Injury Epidemiology最新文献

Background: Epidemiological data and demographics of spinal injuries are varied; previous studies mainly focus on specific injuries or population subgroups. This study assesses the overall incidence and demographic distribution of traumatic spinal injuries in the Capital Region of Denmark to identify current trends.

Methods: We conducted a retrospective, single-center cohort study using prospectively collected electronic health record data. All patients with traumatic spinal injuries referred to Copenhagen University Hospital, Rigshospitalet, were prospectively registered during a two-year period. Gender, age, trauma mechanism, neurological injury, associated injuries and choice of treatment were collected from the patient's electronic health record at time of registration.

Results: A total of 950 patients were registered, sustaining 1,553 injuries of the spine. Almost 60% of injuries were sustained due to high-energy trauma, the majority of which were incurred by patients < 65 years of age. The age-standardized incidence rate of spinal cord injury was 1.2 per 100,000 persons per year. Surgical intervention was performed on 28.5% of injuries, with significantly lower rates among older adults (p-value < 0.001). Low-energy falls accounted for approximately one-third of injuries, predominantly affecting patients aged 65 and older, representing a modest increase compared to earlier reports.

Conclusion: High-energy trauma remains a leading cause of spinal injuries in individuals under 65. Spinal injuries due to low-energy falls are becoming increasingly prevalent among the elderly, though surgical management of these injuries remains below the rates associated with younger patient groups. The findings underscore evolving demographic trends and may inform future research into treatment strategies and outcomes, particularly in older populations.

Background: Firearms are involved in more than 70% of U.S. Veteran suicides. Caregivers, defined as family members or concerned significant others, can play an important role in firearm suicide prevention through initiating conversations about secure firearm storage with Veterans. Our objective was to explore caregivers' experiences with lethal means safety (LMS) conversations and identify perceived barriers to caregivers discussing LMS with healthcare providers and with Veterans.

Methods: We conducted focus groups with 32 caregivers with experience caring for a Veteran at risk for suicide. Qualitative data were analyzed using thematic analysis.

Results: We identified three primary themes: 1) caregivers recognize and endorse the importance of having conversations about secure firearm storage to prevent suicide, 2) despite this, caregivers described barriers to discussing lethal means safety both with healthcare providers and with Veterans, and 3) caregivers suggested strategies to improve their involvement in LMS planning in clinical settings and to support their ability to initiate LMS discussions with Veterans.

Conclusions: Providing additional training for healthcare providers and ensuring availability of caregiver-focused LMS resources could be key to increasing caregiver involvement in LMS planning and improving caregivers' role in reducing access to firearms for Veterans at risk of dying by suicide.

Background: A higher degree of social vulnerability is associated with greater overall injury risk. However, the overlap of social vulnerability with various injury modalities for mortality has been less explored.

Methods: We conducted a cross-sectional study utilizing Georgia death certificates from 2011 to 2021 in youth aged 0-24 years. Mortality rates from firearms, motor vehicle collisions (MVCs), sudden unexpected infant death (SUID), poisonings, and drownings, with census-level social vulnerability index (SVI) categories were evaluated. A negative binomial regression model was created to identify relationships between injury-related cause of death and SVI.

Results: There were 26,362 total deaths from 2011 to 2021 among children and youth. Of these, 10,643 (40%) were due to the top five injury mechanisms causing fatalities in ages 0-24 years in Georgia over the study period. Children and youth with the least advantage in the socioeconomic and minority and language SVIs had higher rates of injury-related mortality from firearm-related deaths, MVCs, and SUID. However, poisonings were most common in the most advantaged quartiles. Differences in number of firearm-related deaths per population were largest in the minority and language status SVI theme.

Conclusions: Children and youth with greater social vulnerability had higher rates of injury-related mortality, except for those due to poisonings. Tailored resources for injury prevention should be focused on least advantaged communities, while poisoning prevention may be best targeted to children and youth in communities with higher SVI. In addition, the impact of systemic investments in healthcare, education, and neighborhood safety on injury-related mortality across SVIs warrants additional investigation.

Background: Immigrants continue to face challenges after entering the labor market and remain overrepresented in '3-D jobs' (dirty, difficult, degrading). This study aims to investigate the differences in occupational injury due to accidents (OIA) among immigrants compared to native-born workers in Sweden, and to examine the role of migrant-specific and work factors in these differences.

Methods: This repeated cross-sectional study used nationwide registers including all gainfully employed individuals in 2004-2020 (average annual sample 4.5 million individuals). OIA was treated as a binary outcome and migrant status was categorized based on region of birth and reason for immigration. OIA odds were estimated using pooled logistic regression analyses, where the crude model was adjusted for sociodemographic factors, time since immigration, and work factors.

Results: First-generation immigrants (odds ratios [OR] 1.41; 95% confidence interval [CI] 1.40, 1.42) and second-generation immigrants (OR 1.10; 95% CI 1.09, 1.11) had higher odds of OIA than native-born workers. Among the first-generation immigrants, the strength of the association varied depending on region of birth and reason for immigration. Immigrating to Sweden for work reasons was associated with lower odds of OIA among first-generation immigrants (OR 0.62; 95% CI 0.61, 0.64). The elevated odds of OIA among immigrants relative to native-born workers remained after adjusting for important covariates.

Conclusions: The differences in OIA underscore the disparities among native-born and immigrant workers in Sweden. The current findings highlight the importance of addressing these issues to ensure a safe work environment for all.

Background: The purpose of this study was to describe the injury and illness epidemiology in Team Korea athletes during 2024 Paris Summer Olympic Games. Incidence rates in pre-Olympic training camp and the Olympic Village were calculated and compared.

Methods: Medical records of Team Korea athletes who competed for 2024 Paris Summer Olympic Games were analyzed. This study was conducted in accordance with the International Olympic Committee Consensus Statement 2020. Incidence rates (case per 1000 athlete-days) were calculated and incidence rate ratios were used for comparisons.

Results: Team Korea athletes (n = 122, 57 males and 65 females) were analyzed. A total of 43 injuries (pre-Olympic training camp, n = 6, 8.3 injuries per 1000 athlete-days; Olympic Village, n = 37, 22.9 injuries per 1000 athlete-days) and 53 illnesses (pre-Olympic training camp, n = 16, 22.1 illnesses per 1000 athlete-days; Olympic Village, n = 37, 22.9 illnesses per 1000 athlete-days) newly occurred. The Olympic Village had a greater risk of injury than the pre-Olympic training camp (incidence rate ratio = 2.8, 95% CI: 1.2 to 6.6, p-value = 0.016). However, there was no significant difference in the risk of illness (incidence rate ratio = 1.04, 95% CI: 0.58 to 1.87, p-value = 0.900).

Conclusions: Team Korea athletes participating in the 2024 Paris Summer Olympic Games exhibited higher incidences of injury and illness than previous Olympic Games statistics. This single-delegation epidemiological research will contribute to our understanding of the true incidence of health problems in Olympians.

Background: Although health inequalities associated with ethnic disadvantage are of increasing concern to policymakers in the United Kingdom (UK), evidence on ethnicity and childhood unintentional injuries is unclear. Given that people from some minority ethnic communities face disproportionate disadvantage such as unemployment, poverty, and insecure and low-quality housing, children from these families might be expected to have higher risks of unintentional injuries compared to their White counterparts.

Aims: To determine whether the likelihood of unintentional childhood injuries vary among children from minority ethnic backgrounds and whether this variation can be explained by maternal migration status and variables relating to household composition, parenting attitudes and behaviours.

Methods: We used logistic regression to analyse data from 12,717 children using sweeps two (2003-2004) and three (2005-2006) of the Millennium Cohort Study. Unintentional childhood injuries were measured in the third sweep of data collection when the children were aged five. Exposure variables included socioeconomic information, ethnicity, housing, household composition, maternal migration status and variables relating to parenting, values, and behaviours.

Results: Children from some minority ethnic backgrounds (Pakistani, Bangladeshi, Black African, and 'other') were less likely to be injured than White children. Having a mother who was born outside the UK explained the relationship in Pakistani and Bangladeshi children. We observed differences in variables such as parenting style, values, household composition, and smoking and alcohol use among minority ethnic and migrant groups, but these variables did not statistically explain the differences in childhood injury.

Conclusions: Children from minority ethnic families in the UK are less likely to sustain unintentional injuries compared to their White peers, with this protective effect primarily evident among children whose mothers were born outside the UK. While cultural and behavioural differences were observed between ethnic groups, these did not statistically explain the injury variation. The findings emphasise the importance of disaggregating ethnicity and migrant status in injury prevention research and investigating the mechanisms underlying lower injury rates among first-generation migrant families.

Background: Youth are at high risk for firearm-related injury and death. However, research combining children and adolescents into one homogeneous group ignores distinct developmental stages and associated risks. Addressing firearm mortality as a public health crisis requires strategies tailored to developmental stage, injury intent, setting, and cultural context. Given this, the purpose of the current study was to identify changes over time in injury mortality and specifically firearm-related mortality, among middle (11-13 year olds) and high school-aged (14-18 year olds) adolescents in metro and non-metro areas of the United States.

Findings: Crude death rate data were pulled from the United States Centers for Disease Control and Prevention Web-based Injury Statistics Query and Reporting System Fatal Injury Data from 2001 to 2022. Across all fatal injury causes among 11-18 year olds, firearms surpassed motor vehicle collisions as the leading cause of death in 2017. When looking specifically at fatal firearm injuries, rates of homicide were consistently higher than those of suicide and unintentional death, with a 79.3% increase from 2018 to 2022. In non-metro areas, suicide was the leading cause of death for the 11-13 year olds. Among the 14-18 year old group suicide remained the leading cause of death despite a 362.9% increase in homicide. In metro areas, homicides among 14-18 year olds surged 127.3% from a 2013 low and remained higher than rates of suicide.

Conclusions: Findings suggest developmental differences influence risk and combining children and adolescents together obscures distinct trends within critical developmental stages. Prevention strategies should be informed by developmental stage and include violence and injury prevention efforts in all areas as well as developmentally and culturally appropriate suicide prevention approaches in rural areas.

Background: Access to lethal means contributes significantly to suicide completion. Lethal means safety counseling (LMSC) is an injury prevention strategy to limit access to firearms, medications, and other means of injury. Not previously evaluated in the trauma setting, this study aims to design and implement a standardized LMSC protocol for pediatric patient discharge education in emergency (ED), trauma, and inpatient psychiatry settings.

Methods: A single-center quality improvement study at an academic pediatric urban tertiary Level-one trauma center was performed from July 2023 to February 2024. Protocol was implemented for pediatric patients discharged from three departments: ED, surgery trauma service, and psychiatry. Interventions included electronic medical record (EMR) based LMSC screening questions, training with Counseling on Access to Lethal Means (CALM) module, a de novo educational training video, and providing families free cable gun locks and medicine lock boxes. Healthcare collaborators completed pre- and post-training surveys. Data was recorded in Redcap and analyzed as descriptive and parametric data. Primary outcome was incorporation of LMSC and intervention into social worker's workflow. Secondary outcomes included project barriers and outcomes, familial impression of counseling, and healthcare provider impression of intervention.

Results: Out of forty-eight persons, 29 providers completed the pre-training survey and 17 completed the post-training survey. Results indicated increased discussions with caregivers about safe medicine storage comparing averages of pre and post-test results (mean difference 0.44, 95% CI 0.05-0.83, p = 0.029), but no differences in discussions about safe firearm storage (mean difference 0.50, 95% CI - 0.05-1.05, p = 0.07) or knives (mean difference 0.56, 95% CI 0.05-1.18 p = 0.07). Provider behavior changes occurred with increased clinical frequency of cable gun lock distribution.

Conclusions: This study describes implementing a standardized LMSC protocol in three pediatric hospital departments with self-reported provider improvements in LMSC. Barriers identified to protocol implementation are an opportunity to improve future preventative patient care.

Background: Kentucky has historically experienced a high burden of drug overdose deaths. During the first years of the COVID-19 pandemic, the state saw a 45% increase in overdose deaths in 2020, followed by an additional 15% increase in 2021. However, drug overdose deaths declined in 2023 and 2024. This study used electronic death certificate records from the Kentucky Office of Vital Statistics (2019-2024) to evaluate whether Kentucky's 2024 drug overdose death rates have declined to pre-pandemic levels and if declines were observed across all demographic groups. The results from Poisson regressions are reported as rate ratios (RRs) and their 95% confidence intervals (CIs).

Findings: The estimated 2024 crude drug overdose death rate (31.7/100,000) remained significantly higher than the 2019 rate (29.2/100,000; RR [CI] = 1.08 [1.01-1.17]; P = .035). Several demographic groups had sustained increases from 2019 to 2024: male (RR [CI] = 1.10 [1.00-1.21]), Black residents (RR [CI] = 1.56 [1.22-2.00]), residents aged 55-64 (RR [CI] = 1.41 [1.18-1.70]) and 65 or older (RR [CI] = 1.71 [1.25-2.33]), and residents of non-metropolitan counties (RR [CI] = 1.38 [1.22-1.57]). However, adults aged 25-34 experienced a significant decrease from 2019 to 2024 (RR [CI] = 0.77 [0.65-0.92]). The 2024 rate of fentanyl-involved overdose deaths was not statistically different from 2019 level [RR [CI] = 1.10 [1.00-1.22]; P = .051], but the psychostimulant-involved overdose death rate (RR [CI] = 1.45 [1.30-1.62]) was significantly higher.

Conclusions: The recent decline in drug overdose deaths is encouraging, but sustained increases in mortality rates among some demographic groups highlight the need for continued public health initiatives to prevent overdose deaths.