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Author: Denise Bäckström
Publisher: Linköping University Electronic Press
ISBN: 9176854116
Category :
Languages : en
Pages : 51
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Book Description
Background: Injuries are one of the most common causes of death in the world. Varying types of injuries dominate in different parts of the world, which also have separate influences mortality. In Scandinavia blunt injuries dominates and the majority of those who die do so pre hospital. Over time different injury pattern may vary and by analyzing this we can assess when, where and how preventive work can be reinforced. The aim of this thesis was to study injury epidemiology in Sweden and assess the contribution of different injury patters on mortality. Method: We used the Swedish cause of death and the national patient registries which have a complete national coverage. ICISS was calculated (based on ICD-10) in the in hospital population. We have chosen to do this investigation with a broad perspective using the term injury, which includes trauma but also other diagnoses like suffocation and drowning. Results: During the study period (1999-2012) the number of deaths because of injury was 1213, 25 388, and 18 332 among children, working age and elderly, respectively. Mortality declined in the children and in the working age but inclined in the elderly. Mortality increased with each age group except between the ages of 15–25 and 26–35 years. One thousand two hundred sixty four (97%) of those who died because of penetrating trauma (sharp objects and firearms) were killed by intentional trauma (assault and intentional self-harm). One thousand and seventeen (83%) of the children died prehospital. In the working age 22 211 (80%) of 25 388 died pre hospital. Nine thousand six hundred and eighteen (53%) of 18 332 of the elderly died prehospital. During 2001- 2011 the risk adjusted in hospital mortality decreased in traffic and assault but not in fall related injuries. Discussion: Largely, the anticipated injury mortality picture was found, with blunt injuries (traffic accidents) dominating in the working age and falls in elderly. Further a significant portion of the deaths occurred pre hospital. The intentional injuries are dominated by intentional selfharm. The decrease in child injury mortality is notable as Sweden already has one of the lowest incidences in child injury mortality in the world. The decrease in injury mortality in the working age also implies that preventive work has had an effect. The incline in injury mortality in elderly on the other hand needs to be further studied. Areas of particular importance for future preventive work is the incline in injury mortality in elderly and intentional injuries among children.
Author: Denise Bäckström
Publisher: Linköping University Electronic Press
ISBN: 9176854116
Category :
Languages : en
Pages : 51
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Book Description
Background: Injuries are one of the most common causes of death in the world. Varying types of injuries dominate in different parts of the world, which also have separate influences mortality. In Scandinavia blunt injuries dominates and the majority of those who die do so pre hospital. Over time different injury pattern may vary and by analyzing this we can assess when, where and how preventive work can be reinforced. The aim of this thesis was to study injury epidemiology in Sweden and assess the contribution of different injury patters on mortality. Method: We used the Swedish cause of death and the national patient registries which have a complete national coverage. ICISS was calculated (based on ICD-10) in the in hospital population. We have chosen to do this investigation with a broad perspective using the term injury, which includes trauma but also other diagnoses like suffocation and drowning. Results: During the study period (1999-2012) the number of deaths because of injury was 1213, 25 388, and 18 332 among children, working age and elderly, respectively. Mortality declined in the children and in the working age but inclined in the elderly. Mortality increased with each age group except between the ages of 15–25 and 26–35 years. One thousand two hundred sixty four (97%) of those who died because of penetrating trauma (sharp objects and firearms) were killed by intentional trauma (assault and intentional self-harm). One thousand and seventeen (83%) of the children died prehospital. In the working age 22 211 (80%) of 25 388 died pre hospital. Nine thousand six hundred and eighteen (53%) of 18 332 of the elderly died prehospital. During 2001- 2011 the risk adjusted in hospital mortality decreased in traffic and assault but not in fall related injuries. Discussion: Largely, the anticipated injury mortality picture was found, with blunt injuries (traffic accidents) dominating in the working age and falls in elderly. Further a significant portion of the deaths occurred pre hospital. The intentional injuries are dominated by intentional selfharm. The decrease in child injury mortality is notable as Sweden already has one of the lowest incidences in child injury mortality in the world. The decrease in injury mortality in the working age also implies that preventive work has had an effect. The incline in injury mortality in elderly on the other hand needs to be further studied. Areas of particular importance for future preventive work is the incline in injury mortality in elderly and intentional injuries among children.
Author: Robert Larsen
Publisher: Linköping University Electronic Press
ISBN: 9176851400
Category :
Languages : sv
Pages : 84
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Book Description
Introduction Different methods have been used to describe the epidemiology of trauma with varying results. Crude mortality outcome data differ significantly from risk-adjusted information. A previous standard method for risk-adjustment in trauma was the Injury Severity Score (ISS), although it has several shortcomings. In this thesis I examine Swedish injury statistics from an epidemiological perspective using crude and risk-adjusted mortality, and to adjust for injury I used the International Classification of disease Injury Severity Score (ICISS). The groups of most lethal injuries (fall, traffic, and assault) were examined separately using an ICISS mortality prediction model that focused particularly on the effects on the prediction of mortality by adding coexisting conditions (comorbidity) to it. Differences in mortality between the sexes and changes over time were tested separately. Material and Methods Data from all patients with ICD-10 based diagnoses of injury (ICD-10: V01 to Y36) in the Swedish National Patient Registry and Cause of Death Registry were collected from 1999 to 2012 and used for assessment of mortality and comorbidity. A subgroup (patients in hospital) from 2001-2011 were selected as the study group. Their injuries were in the subgroups of falls, traffic, and assaults, and are the focus of this thesis. Mortality within 30 days of injury was used as the endpoint. The severity of injury was adjusted for using the ICISS, which was first described by Osler et al. The model was also adjusted for age, sex, and comorbidities. Results The study group comprised 815 846 patients (of whom 17 721 died). There was a decrease over time in injuries caused by falls and traffic (coefficient -4.71, p=0.047 and coefficient -5.37, p<0.001), whereas there was no change in assault-related injuries/100 000 inhabitants. The risk-adjusted 30-day mortality showed a decrease in injuries related to traffic and assault (OR 0.95, p<0.001 and OR 0.93, p=0.022) whereas for falls it remained unchanged. There was also a risk-adjusted survival benefit for women, which increased with increasing age. Adjusting for comorbidities made the prediction of 30-day mortality by the ICISS model better (accuracy, calibration, and discrimination). However, most of this effect was found to be the result of the other characteristics of the fall related injury group (they were older, and had more coexisting conditions). Conclusion During a 10-year period, there has been a significant overall decrease in crude as well as risk-adjusted mortality for these three injury groups combined. Within these groups there is a clear, risk-adjusted, female survival advantage. The ICISS model for the prediction of mortality improves when comorbidities are added, but this effect is minor and seen mainly among the injuries caused by falls, where comorbidity is significant. The ICISS method was a valuable adjunct in the investigation of data on Swedish mortality after injury that has been gathered from health care registry data. Introduktion Olika metoder har använts för att beskriva trauma, alla med varierande resultat. Riskjusterad respektive icke-justerad data skiljer sig markant åt. En metod som oftast används för riskjustering i traumasammanhang är Injury Severity Score (ISS) som tyvärr är belastad med ett antal praktiska tillkortakommande. I denna avhandling har jag undersökt de skadade i Sverige från ett epidemiologiskt perspektiv med både justerad och icke riskjusterad mortalitet. För att kunna justera för skadan använde jag International Classification of disease Injury Severity Score (ICISS). De dödligaste skademekanismerna i Sverige (fall, trafik och övergrepp) analyserades för sig med hjälp av en mortalitetsjusterad modell baserad på ICISS som fokuserade särskilt på mortalitetseffekterna av att lägga till tidigare sjukdomar (komorbiditet) i modellen. Skillnader i dödlighet mellan de olika könen samt förändringar över tid undersöktes. Material och Metod Information om alla patienter med en skadekod från ICD-10 systemet (ICD10: V01-Y36) i slutenvårdsregistret eller dödsorsaksregistrets under åren 1999–2012 samlades in för att användas för att kunna utvärdera mortalitet och komorbiditet. En undergrupp av sjukhusinlagda patienter från 2001–2011 valdes sedan som primär studiegrupp. De som i denna grupp hade drabbats av fall-, trafik- eller övergrepps-relaterade skador är det denna avhandling fokuserar på. Som mätpunkt (endpoint) användes avliden inom 30 dagar från skadan. Skadans allvarlighetsgrad bedömdes med ICISS som Osler var först att beskriva. Modellen justerades även för ålder, kön och komorbiditet. Resultat Studiegruppen innehöll 815 846 patienter (av vilka 17 721 avled). I gruppen med falloch trafik-relaterade skador var det en ren minskning över studietiden (koefficienten -4,71 med ett p=0,047 och med en koefficient på -5,37 med ett p <0,001), medans i övergreppsrelaterade skador kunde jag inte hitta någon minskning per 100 000 invånare. Den riskjusterade 30-dagars dödligheten hade en minskning i trafik- och övergreppsrelaterade skador (OR 0,95 med ett p <0,001 respektive OR 0,93 med ett p=0,022) men ingen minskning i fallrelaterade skador sågs. Riskjusterat gick det också att hitta en överlevnadsfördel för kvinnor, vilken ökade med ålder. När jag justerade för komorbiditeter blev prediktionsmodellen för ICISS med 30-dagars dödlighet bättre (detta gällde både precision, kalibrering och diskriminering). Det bör dock nämnas att det mesta av förbättringen vid eftergranskning var beroende på fall gruppens demografi (högre ålder och mer komorbiditeter). Konklusion Under denna tio-årsperiod har dödligheten minskat för dessa grupper, både riskjusterat och icke justerat. Inom dessa grupper finns en tydlig riskjusterad överlevnadsfördel för kvinnor. ICISS-modellen blir bättre på att förutspå 30-dagars dödlighet när man lägger till komorbiditet, men effekten är att betrakta som en mindre effekt och ses tydligast i fallrelaterade skador (där ålder och komorbiditet är högre). Metoden med ICISS är en värdefull metod för att undersöka stora datamaterial och dödlighet i stora grupper i Sverige. Detta kan göras med redan insamlade data i sjukvårdsregistren.
Author: Dinesh Sethi
Publisher: WHO Regional Office Europe
ISBN: 9289042958
Category : Medical
Languages : en
Pages : 117
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Book Description
Injuries are a leading cause of death and disability in children. This report presents evidence on how they can be prevented and calls for greater commitment and action from policy-makers and practitioners to decrease the burden. Every year, unintentional injuries kill nearly 42,000 children and young people under the age of 20 in the WHO European Region. Injuries are the leading cause of death among those aged 5-19 years, and 5 out of 6 of these deaths occur in low- and middle-income countries. Irrespective of country income, the burden falls disproportionately on children from the most disadvantaged groups. The leading types of unintentional injuries are road traffic injuries, drowning, poisoning, burns and falls. All injury types have similar main causes and socioeconomic and environmental determinants. Children are particularly vulnerable to injuries and need special consideration to safeguard their rights to health and safe environments, free from injury. This report, companion to the World Report on Child Injury Prevention, presents the evidence on both the great potential for injury prevention and the effectiveness and value for money of measures already in use in European countries with low injury mortality. It shows why health systems and particularly programs for child health throughout the WHO European Region should give priority to preventing and controlling child injury.
Author:
Publisher: World Health Organization
ISBN: 924156220X
Category : Accidents
Languages : en
Pages : 86
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Book Description
This publication seeks to provide a global overview of the nature and extent of injury mortality and morbidity in the form of user-friendly tables and charts. It is hoped that the graphical representation of the main patterns of the burden of disease due to injury will raise awareness of the importance of injuries as a public health issue and facilitate the implementation of effective prevention programs.
Author: M. M. Peden
Publisher: World Health Organization
ISBN: 9241563575
Category : Business & Economics
Languages : en
Pages : 233
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Book Description
Child injuries are largely absent from child survival initiatives presently on the global agenda. Through this report, the World Health Organization, the United Nations Children's Fund and many partners have set out to elevate child injury to a priority for the global public health and development communities. It should be seen as a complement to the UN Secretary-General's study on violence against children released in late 2006 (that report addressed violence-related or intentional injuries). Both reports suggest that child injury and violence prevention programs need to be integrated into child survival and other broad strategies focused on improving the lives of children. Evidence demonstrates the dramatic successes in child injury prevention in countries which have made a concerted effort. These results make a case for increasing investments in human resources and institutional capacities. Implementing proven interventions could save more than a thousand children's lives a day.--p. vii.
Author: Daniel Laskowitz
Publisher: CRC Press
ISBN: 1498766579
Category : Medical
Languages : en
Pages : 388
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Book Description
Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme
Author: Marjorie Peden
Publisher: DIANE Publishing
ISBN: 1437904068
Category : Transportation
Languages : en
Pages : 67
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Book Description
Every day thousands of people are killed and injured on our roads. Millions of people each year will spend long weeks in the hospital after severe crashes and many will never be able to live, work or play as they used to do. Current efforts to address road safety are minimal in comparison to this growing human suffering. This report presents a comprehensive overview of what is known about the magnitude, risk factors and impact of road traffic injuries, and about ways to prevent and lessen the impact of road crashes. Over 100 experts, from all continents and different sectors -- including transport, engineering, health, police, education and civil society -- have worked to produce the report. Charts and tables.
Author: World Health Organization
Publisher: World Health Organization
ISBN: 9241546484
Category : Medical
Languages : en
Pages : 152
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Book Description
Injuries and violence pose a major public health and development problem worldwide, particularly in low-income and middle-income countries, resulting in an estimated five million deaths each year, as well as many more who suffer non-fatal but disabling injuries. This publication seeks to help improve the lack of reliable and valid injury information, by providing guidance for the use of a robust but accessible methodology for collecting community injury data, with the aim of highlighting this serious public health problem.
Author: Cristina Morganti-Kossmann
Publisher: Cambridge University Press
ISBN: 1107007437
Category : Medical
Languages : en
Pages : 361
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Book Description
Presents the most up-to-date clinical and experimental research in neurotrauma in an illustrated, accessible, comprehensive volume.
Author: Alan D. Lopez
Publisher: World Bank Publications
ISBN: 0821362631
Category : Medical
Languages : en
Pages : 511
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Book Description
Strategic health planning, the cornerstone of initiatives designed to achieve health improvement goals around the world, requires an understanding of the comparative burden of diseases and injuries, their corresponding risk factors and the likely effects of invervention options. The Global Burden of Disease framework, originally published in 1990, has been widely adopted as the preferred method for health accounting and has become the standard to guide the setting of health research priorities. This publication sets out an updated assessment of the situation, with an analysis of trends observed since 1990 and a chapter on the sensitivity of GBD estimates to various sources of uncertainty in methods and data.
