Chinese National Injury Surveillance System Research Articles

294Epidemiological characteristics of falls among older people: results from Chinese National Injury Surveillance System

Abstract Background Falls are among the most frequent critical health problems for older people. Fall-related injuries are a significant cause of mortality in older people. Understanding the epidemiological characteristics of falls among older people in China is an important basis for falls prevention. Methods Descriptive analysis was applied on general information, injury occurrence and injury clinical characteristics by using the data of people □ 60 years of age from National Injury Surveillance System (NISS). Results In total, 205 670 cases of falls were collected by NISS from 2015 to 2018, with the gender ratio of 1.37. Falls mainly occurred during 10:00-10:59 AM (11.9%). The top three major places where falls might occur were home (56.4%), the road (17.2%) and public residence (14.4%). Leisure activities (37.6%), housework (24.2%) and walk (15.1%) were top three activities when falls occurred. The most common body parts of falls involved were low limbs (31.4%), head (22.5) and truncus (20.7%). Bruise/ scrape (42.2%), fracture (31.8%) and sprain/ strain (14.6%) were the major nature of injury. Moderate and severe injuries accounted for 37.2% of all cases. Conclusions The number of falls among people □ 60 years of age from NISS has increased from 2015 to 2018. Further scientific research on the epidemiological characteristics, risk factors and falls prevention should be conducted. Key messages This data is from Chinese National Injury Surveillance System and results can provide basis for the formulation of corresponding policies.

Analysis on epidemiologic characteristics of fall in old people: results from Chinese National Injury Surveillance System, 2015-2018

Objective: To understand the epidemiologic characteristics of fall in people aged 60 years and above in China from 2015 to 2018, and provide basis for the prevention of fall in old people and the development of related policies. Methods: Descriptive analysis was conducted on general information, injury occurrence information and injury clinical characteristics of fall cases in people aged 60 years and above by using the data from Chinese National Injury Surveillance System(NISS). Results: A total of 205 670 fall cases were reported to NISS from 2015 to 2018 with the male to female ratio of 1.37. Falls mainly occurred during 10:00-10:59 am (11.91%). The top three places where fall might occur were home (56.41%), road (17.24%) and public residence (14.36%). Leisure activity(37.56%), housework (24.20%) and walk (15.07%) were top three activities in which fall occurred. Bruise/scrape (42.17%), fracture (31.79%) and sprain/strain (14.62%) were the major injuries. The most common body parts involved were low limbs (31.38%), head (22.46%) and truncus(20.71%). Moderate and severe injuries accounted for 37.21% of all cases, and 22.49% of the elderly seeking medical care due to fall required hospitalization. Conclusions: The number of fall in people aged 60 years and above increased from 2015 to 2018. The elderly is a key population in the prevention and control of fall.

Study on child head-injuries through data derived from the National Injury Surveillance System of China, 2014

To understand the epidemiological characteristics of head injuries in children. Data was derived from the Chinese National Injury Surveillance System (NISS) in 2014. Method on descriptive analysis was applied to depict general information, injuries events and clinical characteristics of head injuries among children under 18 years of age. A total number of 47 690 cases with child head injuries in 2014 were collected, including 32 542 males and 15 148 females. 43.47% of them were under 1-4 years of age. In October, 06:00 PM appeared the peak time for the injuries to happen. The three leading causes responsible for child head injuries were falls (69.57%), hit by blunt force (14.23%) or road traffic (11.01%). Main locations responsible for the head injuries to happen were:at home (44.98%), at public places (19.65%) or on roads/streets (15.81%). Recreation activates (77.88%), driving (7.32%), sports (5.72%) were the three major activities causing the injuries to take place. Majority of the cases happened unintentionally (95.35%), with bruise (71.69%) or mild injuries (85.27%) and went back home after treatment (90.25%). In 2014, child head injuries were seen more in males than in females and mostly occured at home. The leading causes for head injuries would include falls, hit by blunt stuff or road traffic .

Analysis on sports and recreation related injuries through data from the Chinese National Injury Surveillance System, 2009-2013

To understand the trend and characteristics of sports and recreation related injuries reported from National Injury Surveillance System (NISS) to provide basis for corresponding prevention strategies and decision-making. Descriptive analysis was applied to display the overall trend, general information, injury event and clinical characteristics of sports and recreation related injuries from 2009 to 2013. The proportion of sports and recreation related injuries among all injuries increased from 2009 to 2013, with an annual increase exceeding 45% (46.21%, 47.32%, 48.14%, 52.00%, 53.65%, respectively). Sports and recreation related injuries mainly involved males, with 15-29 age groups, particularly in summer and autumn. Sports and recreation related injuries mostly occurred at home, with annual rates of proportion as 33.07%, 34.16%, 32.98%, 34.57 and 36.22%, mostly caused by falls (41.19%, 41.64%, 44.70%, 47.41%, 47.96%). Contusion and abrasion were the leading types of injuries (43.49%, 44.56%, 45.14%, 45.02%, 45.62%) with the serious leading types as fracture, concussion/cerebral contusion or laceration, and sharp force injury/bite/open wounds. Head was the part mainly involved (31.30%, 32.48%, 31.89%, 30.88%, 29.44%) in injuries. Most sports and recreation related injuries were minor and most of the patients headed home after treatment. Sports and recreation related injury appeared a growing public health problem in China. Children and the elderly should be the target groups for intervention. Falls prevention in sports and the use of protection gears should be the focus countermeasures for prevention.

Study on head injuries through data from the National Injury Surveillance System of China, 2013

To understand the epidemiological characteristics of head injuries through data from the Chinese National Injury Surveillance System (NISS). Descriptive analysis was applied to display the overall trend of head injuries in 2013 in NISS and to depict general information, events and clinical characteristics of head injuries with SPSS 19.0 software. In 2013, 195 189 cases of head injuries were collected, males were twice higher than females, with 25.19% of them under 30-44 years of age. The three leading causes responsible for head injuries were falls (42.17%), blunt force injuries (27.46%) and road traffic injury (23.33%). Main locations causing head injuries were in road/street (31.41%), at home (25.02%) and public places (17.17%). Recreation activates (54.22%), driving (19.73%), paid work (12.95%) were the three major activities when injuries took place. Majority of the cases belonged to unintentional (86.79%) with bruise injuries (65.18%). Those mild injuries (78.87%) were treated and discharged (82.02%). In 2013, head injuries were seen more in males than in females, mostly involved in labor force population on head injuries. The leading causes for head injuries were falls, blunt injuries and road traffic.

Analysis on data from Chinese National Injury Surveillance System, 2008-2013 on the characteristics of falls

To analyze the trend and distribution of Falls, using the data from National Injury Surveillance System (NISS), 2008-2013, to provide basic information for Fall prevention. Data of Falls was descriptively analyzed from the Chinese NISS from 2008 to 2013. In total, 1 223 905 cases of Falls were analyzed, that accounted for 32.94% of all the injury cases, with the gender ratio as 1.57. Both the number and the proportion of the cases showed an increasing trend. Labor population (15-64 years-old) accounted for 66.63% of the total 271 502 cases of Falls in 2013. Cases aged 0-4, 5-14 and over 65 accounted for 55.53%, 52.93% and 56.59% among all the types of injuries in each of their age group. Gender ratio appeared to be 1.54 but more females cases were seen with the increase of age. The peak hours that injuries took place were 10:00-10:59 AM (10.04% of total) and 14:00-20:59 PM (43.56% of total). The top three places that injuries took place were home (33.03%), public residents (22.79%) and on the roads (15.49%). Recreation activates (65.38%), paid jobs (13.01%) and housework (7.52%) were the three major ways causing the Falls to take place. The most common parts of body that injuries involved were head (30.41%), low limbs (27.43%) and upper limbs (21.93%), with bruise (54.60%), sprain/strain (16.87%), fractures (15.48%) most commonly seen. 77.76% of the cases were minor but the proportion of moderate and serious injuries increased along with the increase of age. Fall was the main type of injury in this country, showing an increasing trend of proportion among all the types of injuries. Though labor-related Falls accounted for the biggest proportion, prevention programs targeting the elderly and children should also be prioritized.

Analysis on the characteristics of self-inflicted injury/suicide based on the Chinese National Injury Surveillance System from 2006 to 2013

To understand the characteristics of self-inflicted injury/suicide cases that were seen from the clinic or the emergency rooms, to provide basis for suicide prevention strategies development. Data from the National Injury Surveillance System, from 2006 to 2013 were used to analyze the trend of self-inflicted injury/suicide proportion in injuries as well as the socio-demographic characteristics of the cases with related basic and clinic information related to self-inflicted injury/suicide. The proportion of self-inflicted injury/suicide cases decreased during the past 8 years. 58.6% of the self-inflicted injury/suicide cases were females in 2013 and 42.1% received junior secondary school education. Self-inflicted injury/suicide were mostly taken place at home (76.2% ). Poisoning (56.1% ) and sharp injury were the major ways causing self-inflicted injury or suicide. Interventions on self-inflicted injury/suicide should be strengthened including control programs on pesticide/psychotropic drugs. Prevention on future attempts and suicide should include the full use during the in-hospital time of those suicide attempters.

Analysis on the characteristics of violence based on data from the Chinese National Injury Surveillance System from 2006 to 2013

To understand the characteristics of victims under violence that were enrolled from clinic and emergency room of the hospitals, to provide basis for the development of violence prevention strategies. Data from the National Injury Surveillance Program between 2006 and 2013 were used to analyze: 1) trend of violence proportion in injuries, 2) socio-demographic characteristics of the cases, 3)basic and clinic information on related violence. The proportion of victims of violence decreased during the past 8 years. The number of violence related cases in 2013 was 50 333, including 36 049 males and 14 284 females. Most cases had educational levels as junior (41.2%) or senior high schools (27.3%). 24.0% of the violence occurred between 22:00 PM and 02:59 AM. The proportions of domestic violence were 30.2% in the 0-4 age group and 28.5% in the 65- age group, both were higher than in the other age groups. Interventions on violence including children abuse and elderly abuse should be paid attention to.

Analysis of road traffic injuries from Chinese National Injury Surveillance System, 2006 - 2008.

To describe the distribution of road traffic injuries through hospital based National Injury Surveillance System(NISS). Data of road traffic injuries was descriptively analyzed from Chinese NISS from 2006 to 2008. In 2006 - 2008, road traffic injury was the second leading cause from NISS among attendants in ERs or clinics of the hospitals, with males (64.63%, 64.07%, 64.38%) more than females (35.37%, 35.93%, 35.62%). People aged 30 - 44 (36.04%, 34.82%, 34.28%), 15 - 29 (30.74%, 31.57%, 30.13%), 45 - 64 (20.28%, 20.70%, 22.80%) years were seen more than other age groups. The majority of road traffic injuries were unintentional (98.34%, 99.07%, 99.07%), and mostly injured in head (35.21%, 33.74%, 35.77%) and lower limbs (24.08%, 24.54%, 23.95%) which mainly as bruise (56.47%, 57.92%, 58.89%) and fractures (17.70%, 15.84%, 15.88%). The severities of injuries were mainly minor ones (63.69%, 67.24%, 65.68%), and mostly went home right after treatments (59.43%, 63.76%, 62.80%). The distribution of road traffic injuries from NISS kept stable from 2006 to 2008. Young and middle aged men were the focus population for road traffic injuries intervention. Further improvement of NISS, multi-sectional collaboration-based advocacies and education programs as well as the enforcement of road safety law seemed the good practices for road traffic injury prevention.

Analysis of poisoning cases from Chinese National Injury Surveillance System, 2006 - 2008

To study the preventive strategies through analyzing the poisoning cases from the National Injury Surveillance System (NISS), from 2006 to 2008. Data of poisoning cases was descriptively analyzed from Chinese NISS, from 2006 to 2008. The proportion of poisoning cases to all injuries cases from NISS were 2.57%, 2.48% and 2.52% from 2006 to 2008, which ranked sixth in all the injuries causes. Most people being poisoned had junior middle school education and most of them were agriculture/animal husbandry/fishery/water producers or commercial/service personnel. Most of the poisoning incidents were happened at home, always occurred in leisure time - around 8 PM, every day. The common types of poisoning were alcohol, clinical drugs, pesticide and carbon monoxide. Unintentional injuries were the main causes. Self-harm/suicidal cases in the rural areas were more than in the urban areas, with women more than men. The main type of self-harm/suicide related poisoning cases were through drugs or pesticide. ≥ 65, 15 - 29 and 30 - 44 year-olds were most commonly seen. Alcoholism was the primary type of poisoning injuries which is the highest in young adults (15 - 29 years and 30 - 44 years). It's important to promote civilized drinking habits and limit access to alcohol for youth. Self-harm/suicide had close relationship with clinical drugs and pesticide. The key points to prevent pesticide and clinical drugs poisoning were safe storage of pesticides, universal security of pesticide, and the supervision on drug producing and marketing. Children and the elderly were the high risk people for carbon monoxide poisoning. Monitoring and intervention must be strengthened.

Distribution of children cases in the Chinese National Injury Surveillance System, 2006 - 2008

To understand the pattern of children injuries treated in hospitals and to provide evidence for its further prevention and control. Data of children cases was descriptively analyzed from the Chinese National Injury Surveillance System (NISS), from 2006 to 2008. The incidence rates of boys were twice (2.22, 2.15, 2.15) higher than girls. About one half (50.74%, 49.75%, 49.75%) of them were 5-14 year of age. The main causes were falls (44.14%, 45.68%, 47.15%), RTIs (15.71%, 14.46%, 13.79%), and blunt force injuries (13.20%, 12.92%, 12.40%). Main locations where the injuries happened were at home (34.96%, 36.86%, 38.84%), school and public places (24.72%, 19.80%, 21.19%), and road/street (21.21%, 19.63%, 19.33%). The major injured body parts were head (34.88%, 35.84%, 37.07%), upper limbs (28.00%, 28.21%, 27.81%) and lower limbs (21.86%, 21.49%, 21.31%). The majority cases were unintentional (93.01%, 92.66%, 90.58%), minor (78.50%, 81.20%, 81.52%) injuries, treated and discharged (82.37%, 85.19%, 84.84%). There were considerable differences in the distributions of causes, locations, injured body parts, and other contexts depending on age. The pattern of children's injury would include causes, places and other characteristics treated at hospitals from NISS and was related to the age of the injured child which was quite different from the spectrum of death caused by injury. NISS acts as an important source of information on children's injury in China, and can contribute to the prevention and control program on children's injury.

Analysis on the characteristics of injuries from the Chinese National Injury Surveillance System

To analyze the injury characteristics, using data from the National Injury Surveillance System (NISS), 2006 to 2008, to develop a injury prevention strategy. 129 hospitals from 43 surveillance points in NISS were selected according to the DSP sample framework, also considering the capacity of local CDC. Relative information on 1 318 739 cases were analyzed. The number of male cases were more than the females. The top three causes of injuries were as follows: falls (28.02%, 29.36%, 30.12%), traffic-related (23.07%, 21.61%, 21.44%) and blunt injuries (21.46%, 21.17%, 20.59%). The major places where injuries occurred were: road/street (29.80%, 27.73%, 28.37%) and at home (21.51%, 22.80%, 24.02%). Recreation activities (35.63%, 41.93%, 42.13%) and at work (24.43%, 22.60%, 21.44%) were the two major activities when injuries took place. Most injury cases were unintentional (83.81%, 86.32%, 86.71%) and mild (70.42%, 74.79%, 73.90%). Rush hours that caused injuries to happen were between 7 to 10 AM. Male injury cases were more than females. Falls, road traffic-related and blunt injuries were the major causes, with most of them were unintentional and minor.

Analysis on injuries among the elderly from Chinese Injury Surveillance System, 2006 - 2008

To describe the distribution of injuries among the elderly through hospital based National Injury Surveillance System (NISS), and to provide basic information for prevention of injury among the elderly. Data on injuries among the elderly aged 60 years and above was descriptively analyzed from the Chinese NISS from 2006 to 2008. Using the data of NISS from 2006 to 2008, information was collected on those cases who were diagnosed as injuries for the first-time in the site hospitals. Information included demographic characteristics, features of the injury events, and clinical characteristics of injuries. SPSS 16.0 software was used for data analysis. The leading causes of injuries among the elderly were: falls, road traffic injuries, and blunt injuries, which were in total accounting for more than 70% of all the injuries among the elderly. Most of the injuries occurred at home (46.25%, 44.44%, 46.23%), on the roads (30.95%, 28.51%, 28.61%) and in the public residences (8.89%, 11.57%, 11.25%). Recreation activates (42.14%, 48.09%, 48.59%), housework/study (21.15%, 18.21%, 18.15%) and driving (13.67%, 13.80%, 13.56%) were the three major activities when injuries took place. Most injuries among the elderly were unintentional (91.34%, 92.84%, 93.09%). The leading causes of suicide of the elderly were poisoning and sharp injury. The most common natures of injuries were bruise (36.07%, 38.18%, 38.50%), fractures (25.65%, 22.47%, 23.77%), and sharp/bite/open injuries (17.19%, 18.21%, 17.46%) while the most injured part of bodies were head (26.32%, 25.59%, 25.90%), lower limbs (25.74%, 25.70%, 25.26%) and upper limbs (21.01%, 21.14%, 21.37%). Most of the injuries were minor ones (60.53%, 65.09%, 63.58%), and patients mostly went home after treatment (64.11%, 68.53%, 67.99%). According to NISS, the proportion of injuries among the elderly in all injuries kept increasing from 2006 to 2008, while distribution of injuries among the elderly being stable. Falls was the most common injury type for the elderly which also brought along bad outcome. Falls was the priority for injury prevention among the elderly.