based on identifying and addressing specific risk factors, especially in young athletes.
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Affiliation(s)
- C E de Putter
- Department of Plastic, Reconstructive and Hand Surgery, Erasmus MC Rotterdam, Rotterdam.
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11
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Abstract
STUDY DESIGN Review. OBJECTIVES The aim is to highlight the epidemiology of spinal cord injuries (SCIs) in Sub-Saharan Africa in order to improve prevention strategies. SETTING University Hospitals Leuven, Belgium. METHODS Pubmed was searched over August and September 2010. A combination of the following MeSH-terms was used: 'Africa South of the Sahara', 'Spinal Cord Diseases', 'Paraplegia' and 'Spinal Cord Injuries'. Limits were set on articles published as from 1990. The World Health Organization database was also consulted. RESULTS We obtained 243 hits of which 13 articles were relevant to the case. These papers covered seven countries: Ethiopia, Ghana, Nigeria, Senegal, Sierra Leone, South Africa and Zimbabwe. In traumatic SCIs, motor vehicle accidents are the most frequent cause of injury followed by falling from a height and thirdly violence, being the most important cause of SCI in South Africa. In the Plateau State of Nigeria, collapsing tunnels in illegal mining are the most prevalent cause. For the non-traumatic SCIs, tuberculosis appeared to be the most important cause, followed by malignant illnesses. Human immunodeficiency virus (HIV) serology tests were only available in the article concerning Ethiopia. Relatively more men were involved in traumatic SCIs and the average age was higher in the non-traumatic than in the traumatic group. CONCLUSION Although literature on the subject is scarce, prevention should focus on road-safety, tuberculosis and HIV. Standardized registration of SCI is needed for prevention and further research. The use of the current International SCI core data set should be encouraged worldwide as a uniform classification method.
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Spinks AB, Macpherson AK, Bain C, McClure RJ. Injury risk from popular childhood physical activities: results from an Australian primary school cohort. Inj Prev 2007; 12:390-4. [PMID: 17170188 PMCID: PMC2704354 DOI: 10.1136/ip.2006.011502] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Children engage in various physical activities that pose different injury risks. However, the lack of adequate data on exposure has meant that these risks have not been quantified or compared in young children aged 5-12 years. OBJECTIVES To measure exposure to popular activities among Australian primary school children and to quantify the associated injury risks. METHOD The Childhood Injury Prevention Study prospectively followed up a cohort of randomly selected Australian primary and preschool children aged 5-12 years. Time (min) engaged in various physical activities was measured using a parent-completed 7-day diary. All injuries over 12 months were reported to the study. All data on exposure and injuries were coded using the International classification of external causes of injury. Injury rates per 1000 h of exposure were calculated for the most popular activities. RESULTS Complete diaries and data on injuries were available for 744 children. Over 12 months, 314 injuries relating to physical activity outside of school were reported. The highest injury risks per exposure time occurred for tackle-style football (2.18/1000 h), wheeled activities (1.72/1000 h) and tennis (1.19/1000 h). Overall, boys were injured more often than girls; however, the differences were non-significant or reversed for some activities including soccer, trampolining and team ball sports. CONCLUSION Although the overall injury rate was low in this prospective cohort, the safety of some popular childhood activities can be improved so that the benefits may be enjoyed with fewer negative consequences.
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Affiliation(s)
- A B Spinks
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia.
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