Annual Injury Rate Research Articles

Trends and epidemiology of lower trunk fractures in the super elderly population in the United States from 2011 to 2020

IntroductionFractures of the lower trunk are among the most common fractures occurring in the elderly. Super elderly individuals (i.e., those 80 years of age and older) represent a growing segment of the population and are especially prone to these fractures. The contemporary epidemiology of lower trunk fractures in the super elderly population is incompletely described in the literature. Materials and MethodsThis descriptive epidemiology study used the National Electronic Injury Surveillance System (NEISS) to examine the incidence and recent trends of lower trunk fractures (i.e., fractures of the hip, pelvis, and lumbar spine) occurring among super elderly individuals in the United States (US) from 2011 to 2020. Annual, overall, and age-/sex-specific incidence rates (IRs) were analyzed. Average annual percent change (AAPC) estimates were calculated to indicate the magnitude/direction of trends in annual injury rates. ResultsAn estimated N=1,226,160 super elderly patients sustained lower trunk fractures over the 10-year study period for an overall IR of 100.2 per 10,000 person-years at-risk (PYR). Hip fractures accounted for the largest percentage of cases (IR=71.7 PYR), followed by lumbar spine fractures (IR=14.7), and pelvic fractures (IR=14.3). The incidence of lower trunk fractures among super elderly females (IR=121.5 PYR) was significantly greater than that of males (IR=65.7 PYR). The incidence of lower trunk fractures among nonagenarians and centenarians was significantly higher than that of octogenarians. Accounting for population growth yielded a significantly increasing annual incidence of lower trunk fractures in super elderly patients over the study period from 86.7 PYR in 2011 to 107.2 PYR in 2020 (AAPC=2.7, p<0.001). The annual incidence of both pelvic (AAPC=5.8) and lumbar spine (AAPC=6.9) fractures increased at a significantly higher rate than that of hip fractures (AAPC=1.4). ConclusionsThis study suggests that the annual incidence of lower trunk fractures in the oldest cohort of patients in the US (80+ years of age) increased significantly during the recent decade from 2011 to 2020, with pelvic and lumbar fractures in particular becoming increasingly common. Increased incidence rates highlight the need for future research aimed at optimizing outcomes and quality of life in this frail and ever-growing segment of the population.

Trends and epidemiology of spine fractures in the super-elderly population in the United States.

Spine fractures occur commonly in the geriatric population. Super-elderly individuals (i.e., those 80 years of age and older) represent a growing segment of the population and are especially prone to these fractures. The contemporary epidemiology of spine fractures in the super-elderly population is incompletely described in the literature. This descriptive epidemiology study used the National Electronic Injury Surveillance System to examine the incidence and recent trends of spine fractures occurring among super-elderly individuals in the United States (US) from 2011 to 2020. Annual, overall, and age-/sex-specific incidence rates (IRs) were analyzed. Average annual percent change (AAPC) estimates were calculated to indicate the magnitude/direction of trends in annual injury rates. An estimated n = 385,375 super-elderly patients sustained spine fractures over the 10-year study period for an overall IR of 31.5 per 10,000 person-years at-risk. Lumbar fractures (IR = 16.3) were the most common, followed by thoracic (IR = 9.4) and cervical (IR = 6.9) fractures. Incidence was significantly higher in super-elderly females (IR = 35.6) than in males (IR = 24.8). Incidence was significantly higher in nonagenarians (IR = 50.7) and centenarians (IR = 42.6) than in octogenarians (IR = 26.8). Accounting for population growth yielded a significantly increasing incidence over the study period from 20.8 in 2011 to 40.3 in 2020 (AAPC = 8, P < 0.0001). This study suggests that the annual incidence of spine fractures in the oldest cohort of patients in the US (80 + years of age) increased significantly during the recent decade from 2011 to 2020. Increased IRs highlight the need for future research aimed at optimizing outcomes and quality of life in this frail and ever-growing segment of the population.

A Five-Year Overview of Bicycle Injuries in the United States Between the Years 2017 and 2021.

Introduction This study investigates the changes in bicycle-related injury rates between 2017 and 2021. We focus specifically onchanges in age demographics, and the most common diagnosesand body parts injured. Methods We queried the National Electronic Injury Surveillance System (NEISS) for injuries associated with bicycles from 2017 to 2021. Chi-square analysis was used to evaluate trends in injuries vs. time for the entire sample, age groups in five-year increments, and the proportion of injury types by diagnosis and body part. Results The highest annual injury rate (12,800 counts) occurred in 2020, coinciding with the COVID-19 safer-at-home order. Pediatric patients continue to make up the majority of injured cyclists (48% of patients are younger than 19 years), but their percentage is decreasing (zero to four years (-13%, p < 0.005), five to nine years (-17%, p < 0.005), 10-14years (-5%, p < 0.005), 20-24years (-16%, p < 0.005), 25-29 years (-2%, p < 0.005), and 50-54 years (-14%, p < 0.005)) and mirrored by an increase in the proportion of older injured cyclists (40-44years (+26%, p < 0.005), 60-64years (+44%, p< 0.005), 65-69years (+69%, p < 0.005), and 70+years (+57%, p < 0.005)). The past five years saw an increase in injuries associated with higher impact forces and the potential for more severe morbidity and mortality, such as internal organ injuries (+13%, p < 0.01). The incidence of concussions, however, has not changed significantly. The extremities are the most commonly injured body parts(upper and lower arm, elbow, wrist, hand, fingers, upper and lower leg, knee, ankle, foot, and toe = 47% total) and continue to increase in frequency (lower arm (+2%, p < 0.005), lower leg (+3%, p < 0.01), upper arm (+18%, p < 0.005), and hand (+11%, p < 0.05)), while facial injuries are becoming less common(-3%, p < 0.05), and head injuries have not experienced a significant change of incidence. Conclusion Although there was an increase in bicycle-related injuries during the COVID-19 safer-at-home order, numbers have since returned to pre-COVID-19 levels. Other changes in bicycle injury demographics and mechanisms, such as a rise in older adult cyclists and high-force mechanism injuries, however, call for a re-evaluation of preventive and treatment priorities.

Prevalence of occupational injuries and associated factors among workers of textile and garment factories during the era of COVID-19 pandemic in mekelle city, Northern Ethiopia: A cross-sectional study.

Occupational injury is any personal injury that can lead to disease, disability, or death due to accidents sustained by workers while performing their work. The present study aimed to determine the prevalence of occupational injuries and associated factors among workers of textile and garment factories in Mekelle City, Northern Ethiopia during the era of COVID-19. A cross-ectional study was conducted among 348 Textile and Garment factories in Mekelle City, Northern Ethiopia on September and October 2020. Data were collected using a semi-structured face-to-face interview questionnaire by trained data collectors and supervisors. Occupational injury was assessed by a yes/no question "Have you had any injury related to your occupation in the last 12 months?."Epi Data version 3.1 was used to enter data and Statistical Package for Social Sciences (SPSS) version 23 was used for data analysis. A multivariable logistic regression model was used to determine the independent determinants of occupational injury, and variables with p < 0.05 were considered as statistically significant. The annual prevalence rate of occupational injury among textile and garment factories was 27.8% (95% confidence interval [CI] = 23.2-32.9%). Factors like being a male (AOR = 3.65; 95% CI = 1.92-6.92), job satisfaction (AOR = 0.22; 95% CI = 0.11-0.43), sleeping disorder (AOR = 3.47; 95% CI = 1.91-6.32), job stress (AOR = 2.62; 95% CI = 1.44-4.73), and safety and health training (AOR = 0.40; 95% CI = 0.22-0.74) were significantly associated with the occurrence of occupational injury. Expectedly, lockdown during COVID-19 could lead to absenteeism and reduced prevalence of occupational injuries as the outcome of this study.

Fifteen-year temporal changes in rates of acute kidney injury among children in Denmark

BackgroundWe aimed to examine temporal changes in the annual rate of acute kidney injury (AKI) in Danish children and associated changes in patient characteristics including potential underlying risk factors.MethodsIn this population-based cohort study, we used plasma creatinine measurements from Danish laboratory databases to identify AKI episodes in children aged 0–17 years from 2007 to 2021. For each child, the first AKI episode per calendar year was included. We estimated the annual crude and sex- and age-standardized AKI rate as the number of children with an AKI episode divided by the total number of children as reported by census numbers. Using Danish medical databases, we assessed patient characteristics including potential risk factors for AKI, such as use of nephrotoxic medication, surgery, sepsis, and perinatal factors.ResultsIn total, 14,200 children contributed with 16,345 AKI episodes over 15 years. The mean annual AKI rate was 148 (95% CI: 141–155) per 100,000 children. From 2007 to 2021, the annual AKI rate demonstrated minor year-to-year variability without any discernible overall trend. The highest AKI rate was recorded in 2007 at 174 (95% CI: 161–187) per 100,000 children, while the lowest rate occurred in 2012 at 129 (95% CI: 118–140) per 100,000 children. In 2021, the AKI rate was 148 (95% CI: 141–155) per 100,000 children. Characteristics of children with AKI were similar throughout the study period.ConclusionThe rate of AKI among Danish children was stable from 2007 to 2021 with little variation in patient characteristics over time.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information

Epidemiology of dog bites to people in Uruguay (2010-2020).

Dog bites to people are a serious public health problem. Limited information exists at the country level in Latin America. The COVID-19 pandemic changed people's lifestyles and their relationship with pets, and this could potentially affect the incidence of dog bites injuries. The main objectives of our study were to determine the prevalence of dog-bite injuries in Uruguay from 2010 to 2020 and to compare the prevalence in 2020 to that of pre-pandemic years. Cross-sectional study. Dog-bite notifications for the 2010 and 2020 period were analysed using data from the Uruguayan Ministry of Public Health. The annual dog-bite injury rate for the 2010-2020 period was 87.51 per 100,000 people. The frequency of bites varied with the victims' sex, with males accounting for 51.8% of the bites (p < 0.0001), and with age, with a higher frequency of bites in the ≤14 years old age group (p < 0.01). The frequency of dog bites was also higher in spring and summer than in autumn (p < 0.0001). There was no statistical difference in the frequency of dog-bite injuries when comparing 2020 with the pre-COVID-19 pandemic years. In Uruguay, the frequency of dog-bite injuries varied with season and with the age and sex of the victim. In the first year of the COVID-19 pandemic, the number of people bitten by dogs was no different than that of previous years. This is the first study in Latin America to report national rather than regional data and to include all age groups.

The Shieh Score as a Risk Assessment Instrument for Reducing Hospital-Acquired Pressure Injuries: A Prospective Cohort Study.

The purpose of this study was to evaluate the Shieh Score's effectiveness in decreasing the rate of hospital-acquired pressure injuries when combined with an early warning notification system and standard order set of preventative measures. This was a prospective cohort study. This target population was nonpregnant, adult, hospitalized patients on inpatient and observation status at a tertiary hospital (Kaiser Permanente, Baldwin Park, California) during the 2020 year of the COVID-19 pandemic. A new, risk assessment instrument, the Shieh Score, was developed in 2019 to predict hospitalized patients at high risk for pressure injuries. Data collection occurred between January 21, 2020, and December 31, 2020. When a hospital patient met the high-risk criteria for the Shieh Score, a provider-ordered pink-colored sheet of paper titled "Skin at Risk" was hung at the head of the bed and a standard order set of pressure injury preventative measures was implemented by nursing staff. Implementation of the program (Shieh Score, early warning system, and standard order set for preventive interventions) resulted in a 38% reduction in the annual hospital-acquired pressure injury rate from a mean incidence rate of 1.03 to 0.64 hospital-acquired pressure injuries per 1000 patient-days measured for the year 2020. The Shieh Score is a pressure injury risk assessment instrument, which effectively identifies patients at high risk for hospital-acquired pressure injuries and decreases the hospital-acquired pressure injury rate when combined with an early warning notification system and standard order set.

Poor adherence to dust, noise and safety regulations predict injury rates in underground coal mines

BackgroundWhile safety in US coal mining has improved over the past two decades, general occupational health research shows that risk of injury varies across individual worksites and is influenced by...

Epidemiology of patellar dislocations in the United States from 2001 to 2020: results of a national emergency department database

ABSTRACT Objectives Recent studies have shown an increasing incidence of patellar dislocations among children and adolescents. Updated, population-based studies of all patellar dislocations in the United States (US), however, are lacking. This study investigated recent trends in injury rates and demographics among patients sustaining patellar dislocations in the US from 2001 to 2020. Methods This descriptive epidemiologic study retrospectively analyzed the National Electronic Injury Surveillance System (NEISS) database to identify cases of acute patellar dislocations presenting to US Emergency Departments (EDs) from 2001 to 2020. Annual, overall, and age-adjusted incidence rates (IRs, expressed per 100,000 at-risk person-years) and additional patient/injury characteristics were analyzed. Average annual percent change (AAPC) estimates are presented to indicate the magnitude/direction of trends in annual injury rates. Results An estimated total of 159,529 patellar dislocations occurred over the study period for an overall IR of 2.58 (95% CI = 2.04–3.12). Accounting for population growth, the overall annual incidence increased significantly from 2.61 in 2001 to 3.0 in 2020 (AAPC = 2.8, p < 0.0001). When considering sex and age, statistically significant increases in annual IRs were observed among males aged 10–19 years (AAPC = 3.8, p < 0.0001), females aged 10–19 years (AAPC = 5.3, p < 0.0001), and females aged 20–29 years (AAPC = 3.5, p = 0.0152), while no significant changes were observed in any other age groups. Two-thirds of patellar dislocations involved sports-related injury mechanisms. The annual incidence of both sports-related and non-sports-related injuries increased significantly over the study period (sports-related: AAPC = 2.6, p = 0.0001; non-sports-related: AAPC = 3.4, p = 0.0001). Athletic patellar dislocations occurred most commonly in basketball and dance. Conclusion The number of patients sustaining patellar dislocations is increasing in the US. Similar increasing trends were observed in both males and females aged 10–19 years, whereas injury rates increased in the third decade only among females. A large percentage of injuries occur during athletic activity, but both sports- and non-sports-related patellar dislocations are on the rise.

Epidemiology of Sports-Related Clavicle Fractures in the United States: Injuries From 2015 to 2019.

Background:Clavicle fractures are common orthopaedic injuries that frequently occur during sports and recreational activity.Purpose:To (1) determine the incidence rate of sports-related clavicle fractures among patients evaluated in emergency departments in the United States over a 5-year period, (2) determine the most common sports and risks associated with clavicle fractures, and (3) update the literature by comparing past and present injury trends.Study Design:Descriptive epidemiology study.Methods:The National Electronic Injury Surveillance System (NEISS) database was queried for patients evaluated with clavicle fractures in US emergency departments from 2015 to 2019. The authors evaluated the data by age, sex, race, and sport/recreational activity. Injuries were characterized based on sports-specific mechanism of injury. Using the NEISS weighted multiplier, the authors estimated annual incidence rates based on US Census data. Contingency table comparisons of categorical variables (ie, age groups vs sex distributions) were analyzed using either chi-square or Fisher exact tests as appropriate for the population size, while continuous variable comparisons were performed using 1-way analysis of variance statistical testing.Results:A total of 2386 athletic-related clavicle fractures were evaluated at participating emergency departments, translating to 304,211 clavicle fractures, with an annual per-year injury rate of 18.72 clavicle fractures per 100,000 persons at risk (95% CI, 15.28-23.67). Male athletes had disproportionately higher injury rates than female athletes (P < .001) for every year of the study and demonstrated a higher incidence of fractures compared with female athletes (injury proportion ratio, 5.54). Patients aged 10 to 19 years accounted for the highest overall incidence of injury (64.5%). The annual incidence rate of athletic-related clavicle fractures was not significantly different during the study period (P = .24). The most common mechanisms of injury were participation in football (26.87%), soccer (15.76%), snowboarding (5.03%), bicycling (3.77%), wrestling (3.65%), and snow skiing (3.52%).Conclusion:Study findings indicated that clavicle fractures sustained during sports and recreational activity disproportionately affect male athletes. Adolescent populations (10-19 years of age) had the highest overall incidence of injury, and the most common activities associated with clavicle fractures were football and soccer.

Epidemiology of Patella Instability Injuries in Collegiate Level Athletes in the United States

Objective: Patella instability injuries are often sports-related and occur in young athletes. These injuries severely impact the season and career trajectory of high-level competitors. This is the first large epidemiological study that evaluates these injury events in NCAA athletes. Methods: Patellar instability injuries across 16 sports among NCAA men and women during the 2004-05 to 2013-14 academic years were analyzed using the NCAA Injury Surveillance Program (NCAA-ISP). Patellar instability injuries per 100,000 Athlete-Exposures (AEs), operative rate, annual injury and reinjury rates, in-season status (pre/regular/post-season) and time lost were compiled and calculated. Results: A total of 11,778,265 Athlete-Exposures (AE) were identified and included. 380 patellar instability injuries were identified (Injury Rate IR = 3.23 per 100,000 AEs). 91 (23.95%) were severe injuries with a significantly higher time loss from play (40.5 days) and risk of operative management (50.55%). The most common sports during which a patellar instability event occurred were Women’s Gymnastics (IR=7.87), Soccer (IR=5.83), and Basketball (IR=4.34) and Men’s Wrestling (IR=5.44), Football (IR=4.84), and Soccer (IR=3.06). Male athletes had a statistically significant higher risk of season or career-ending injuries in all patellar instability injuries (3.20% vs 0.89%, p=0.0013). Severe injuries were more likely to result from contact mechanisms (58.24% vs 40.66%). Conclusion: Patella instability injuries have a profound impact on the longevity and sustainability of a collegiate athletes’ career. The risk of recurrence once a patellar injury has occurred is significant and athletes often require surgery. While more female athletes sustained these injuries, male athletes were more likely to require operative management and sustain a season-ending injury.

Industrial robots, Workers’ safety, and health

This study explores the relationship between the adoption of industrial robots and workplace injuries. Using establishment-level data on injuries, we find that a one standard deviation increase in our commuting zone-level measure of robot exposure reduces work-related annual injury rates by approximately 1.2 cases per 100 workers. US commuting zones more exposed to robot penetration experience a significant increase in drug- or alcohol-related deaths and mental health problems. Employing longitudinal data from Germany, we exploit within-individual changes in robot exposure and document that a one standard deviation change in robot exposure led to a 4% decline in physical job intensity and a 5% decline in disability, but no evidence of significant effects on mental health and work and life satisfaction.

Occupational injuries in categories of personnel of Federal Fire Service of EMERCOM of Russia (2006–2020)

Relevance. Occupational injuries - a set of injuries received by workers in the workplace and caused by non-compliance with working conditions for a certain period of time, for example, for 1 year. Industrial injuries - a controlled process and an indicator of occupational safety. Intention. To analyze occupational injuries among the personnel of the Federal Fire Service (FFS) of the EMERCOM of Russia by category for 15 years from 2006 to 2020. Methodology. The injury rates for personnel (with special ranks and employees) of the FFS of the EMERCOM of Russia were obtained from the statistical data bank on morbidity, injuries, disability and death of personnel of the EMERCOM of Russia units during the performance of their duties. Injury rates per 10,000 firefighters were calculated. The received injuries were correlated with the categories of personnel (operational personnel, preventive, technical and managerial personnel) and activities (fire fighting, training / sports and everyday activities). The circumstances of receiving injuries were generalized by causes: technical, organizational, psycho-physiological and dangerous fire-related factors. The results were checked for normality of distribution. Arithmetic mean values and their errors are presented. The dynamics of receiving injuries was assessed using time series and 2nd order polynomial trends. Consistency (congruence) of the studied trends was assessed using Pearson's correlation coefficients. Results and Discussion. There is a decrease in occupational injuries in all categories of personnel of the EMERCOM of Russia FFS. Average annual level of occupational injuries in 2006-2020 was (14.66 ± 2.01) per 10,000 firefighters. Russian workers overall tended to have higher levels (17.87 ± 1.56) per 10,000 Russian workforce (nonsignificant difference). The consistency of the trends is strong positive and statistically significant (r = 0.833; p &lt; 0.001), which may indicate the influence of unidirectional factors in recieving injuries. The proportion of injuries among operational personnel was 67.1% of the structure of all occupational injuries, the average annual injury rate was (14.47 ± 2.06) per 10 thousand firefighters; among preventive personnel - 6.6 % and (12.33 ? 2.33) per 10 thousand, respectively; among technical personnel - 6.5 % and (10.86 ± 1.58) per 10 thousand, respectively; among managerial personnel - 19.8 % and (18.65 ± 2.49) per 10 thousand firefighters, respectively. The highest level of occupational injuries and the proportion of injuries among the operational staff were due to psychophysiological causes during daily activities - (4.31 ± 0.86) per 10 thousand firefighters and 19.5 % of the structure of all injuries and fire hazards during fire extinguishing - (4.03 ± 0.45) per 10 thousand and 18.2 %, respectively. For preventive, technical and managerial personnel, the leading causes of injuries were psychophysiological factors during daily activities - (7.21 ± 1.43) per 10 thousand and 3.8 %; (6.19 ± 0.95) per 10 thousand and 3.7 %; (6.55 ± 0.81) per 10 thousand firefighters and 7.2 %, respectively. The average annual risk of receiving injury during firefighting among the personnel of the EMERCOM of Russia FFS in 2009-2020 amounted to (0.18 ± 0.01) x 10-3 injuries/(fire x year), for the operational staff -(0.15 ± 0.01) x 10-3 injuries/(fire x year). There is a tendency to reducing risks of injury. Risks of injury turned out not to depend on the number of fires; the congruence of trends for fires and risks in the personnel and operational staff is weak positive and statistically nonsignificant (r = 0.208 and r = 0.201, respectively; p &gt; 0.05 for both coefficients). Conclusion. Occupational injuries can become manageable only if all injuries are taken into account and a wide range of concerned professionals (firefighters, managers, engineers, doctors, etc.) are involved in the analysis of their causes.

Epidemiology of Pediatric Gymnastics Injuries Reported in US Emergency Departments: Sex- and Age-Based Injury Patterns.

Background:Despite increasing participation rates in youth gymnastics, the majority of epidemiologic literature focuses on older elite athletes or stratifies athletes by level of competition.Hypothesis:The authors hypothesized that sex- and age-based patterns in youth gymnastics–related injuries exist, which are otherwise overlooked in an unstratified population.Study Design:Descriptive epidemiology study.Methods:Publicly available injury data from the National Electronic Injury Surveillance System were collected on pediatric gymnastics injuries presenting to emergency departments in the United States. Participation data from the National Sporting Goods Association were used to calculate national injury incidence rates in 7- to 11-year-olds (childhood) and 12- to 17-year-olds (adolescence) from January 1, 2012, to December 31, 2018. Z tests were conducted for the comparison of injury rates between girls and boys within each age group and for overall injury rate across age groups.Results:Girls participated in gymnastics at a frequency 6.5 times that of boys in childhood and 13.5 times that of boys in adolescence. An estimated 72,542 youth gymnastics–related injuries were reported in US emergency departments each year. A large proportion (61.3%) occurred in childhood, with female predominance in both age groups. Overall, there was no difference in weighted annual injury rate (injuries per 100,000 athlete-days per year) by age group (6.9 [childhood] vs 8.8 [adolescence]; P = .19) or sex (7.4 [girls] vs 8.1 [boys]; P = .65). In adolescence, boys were more likely than girls to experience injury (16.47 vs 8.2; P = .003). Wrist and lower arm fractures were more common in childhood than adolescence (1.07 vs 0.43; P = .002) and specifically in girls (childhood vs adolescence, 1.06 vs 0.37; P = .001). Ankle injuries and concussions were more common in adolescence vs childhood (P = .01 and .0002).Conclusion:Upper extremity injuries predominated among childhood gymnasts, particularly girls. In adolescence, girls and boys experienced increases in concussions and foot and ankle injuries. Although representing a lower overall number of training gymnasts as compared with girls, adolescent boys experience a higher rate of injuries overall.

Total, gender- and age-specific incidence rates of upper extremity nerve injuries in Finland.

The aim of this study was to describe the epidemiology of nerve injuries of the upper extremity in the whole population of Finland (1998-2016). Data based on diagnosis codes were obtained from the Care Register for Health Care, including cases of median, radial, ulnar, musculocutaneous, axillary and digital nerves. Age- and gender-specific incidence rates, both crude and standardized (for the European normal population in 2011), were calculated. Our study included 13,440 patients with upper extremity nerve injury. The mean standardized annual incidence rate of any upper extremity nerve injury was 18.18 among men and 8.15 among women per 100,000 person-years over the study period. The incidence peaked among men at working age. Nerve injuries occurred most commonly in the fingers and thumb, with 5532 cases and mean standardized incidence rates per 100,000 person-years of 7.84 among men and 2.95 among women. The annual incidence did not change significantly over the study period.Level of evidence: III.

ПОКАЗАТЕЛИ ТРАВМАТИЗМА ВОЕННОСЛУЖАЩИХ ПО ПРИЗЫВУ ВООРУЖЕННЫХ СИЛ РЕСПУБЛИКИ БЕЛАРУСЬ (2003-2019 гг.)

Research objective. Calculate the injury rates among conscripts during 2003-2019 years using an integral assessment to improve medical support and ensure the security of military service. Materials and methods. We studied annual medical reports about health status and morbidity of conscripts in the Armed Forces of the Republic of Belarus (form №3/med) for 2003-2019. Results. Average annual injury rate among conscripts in 2003-2019 was 20.64±2.03%, proportion in the structure of primary morbidity for all chapters of ICD-10 was 1.3±0.1%, hospitalizations - 14.74±0.98% and 1.6±0.2%, days away from work - 325.2±17.3% and 3.9±0.3%, dismission rates - 0.56±0.05% and 3.5±0.3%, mortality - 25.20±4,42per 100 000 conscripts and 75.1±5.7%, respectively. With different in significance coefficients of determination polynomial trends of the listed medical and statistical indicators demonstrate a data decrease. In the structure of the constructed integral assessment 83.8% accounted for the sum of the proportions of injuries of the shoulder girdle and upper limbs (group 8-10), pelvis and lower limbs (group 5-7), head injuries (group 1), injuries affecting several areas of the body (group 11), consequences of trauma, poisoning and other influences of external causes (group 22). Conclusion. Analysis of the data on injuries of conscripts using an integral assessment will improve medical support in order to maintain health, conduct targeted and high-quality prevention of injuries while ensuring the safety of military service.

Quantifying the risk of falls and injuries for amputees beyond annual fall rates—A longitudinal cohort analysis based on person-step exposure over time

People with lower-limb loss (PLL) have high annual fall and injury rates. People with transtibial amputations have better walking function than those with transfemoral amputations but paradoxically incur more fall-related injuries. Risk exposure, however, has not been previously considered. This study examined whether all-cause fall and injury incidence per person-step exposure over time varied in PLL of different walking abilities. The prospective cohort design, conducted at a major medical center, included five assessments 1-month apart. Walking ability level was categorized by Houghton Scale scores: ≥9 indicating community walking and ≤ 8 indicating limited community-household walking. Accelerometer-measured daily step counts were collected via StepWatch4 monitors. The main outcome measures, self-reported all-cause falls and injuries were assessed using the standard National Health Injury Survey. Generalized estimating equations, using Poisson distributions and log of step count as an offset, determined fall and injury incidence rate ratio [IRR] according to walking ability level. Ten people, aged 33–63 years with amputations of different causes and levels, were assessed monthly over five months. The community walking group (n = 6) had six falls and seven injuries; the limited community walking group (n = 4) had four falls and three injuries. For PLL, limited community walking ability was associated with higher incidence of falls (IRR = 6.10, 95%CI = 1.12–33.33, p = 0.037) and injuries (IRR = 8.56, 95%CI = 1.73–42.40, p = 0.009) when accounting for person-steps. Considering per person-step exposure over time added precision to fall and injury risk assessment that clarified the risks: PLL with limited community walking ability have higher fall and injury risks.

Long-Term Trends in the Epidemiology of Major Traumatic Brain Injury.

Traumatic brain injury (TBI) is a leading cause of death and disability among adults. Falls and motor vehicle collisions (MVCs) are the most common causes of TBI hospitalizations in Canada. The purpose of this study was to determine whether, at the provincial level, there have been significant changes in the injury rate and causes of major TBI. This was a retrospective cohort study of all patients in Nova Scotia who presented with major TBI (Abbreviated Injury Scale Head score ≥ 3) between 2002 and 2018. Prospectively entered data were collected from the Nova Scotia Trauma Registry. Annual injury rates were calculated based on 100,000 population (all ages) using population estimates from Statistics Canada. Linear regression was performed to analyze annual trends of major TBI within the province. There were 5590 major TBI patients in Nova Scotia during the 16-year study period. The overall annual rate of major TBI was 37 per 100,000 population. There was a 39% increase in the rate of major TBI over the study period (r = - 0.72, R2 = 0.51, p < 0.002). Patients had a mean age of 51 ± 25years; 72% were male. The proportion of TBIs in males decreased significantly from 76% in 2002 to 69% in 2017 (p < 0.001). Mechanisms of injury were predominantly falls (45%) and MVCs (29%); the proportion of violent injuries was 11.5%. The rate of fall-related TBIs more than doubled between 2002 and 2017, increasing from 9.1 to 20.5 injuries per 100,000 (p < 0.001). Our findings demonstrate an increasing incidence of major TBI over a 16-year period with a greater than two-fold increase in the rate of fall-related TBI. These results are important for targeting TBI prevention efforts in reducing falls, especially in older adults.

Comparison of indicators of injuries in military personnel serving on conscription in the Armed Forces of Russia and the Republic of Belarus (2003–2020)

Relevance. Injury indicators in military personnel reflect injuries and their consequences that occur in a certain period, as a rule, over a year. Injury indicators in the Armed Forces (AF) are important for assessing occupational safety.Intention: To compare injury indicators in military conscripts between the Russian Armed Forces and the Republic of Belarus for 18 years from 2003 to 2020.Methodology. We carried out a selective statistical analysis of medical reports on the health status of personnel and the activities of the medical service according to 3/MED form in military units where at least 80 % of the total number of conscripts of the Armed Forces of Russia and Belarus served. Groups (blocks) of injuries in Chapter XIX “Injuries, poisoning and certain other consequences of exposure to external causes” were agreed with the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). Injury data were calculated per 1000 military personnel or ‰, mortality rates – per 100 000 military personnel.Results and their Discussion. In the Russian Armed Forces compared to the Belarusian Armed Forces, the average annual injury rates (primary morbidity) of conscripts were (15.91 ± 1.65) ‰ vs (20.23 ± 1.96) ‰, hospitalizations with injuries (14.16 ± 1.29 ) vs (14.50 ± 0.96) ‰, work days lost (303.4 ± 27.0) vs (303.4 ± 27.0) ‰, dismissal due to injuries (0.552 ± 0.066) vs (0.551 ± 0.051) ‰, injury-related mortality (21.96 ± 4.26) vs (24.18 ± 4.29) per 100 000, respectively. As a rule, polynomial trends with high determination coefficients showed a decrease in the levels of injury, hospitalization, work days lost and mortality. Dismissal trends showed decrease in the Russian Armed Forces and increase in the Belarusian Armed Forces. The conscripts of the Armed Forces of Russia and Belarus have a positive statistically significant congruence in indicators of injuries, hospitalizations, work days lost and mortality, which may indicate the influence of the same (unidirectional) factors in the formation of annual indicators. Injuries of the head (Group 1, Chapter XIX by ICD-10), shoulder girdle and upper limbs (Groups 5–7), the area of the hip joint and lower extremities (Groups 8–10), injuries, affecting several areas of the body (Group 11), and the consequences of injuries, poisoning and other external causes (Group 22) are of high military-epidemiological significance for conscripts in the Russian Armed Forces and the Belarusian Armed Forces. These injuries accounted for 78.7 % and 82.8 % of the generalized estimate in the Russian Armed Forces and the Armed Forces of Belarus, respectively.Conclusion. Taking into account the indicators of injuries will allow the medical service to optimize the calculation of forces and assets for treatment and rehabilitation of servicemen with injuries. Injuries are not only a medical problem; it is necessary to involve more extensively military professionals from various services to analyze the cause-and-effect relationships of injuries and develop measures for their prevention.

Epidemiology of Acute Extensor Mechanism Injuries in Collegiate-Level Athletes in the United States.

Extensor mechanism injuries involving the quadriceps tendon, patella, or patellar tendon can be a devastating setback for athletes. Despite the potential severity and relative frequency with which these injuries occur, large-scale epidemiological data on collegiate-level athletes are lacking. Descriptive epidemiology study. Level 4. Knee extensor mechanism injuries across 16 sports among National Collegiate Athletic Association (NCAA) men and women during the 2004-2005 to 2013-2014 academic years were analyzed using the NCAA Injury Surveillance Program (NCAA-ISP). Extensor mechanism injuries per 100,000 athlete-exposures (AEs), operative rate, annual injury and reinjury rates, in-season status (pre-/regular/postseason), and time lost were compiled and calculated. A total of 11,778,265 AEs were identified and included in the study. Overall, 1,748 extensor mechanism injuries were identified, with an injury rate (IR) of 14.84 (per 100,000 AEs). N = 114 (6.5%) injuries were classified as severe injuries with a relatively higher median time loss (44 days) and operative risk (18.42%). Male athletes had higher risk of season-ending injuries in both all (3.20% vs 0.89%, P < 0.01) and severe (41.54% vs 16.33%, P < 0.01) extensor mechanism injuries. Similarly, contact injuries were more frequently season-ending injuries (4.44% vs 1.69%, P = 0.01). Women's soccer (IR = 2.59), women's field hockey (IR = 2.15), and women's cross country (IR = 2.14) were the sports with the highest rate of severe extensor mechanism injuries. Extensor mechanism injuries in collegiate athletes represent a significant set of injuries both in terms of volume and potentially to their athletic careers. Male athletes and contact injuries appear to have a greater risk of severe injuries. Injuries defined as severe had a higher risk of operative intervention and greater amount of missed playing time. Knowledge of the epidemiology of extensor mechanism injuries may help clinicians guide their athlete patients in sports-related injury prevention and management.