Epidemiology of Fall Injury in Rural Bangladesh

The effectiveness of digital technology-based Otago Exercise Program on balance ability, muscle strength and fall efficacy in the elderly: a systematic review and meta-analysis

OBJECTIVE

To explore the impact of the digital implementation of the Otago Exercise Program (OEP) on balance ability (static and dynamic), muscle strength, and fall efficacy in elderly people; and analyze different potential influencing factors in subgroups to find the most suitable training plan.

METHODS

EBSCO, PubMed, Web of Science, and China Knowledge Network databases (core) were searched up to August 1, 2023. Experimental studies of implementing OEP based on digital technology to improve outcomes related to falls in the elderly were included. Bias risks were assessed using the Cochrane collaboration tool. Meta-analysis was performed to assess the pooled effect of balance ability (static and dynamic), muscle strength, and fall efficacy using a random effects model. Subgroup analyses were conducted to examine the potential modifying effects of different factors (e.g., training period, frequency, duration, age).

RESULTS

Twelve articles were included from the literature, including 10 randomized controlled trials, one single-group quasi-experimental study, and one case report. Digital technologies used in the studies were categorized into three types: (1) online interventions (Zoom, WeChat), (2) recorded videos (via computers, TVs, DVDs), and (3) wearable technologies (motion sensors, augmented reality systems). The implementation of OEP based on digital technology showed significantly improved on static balance (SMD = 0.86, 95% CI 0.35-1.37), dynamic balance (SMD = 1.07, 95% CI 0.90-1.24), muscular strength (SMD = 0.43, 95% CI 0.17-0.69), and fall efficacy (SMD=-0.70, 95% CI -0.98, -0.41); Subgroup analysis by period '≥12 weeks', frequency '≥3 times/week', and duration '≤45 minutes per session', respectively, showed significant improvements on static balance (SMD = 0.73, 95% CI 0.21-1.25; SMD = 0.86, 95% CI 0.35-1.37; SMD = 1.10, 95% CI 0.31-1.89), dynamic balance (SMD = 1.08, 95% CI 0.88-1.28; SMD = 1.01, 95% CI 0.93-1.27; SMD = 1.07, 95% CI 0.89-1.25), muscle strength (SMD = 0.43, 95% CI 0.10-0.75; SMD = 0.54, 95% CI 0.30-0.77; SMD = 0.53, 95% CI 0.19-0.87), and fall efficacy (SMD=-0.75, 95% CI -1.39, -0.11; SMD=-0.70, 95% CI -0.98, -0.41; SMD=-0.74, 95% CI -1.10, -0.39).

CONCLUSIONS

OEP implemented through digital technology effectively enhances static and dynamic balance, muscle strength, and self-efficacy in older adults. A training regimen of 12 weeks or more, with sessions occurring three or more times per week for 30 to 45 min, appears to be an effective approach for improving these outcomes based on the available evidence from the included studies. Future research should prioritize specific digital technologies and target populations, employing high-quality research designs to further explore these interventions, and consider new technologies such as wearables, to assess changes in fall prevalence.

Epidemiology of injuries among children and adolescents from the Xinglin District in Xiamen, 2016-2019

Objective

To investigate the epidemiology of injuries among children and adolescents in the Xinglin District of Xiamen from 2016 to 2019.

Methods

This study collected data from patients who attended the outpatient and emergency departments of the Xinglin District at the First Affiliated Hospital of Xiamen University between January 2016 and December 2019, diagnosed with injuries.

Results

A total of 13,123 patients were included, categorized into age groups 0-4 (n = 4,834), 5-9 (n = 3,924), 10-14 (n = 2,671), and 15-18 (n = 1,694). The rates of unintentional injuries were 97.00%, 96.94%, 94.50%, and 90.08% in the 0-4, 5-9, 10-14, and 15-18 age groups, respectively (P < 0.001). The proportion of head injuries decreased with age (from 41.13% in the 0-4 age group to 18.00% in the 15-18 age group), compensated by an increase in rates of injuries to upper and lower extremities and multisite injuries (P < 0.001). The most common causes of injuries were fall-related injuries (30.46%-52.05%), followed by mechanical injuries (18.35%-36.42%), with the rates of fall-related injuries decreasing with age and rates of mechanical injuries increasing with age (P < 0.001). Age-period-cohort models revealed that the time factor was not significant for fall-related injuries and mechanical injuries (all P > 0.05) despite apparent increases in incidence over time.

Conclusion

Injuries in children and adolescents continue to be a significant public health concern in the Xinglin District (China), predominantly driven by fall-related injuries and mechanical injuries.

Measuring the Prevalence, Treatment, and Associated Treatment Costs of Injury for Older Adults in India: Insights from the National Longitudinal Aging Study

This cross-sectional analysis of secondary data aimed to examine the injury prevalence, treatment, and associated healthcare expenditure among older adults in India. Longitudinal Aging Study India Wave 1 data for those aged 60+ years comprising sociodemographic characteristics and self-reported major injury, injury mechanism, falls and joint/bone fractures, treatment sought, and out-of-pocket expenditure (OOPE) were analyzed. Descriptive, relative risk, bivariate, and two-part regression model analyses were conducted. Fifteen percent of the 31,464 older adults surveyed had experienced a major injury, 13% a fall and 5% a bone/joint fracture. The risk of injury increased with age and income and was higher for urban residents and females. Seventy-eight percent of those who experienced injury sought medical treatment, 56% needing treatment for a serious fall and 3% undergoing surgery. Higher proportions of females than males required medical treatment for falls and injury-related surgery, yet on average, females were spending less than males for public or private hospital treatment. Injury-related OOPE increased with age and decreased with lower education. Scaling up injury prevention efforts specifically focused on older adults will be vital given the projected growth in the older adult population in India in coming years. Such efforts will prevent unnecessary health impacts and reduce health system utilization and associated individual and family economic burden.

Trend Analysis of Unintentional Fall Mortality and Years of Life Lost in the Fars Province of Iran, 2004-2019

Background

Unintentional falls are one of the main causes of death and a significant burden on victims, families, and communities. This study aimed to determine the trend analysis of mortality rate and years of life lost (YLL) due to unintentional falls in Fars Province, Iran.

Methods

All deaths due to unintentional fall in Fars Province, central Iran from the electronic population-based death registration system (EDRS) were obtained. Crude and age-standardized mortality rate, YLL and YLL rate data were calculated and to examine the trend, joinpoint regression was used.

Results

During the 16-year study period (2004-2019), 1816 deaths due to falls occurred in Fars Province. Crude mortality rate had stable trend in men and increasing trend in women. The total years of life lost due to falls, were 25,437 in men and 5,720 in women. According to the joinpoint regression analysis, the 16-year trend of YLL rate due to premature mortality was decreasing in males. The annual percent change (APC) was -2.8% (95% CI -4.5 to -1.0, P=0.005). However, there were stable trends for females, APC was 3.5% (95% CI -1.8 to 9.1, P=0.181).

Conclusion

Due to the increase in mortality caused by falls in women and stable trend in men, there is an urgent need to plan and implement preventive strategies to reduce the incidence of injuries caused by falls. Home and behavioral modifications such as increasing home lighting, providing handrails on stairs and bathrooms, and educating the people may play an important role in reducing fall deaths.

Epidemiological and clinical characteristics of hospitalized unintentional injuries among children in central China from 2017-2023

Objectives

To examine the epidemiological and clinical characteristics of hospitalized unintentional injuries among children in Central China and theoretically propose preventive and control measures.

Methods

We conducted a retrospective study of children aged 0-18 years with unintentional injuries who were admitted to a tertiary hospital in Central China from January 2017 to December 2023. We examined various aspects of the unintentional injuries, including age, gender, urban-rural distribution, external causes, trends, location of injury, cost, and length of stay.

Results

A total of 20,166 children with hospitalized unintentional injuries were enrolled. The median age with IQR was 2.8 (1.6, 5.1) years, with majority of the patients (57.0%) were aged 1-3 years, while the fewest were aged 11-18 years. The male-to-female ratio was 1.8:1, and the urban-to-rural ratio was 1.1:1. The most common external causes were foreign bodies (41.7%), exposure to inanimate mechanical forces (25.1%), and falls (22.1%). The most frequently injured body parts were head (72.5%). The total number of unintentional injuries exhibited an increasing trend from 2017-2022, and a decreasing trend from 2022-2023. The urban-rural distribution reversed after 2020. The overall hospitalization cost was 20,810,870.4 USD, with an median cost of 758.7 (556.4, 1,186.2) USD per person.

Conclusion

Unintentional injuries imposed a heavy burden on society and families. However, the number of cases and the urban-rural distribution showed significant trend changes from 2017-2023. The external causes varied by age group, gender, and region, while prevention and control measures should be developed accordingly.

Mortality from fall: A descriptive analysis of a multicenter Indian trauma registry

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.

Evaluation of unintentional falls among children and adolescents treated in emergency medical services

Introduction: Unintentional falls are the leading cause of traumatic injuries, without fatal consequences, with significant morbidity in the population of children and adolescents. Goal: The main goal of this research was to analyze the manner of falling in relation to age and gender, and to assess the type of injury and the anatomical region of the body affected by the injury sustained during a fall in patients ≤19 years of age treated in the emergency medical services in the Republic of Srpska. Material and methods: A cross-section study with retrospective analysis of the national e-database WebMedic from 11 emergency medical services between January 2018 and December 2020 was conducted. Research included patients with diagnosis of unintentional injury caused by a fall, aged ≤19 years. Descriptive statistics and the Chi-square test were used for comparisons between groups. Results: During the observed period, 857 cases of unintentional falls were identified, where 87.5% were referred for hospitalization. The group of children aged 0 to 9 years (55.7%) was more often treated for falls (p<0.001), and boys were affected 6.7 times more often than girls (p<0.001). Falls from the same level caused different types of injuries depending on the age and gender of the children (p<0.001). According to the type of injury, superficial injuries (36.8%) and open wounds (29.4%) were most often identified, and the most frequently affected body region was the head (52.0%). Conclusion: The group of children up to the age of nine and males were more often affected by superficial injuries and open wounds, with head injuries being predominant in all age groups. These results could indicate the necessity of creating programs with targeted prevention.

Prevalence and Risk Factors for Fall among Rural Elderly: A County-Based Cross-Sectional Survey

AIM

The aim of the study was to provide evidence for the prevention and reduction of falls in the elderly living in rural areas by analyzing epidemiological data of falls among the rural older people (>65 years old) and identifying the risk and protective factors.

METHODS

This study analyzed the sociodemographic characteristics, living environment, lifestyle, chronic disease condition, mental health, activities of daily living (ADL), and detailed information of falls of 3752 rural elderly. Rank tests, chi-square tests, and binary logistic regression were used for data analysis.

RESULTS

The prevalence of falls was 30.0%, and the 75-84-years age group had the highest fall rate (18.8%). According to the binary logistic regression analysis, six variables, including roughage intake frequency, age, gender, cane use, floor tiles, and IADL, were involved in the fall patterns. Low roughage intake (OR = 2.48, 95% CI 1.24-4.97), female gender (OR = 2.12, 95% CI 1.48-3.05), the use of a cane (OR = 2.11, 95% CI 1.08-4.10), and medium IADL (OR = 2.02, 95% CI 1.89-2.32) were the top four risk factors.

CONCLUSION

The fall in the rural elderly was mainly due to the poor living and working conditions. Routine fall assessment could address several preventable risk factors to reduce the prevalence and mitigate the harm of falls.

Home-related and work-related injuries in Makwanpur district, Nepal: a household survey

OBJECTIVE

To describe the epidemiology of home-related and work-related injuries, their mechanisms, inequalities and costs associated with these injuries.

METHODS

A household survey was undertaken in three palikas of Makwanpur district between April and June 2019. Data were collected electronically on non-fatal injuries that occurred in the previous 3 months and fatal injuries that occurred in the previous 5 years.

FINDINGS

17 593 individuals were surveyed from 3327 households. Injury rates were 8.0 per 1000 population for home injuries and 6.4 per 1000 for work-related injuries; 61.0% of home injuries were among women and 69.9% of work-related injuries among men. Falls were the cause of 48% home injuries, affecting 50.9% of men and 46.5% of women. Burns/scalds were higher in women than men, affecting 17.4% of women reporting home injuries. Cuts and piercings accounted for 39.8% of all work-related injuries and 36.3% were falls. Injury incidence varied by ethnic group: home injuries were highest in Brahmin (12.0 per 1000) and work-related injuries highest in Rai groups (21.0 per 1000). The total mean costs (transport and treatment) of work-related injury was US$143.3 (SD 276.7), higher than for home injuries (US$130.4, SD 347.6). The number of home (n=74, 64.9%) and work-related (n=67, 77.9%) injuries were higher in families below the poverty line than families in the next income bracket (home: n=22, 19.3%; work: n=11, 12.8%).

CONCLUSIONS

Home-related and work-related fall injuries are common. The inequalities in injury identified in our study by rurality, age, sex, income level and ethnic group can help target injury prevention interventions for vulnerable groups.

Pattern and Outcomes of Fall Injuries and Associated Factors in Emergency Department at Addis Ababa Burn, Emergency and Trauma Hospital

INTRODUCTION

Fall injuries are an important public health concern and remain a growing health problem globally. Falls are predicted to rise in rank compared to other causes of death, to become the 17th leading cause of death by 2030 unless necessary intervention is given.

PURPOSE

This study was aimed to assess the pattern, outcomes of fall injuries, and associated factors.

METHODS

A cross-sectional study design was employed to review a patient's registration chart from January 1, 2019 to December 31, 2019. Data were collected using a structured checklist developed from previous similar studies. The checked data were entered into Epi data 4.1 versions. Then, it was exported to SPSS 25 versions for analysis. Data were analyzed using descriptive statistics and logistic regression. In the multivariate logistic regression predictors having a P-value < 0.05 were considered to be statistically associated.

RESULTS

A total of 331 patients' charts were reviewed. The most common outcome of falling injury was alive 284 (85.8%) while death accounts for 47 (14.2%). Among injured body parts, extremity accounts for around one-fourth, 88 (26.6%), followed by head injury 68 (20.5%). In multivariate logistic regression, those patients aged ≥65 years had 6.15 times more likely to die than those patients aged between 15 and 30 years (AOR 6.15; 95% CI 2.82-14.37, P=0.015), and participants with comorbidity were 1.6 times more likely to die than to be discharged (AOR 1.60; 95% CI, 1.01-5.09, P=0.005) due to falling injury, whereas patient's occupation, marital status, and sex had no significant association with outcomes of a fall injury.

CONCLUSION

The most common outcomes of fall injury were discharged with improvement even though there was a high death rate. Extremity injuries were the most common pattern of injury. Fall is high-risk mortality in the older age group. Furthermore, patient with comorbidity, fall from height and injury to spinal cord and poly-trauma is more likely to die relative to other patients.

The injury mechanisms and injury pyramids among children and adolescents in Zhuhai City, China

BACKGROUND

The unclear mechanisms and severity of injuries in the injury pyramids for Chinese children and adolescents prevent the prioritization of interventions. This study aimed to describe the injury mechanisms and injury pyramids in this population to provide a priority for injury prevention strategies.

METHODS

Death, hospitalization, and outpatient/emergency department visit data from patients aged 0 ~ 17 years with injuries were obtained from January 1, 2013, to December 31, 2017, in Zhuhai City, China. The injury mechanism ratios were calculated, and the injury pyramid ratios were drawn in proportion using injury mortality and the incidence of both injury hospitalizations and outpatient/emergency department injury visits.

RESULTS

The top three mechanisms for injuries in children and adolescents treated in outpatient/emergency departments were falls (52.02%), animal bites (14.57%), and blunt injuries (10.60%). The top three mechanisms for injury hospitalizations were falls (37.33%), road traffic injuries (17.87%), and fire/burns (14.29%), while the top three mechanisms for injury deaths were drowning (32.91%), road traffic injuries (20.25%) and falls (13.92%). The incidence rate of outpatient/emergency department injury visits for children and adolescents was 11,210.87/100,000; the incidence rate of injury hospitalization was 627.09/100,000, and the injury death rate was 10.70/100,000. For each injury death, there were 59 injury hospitalizations and 1048 outpatient/emergency injury visits.

CONCLUSIONS

The injury mechanisms were different for injury-related outpatient/emergency department visits, hospitalizations, and deaths among children and adolescents. The injury mechanisms by sex at different stages of child development, and interventions should be formulated based on this finding. The ratios of the injury pyramids varied by age, sex, region, and injury mechanisms; minor nonfatal injuries were more common in children and adolescents. The differences in the severity and extent of the injuries suggested that injury interventions in children and adolescents still have a long way to go.

Risk Factors for Intracranial Injury Caused by Falls at Home in Korea Using Data from the Emergency Department-based Injury In-depth Surveillance (2011-2018)

BACKGROUND

Most unintentional injuries that occur at home are preventable. However, it may be difficult to sufficiently reduce the number of falls occurring at home by only identifying risk factors focused on specific age groups. Therefore, this study aimed to identify the risk factors (especially age and places where injuries occurred at home) for intracranial injury (ICI) caused by unintentional falls at home.

METHODS

Using the Emergency Department (ED)-Based Injury In-depth Surveillance, we analyzed the data of patients who visited the ED due to unintentional falls at home. Risk factors were identified using multivariable logistic regression according to age groups and interactions between place of injury occurrence and age groups, and sex and age groups were assessed.

RESULTS

In total, 232,124 patients were included in the analysis; older adults had a higher adjusted odds ratio (aOR) 14.05 (95% confidence interval [CI], 12.74-15.49) of ICI than infants. The corridor was associated with ICI in the male pediatric group (aOR, 2.71; 95% CI, 1.08-6.84) and the balcony with the female pediatric group (aOR, 2.04; 95% CI, 1.03-4.04). In the adult group, aOR of kitchen was 1.38 (95% CI, 1.02-1.88) in females and 0.56 (95% CI, 0.48-0.66) in males.

CONCLUSION

In this study, we identified the risk factors of ICI caused by falls at home using ED-based injury surveillance data. The risk of ICI was different among places of occurrence in the home depending on the age groups and sex.

Mechanisms of accidental fall injuries and involved injury factors: a registry-based study

Background

Falls are the leading cause of injury-related morbidity and mortality worldwide, but fall injury circumstances differ by age. We studied the circumstances of accidental fall injuries by age in Shenkursk District, Northwest Russia, using the data from the population-based Shenkursk Injury Registry.

Methods

Data on accidental fall injuries (hereafter: fall injuries) occurring in January 2015–June 2018 were extracted from the Shenkursk Injury Registry (N = 1551) and categorized by age group (0–6, 7–17, 18–59, and 60+ years). The chi-square test and ANOVA were used to compare descriptive injury variables across age groups, and a two-step cluster analysis was performed to identify homogeneous groups of fall injuries by preceding circumstances.

Results

Half of recorded fall injuries in the 0–6 year age group occurred inside dwellings (49%). The largest cluster of falls (64%) mainly included climbing up or down on home furnishings. In the 7–17 year age group, public outdoor residential areas were the most common fall injury site (29%), and the largest cluster of falls (37%) involved physical exercise and sport or play equipment. Homestead lands or areas near a dwelling were the most typical fall injury sites in the age groups 18–59 and 60+ years (31 and 33%, respectively). Most frequently, fall injury circumstances in these groups involved slipping on ice-covered surfaces (32% in 18–59 years, 37% in 60+ years).

Conclusion

The circumstances of fall injuries in the Shenkursk District varied across age groups. This knowledge can be used to guide age-specific preventive strategies in the study area and similar settings.

Incidence, Risk and Protective Factors for Unintentional, Nonfatal, Fall-Related Injuries at Home: A Community-Based Household Survey from Ujjain, India

Background

Childhood injury is an increasing public health burden and considered a major cause of childhood morbidity and mortality worldwide. In this study, we identified the distribution and risk factors for fall-related child injuries at home in Ujjain, India.

Methods

A community-based, cross-sectional study was conducted in 2017 in Ujjain, India, which included 6308 children up to 18 years of age living in 2518 households. Data were collected using a pretested, semi-structured, proforma from the parents of the included children.

Results

The overall incidence of home injury was 7.78% (95% confidence interval [CI]: 7.12–8.84) in the last 1 year, ie, 2015–16. The incidence was significantly higher at 5–10 years of age (odds ratio [OR]: 2.91, 95% CI: 1.75–4.85; P < 0.001), followed by 1–5 years (OR: 2.66, 95% CI: 1.59–4.45; P < 0.001). The incidence of injuries was higher in boys than in girls (adjusted odds ratio [aOR]: 1.73, 95% CI: 1.43–2.10; P < 0.001). Other risk factors associated with unintentional fall injuries at home were residence (rural vs urban; aOR: 1.25, 95% CI: 1.03–1.51; P = 0.018), number of family members (≤4 vs 5–10 and ≤4 vs >10; aOR: 0.69, 95% CI: 0.56–0.86; P < 0.001 and aOR: 0.67, CI: 0.48–0.94; P < 0.023, respectively), cooking area (combined vs separate; aOR: 0.82, 95% CI: 0.68–1.00; P = 0.057), and whether mother is alive vs not alive (aOR: 2.09, 95% CI: 1.10–3.94; P = 0.023).

Conclusion

The incidence of fall injuries among children at home in Ujjain, India, was similar to other resource constraint settings. The incidence was higher in rural areas, in the age group of 5–10 years, and in families in which the mother was not alive. By contrast, large and combined families had a lower incidence of falls.

Burden of injuries in Nepal, 1990-2017: findings from the Global Burden of Disease Study 2017

Background

Nepal is a low-income country undergoing rapid political, economic and social development. To date, there has been little evidence published on the burden of injuries during this period of transition.

Methods

The Global Burden of Disease Study (GBD) is a comprehensive measurement of population health outcomes in terms of morbidity and mortality. We analysed the GBD 2017 estimates for deaths, years of life lost, years lived with disability, incidence and disability-adjusted life years (DALYs) from injuries to ascertain the burden of injuries in Nepal from 1990 to 2017.

Results

There were 16 831 (95% uncertainty interval 13 323 to 20 579) deaths caused by injuries (9.21% of all-cause deaths (7.45% to 11.25%)) in 2017 while the proportion of deaths from injuries was 6.31% in 1990. Overall, the injury-specific age-standardised mortality rate declined from 88.91 (71.54 to 105.31) per 100 000 in 1990 to 70.25 (56.75 to 85.11) per 100 000 in 2017. In 2017, 4.11% (2.47% to 6.10%) of all deaths in Nepal were attributed to transport injuries, 3.54% (2.86% to 4.08%) were attributed to unintentional injuries and 1.55% (1.16% to 1.85%) were attributed to self-harm and interpersonal violence. From 1990 to 2017, road injuries, falls and self-harm all rose in rank for all causes of death.

Conclusions

The increase in injury-related deaths and DALYs in Nepal between 1990 and 2017 indicates the need for further research and prevention interventions. Injuries remain an important public health burden in Nepal with the magnitude and trend of burden varying over time by cause-specific, sex and age group. Findings from this study may be used by the federal, provincial and local governments in Nepal to prioritise injury prevention as a public health agenda and as evidence for country-specific interventions.

Burden of Lesser-Known Unintentional Non-Fatal Injuries in Rural Bangladesh: Findings from a Large-Scale Population-Based Study

Around 90% of all fatal and non-fatal unintentional injuries occur in low- and middle-income countries (LMICs). The magnitude of unintentional injuries is unclear due to limited research and data. This paper describes the burden of lesser-known injuries (LKIs-cut injuries, unintentional poisoning, machine injuries, electrocution, injury by blunt objects, and suffocation) in rural Bangladesh, using data from the Saving of Lives from Drowning (SoLiD) project in Bangladesh. Descriptive statistics were used to report counts and rates of injuries by socio-demographic factors, injury characteristics, and circumstantial details. The annual morbidity rate of LKIs was 6878 injuries per 100,000 persons, involving 3.4% (40,520) of the population. Cut injury (44,131.2/100,000 per year) and injury by blunt objects (19768.6/100,000 per year) attributed in large numbers to the overall burden of LKIs. Males (66.1%) suffered more injuries than females. More than half (52.9%) occurred among people aged 25 to 64 years. Those involved in agriculture suffered the most injuries, mainly cut injuries (9234.1/100,000 per year) and machine-related injuries (582.9/100,000 per year). Most injuries occurred in the home setting. Increased awareness about packaging, storage, and the proper handling of appliances can help lower the frequency of LKIs. Safe architecture and awareness about home injuries is required to reduce injuries occurring in the home environment.

Unintentional falls mortality in China, 2006-2016

BACKGROUND

To examine trends in unintentional falls mortality from 2006 to 2016 in China by location (urban/rural), sex, age group and mechanism.

METHODS

Mortality data were retrieved from the National Disease Surveillance Points system (DSPs) of China, a nationally representative data source. Percent change in mortality between 2006 and 2016 was calculated as "mortality rate ratio - 1" based on a negative binomial regression model.

RESULTS

The crude unintentional falls mortality was 9.55 per 100 000 population in 2016. From 2006 to 2016, the age-adjusted unintentional falls mortality increased by 5% (95% confidence interval (CI) = 1%-9%), rising from 7.65 to 8.03 per 100 000 population. Males, rural residents and older age groups consistently had higher falls mortality rates than females, urban residents and younger age groups. Falls on the same level from slipping, tripping and stumbling (W01) was the most common mechanisms of falls mortality, accounting for 29% of total mortality.

CONCLUSIONS

Unintentional falls continued to be a major cause of death in China from 2006 to 2016. Empirically-supported interventions should be implemented to reduce unintentional falls mortality.

Tai Chi for improving balance and reducing falls: A protocol of systematic review and meta-analysis

INTRODUCTION

To investigate the effectiveness and safety of Tai Chi for improving balance and reducing falls on people.

METHODS AND ANALYSIS

The following databases will be searched: China Biology Medicine (CBM), China National Knowledge infrastructure (CNKI), Wan Fang Data, the Chinese Science and Technology Periodical Database (VIP), Medline, EMBASE, Web of Science, The Cochrane Library from inception to March 2019. All randomized controlled trials (RCTs) utilized Tai Chi to improve balance ability and reduce falls will be included. Primary outcomes are the fall-related indicators, including the number of falls, fall rate, and other fall-related outcomes. Additional outcomes include the Berg Balance Scale (BBS), standing-walk test, single-legged time, or other balance-related outcomes. Study selection, data extraction, and quality assessment will be performed independently by 2 reviewers. Assessment of risk of bias and data synthesis will be performed using Review Manager V5.3 software.

ETHICS AND DISSEMINATION

The findings of this systematic review will be disseminated through peer-reviewed publication or conference presentations.Trial registration number PROSPERO CRD42019127810.