Incidence Of Head Injuries Research Articles

Pediatric injuries related to electric scooter use: a national database review.

Electric scooter (e-scooter) use and resulting injuries have grown exponentially since expansion into ridesharing in 2017. No study has described pediatric e-scooter injuries and focused on their impact in an adolescent cohort. Our primary purpose was to describe the epidemiology of admitted pediatric e-scooter injuries and compare them with existing literature on adults. We queried the National Electronic Injury Surveillance System for e-scooter injuries between 2015 and 2019 in patients 0-18 years old. Injuries caused by an e-scooter to a nonrider were removed. Patients admitted to the hospital were analyzed and weighted national estimates were calculated. A P value of <0.05 was considered significant. Nine hundred and two pediatric patients were treated for an e-scooter injury at an emergency department (ED) between 2015 and 2019. Among those admitted (n = 47), 72.3% were men, and the average age at injury was 11.3 years. Among all injuries (n = 56), the most common diagnosis was fracture (24/56, 42.9%). The 19% (9/47) of patients that experienced polytrauma were significantly older than those with single injuries (P < 0.001). ED admissions grew by 616% from 2017 to 2018. Children experience a greater rate of fractures and polytrauma from e-scooters compared to adults, but fewer facial injuries despite a similar rate of head trauma. The incidence of pediatric head injuries indicates a lack of helmet use similar to adults. Lawmakers should consider bolstering e-scooter regulations to decrease pediatric injuries.

Head and Neck Injuries and Electronic Scooter Use in the United States.

To quantify electric scooter injuries encountered in United States emergency departments, focusing on the head and neck, to understand the safety impact of these scooters to improve safe usage. Retrospective cross-sectional study from January 2009 to December 2019 of patients presenting to United States emergency departments with electric scooter injuries collected from a national database. About 2,823 cases of injuries were related to electric scooter use from January 2009 to December 2019. Stratified weighted counts and incidence rates were estimated for injury characteristics. Piecewise linear regression quantified the yearly change in incidence of injuries before and after introduction of rideshare programs. The estimated national total of electric scooter cases from 2009 to 2019 was 103,943 (95% CI: 79,650-128,237). Incidence grew in 2019 to 8.63 cases per 100,000 person-years from 4.46 in 2018 to 2.42 in 2017. Head and neck injuries represented 28.5% of total injuries (weighted estimate=29,610). The most common age group of head and neck injuries before 2018 was ≤17 years, but injuries in 18- to 44-year-olds grew significantly to become the most injured group in 2018 to 2019 (P < .001). From 2009 to 2017, incidence of head and neck injuries fell by 0.02 cases per 100,000 person-years, but cases grew by 1.22 cases per 100,000 person-years post-2017 (P < .001). Injuries following the launch of rideshare electric scooter programs increased significantly, especially in patients 18 to 44 years of age. Head and neck injuries represent many of these injuries. User safety education must be addressed to prevent injury as programs become more pervasive in the United States. 2 Laryngoscope, 131:E2784-E2789, 2021.

Profile of Fatal Head Injury Cases Autopsied at District Governament Hospital Mortuary

Background and Objectives: the study of profile of skull fractures is important as head being the most exposed and prominent part of body; it becomes most susceptible to injuries, as a result of criminal violence or accident. The present study was taken up to know the incidence of head injuries, age relationship,sex relationship, agent causing skull fractures, common skull bone fractures. Methodology: data in the current study was collected from the autopsy reports and from police inquest of all fatal skull fractures from the period of june 2012 to may 2014 irrespective of age and sex with history of death due to head injuries brought for postmortem examination to the department of forensic medicine &amp; toxicology, al-ameen medical college mortuary and district hospital mortuary, bijapur between june 2012 to may 2014.Results: most common circumstance causing skull fractures are road traffic accidents in 77 cases (81.94 %). Male preponderance over females noted in this study with males constituting 80 cases (85.10 %) and females 14 cases (14.89 %). The most common age group affected was 21-30 years. Blunt force is the most common agent causing the skull fracture in 90 cases (95.74 %) and least is sharp in 4 cases (4.25 %). Among skull fracture comminuted fracture were seen in 46 cases (48.93%) , linear fracture in 38 cases (40.42%), depressed fracture in 8cases (8.5%) and sutural fracture in 1 case and gutter fracture in 1 case (1.06%) respectively. Temporal bone was the commonest bone fracture in 17 cases (18.08%). Conclusion: the study had concluded that incidence of skull fractures were common at the age group of 21-30 years, with male predominance, most common cases were those of RTA, cause of death that were given in majority of cases was that of Head injury as a consequence of injuries sustained.

The Incidence Rate of Cranii Base Fracture in Dr. Kariadi Hospital Semarang Period 2019

Introduction: Head injury is a major cause of death, especially in young adults and a major cause of disability. The incidence of head injuries is increasing due to the increasing use of motorized vehicles. As many as 4% of cases of head fracture occur in the base of the cranii.&#x0D; Method: This research used a descriptive observational method. The data used is secondary data taken from medical records. In this study, we wanted to know the incidence of cranii base fracture cases due to head trauma in patients treated at Dr. Kariadi period 2019.&#x0D; Result: From 29 samples of medical records obtained, 48.3% had mild head trauma, 27.6% had moderate head trauma, and 24.1% had severe head trauma. Symptoms of patients with the most clinical symptoms of cranii base fracture were raccoon eyes 51.7%, with the most fracture locations in the anterior fossa as much as 51.7%.&#x0D; Conclusion: The incidence of cranii fracture due to head trauma at RSUP Dr. Kariadi in 2019 was found mostly over 40 years old and most of them were men. The type of injury is a minor head injury, with the largest location in the anterior fossa, and the most common clinical sign found in patients with cranii fracture is raccoon eyes.

The Incidence Rate of Cranii Base Fracture in Dr. Kariadi Hospital Semarang Period 2019

Introduction: Head injury is a major cause of death, especially in young adults and a major cause of disability. The incidence of head injuries is increasing due to the increasing use of motorized vehicles. As many as 4% of cases of head fracture occur in the base of the cranii.&#x0D; Method: This research used a descriptive observational method. The data used is secondary data taken from medical records. In this study, we wanted to know the incidence of cranii base fracture cases due to head trauma in patients treated at Dr. Kariadi period 2019.&#x0D; Result: From 29 samples of medical records obtained, 48.3% had mild head trauma, 27.6% had moderate head trauma, and 24.1% had severe head trauma. Symptoms of patients with the most clinical symptoms of cranii base fracture were raccoon eyes 51.7%, with the most fracture locations in the anterior fossa as much as 51.7%.&#x0D; Conclusion: The incidence of cranii fracture due to head trauma at RSUP Dr. Kariadi in 2019 was found mostly over 40 years old and most of them were men. The type of injury is a minor head injury, with the largest location in the anterior fossa, and the most common clinical sign found in patients with cranii fracture is raccoon eyes.

Feel the Burn! Fireworks-related Otolaryngologic Trauma.

Fireworks are used commonly for celebrations in the United States, but can lead to severe injury to the head and neck. We aim to assess the incidence, types, and mechanisms of head and neck injuries associated with fireworks use from 2010 to 2019. A retrospective cross-sectional study, using data from the National Electronic Injury Surveillance System, of individuals presenting to United States Emergency Departments with head and neck injuries caused by fireworks and flares from 2010 to 2019. Incidence, types, and mechanisms of injury related to fireworks use in the US population were assessed. A total of 541 patients (349 [64.5%] male, and 294 [54%] under 18 years of age) presented to emergency departments with fireworks-related head and neck injuries; the estimated national total was 20 584 patients (13 279 male, 9170 white, and 11 186 under 18 years of age). The most common injury diagnoses were burns (44.7% of injuries), laceration/avulsion/penetrating trauma (21.1%), and otologic injury (15.2%), which included hearing loss, otalgia, tinnitus, unspecified acoustic trauma, and tympanic membrane perforation. The remaining 19% of injuries were a mix, including contusion, abrasion, hematoma, fracture, and closed head injury. Associations between fireworks type and injury diagnosis (chi-square P < .001), as well as fireworks type by age group (chi-square P < .001) were found. Similarly, associations were found between age groups and injury diagnoses (chi-square P < .001); these included children 5 years and younger and adults older than 30 years. Fireworks-related head and neck injuries are more likely to occur in young, white, and male individuals. Burns are the most common injury, while otologic injury is a significant contributor. Annual rates of fireworks-related head and neck injuries have not changed or improved significantly in the United States in the past decade, suggesting efforts to identify and prevent these injuries are insufficient.

Head Impact Situations in Professional Football (Soccer).

To assess head impact incidents (HIIs) and to distinguish diagnosed head injuries from other incidents, a video observation analysis of match HIIs was conducted in the German Bundesliga (2017/18 season). Video recordings of each match were screened to identify the respective events. Head injury data were identified by a prospective injury registry. HII and head injury incidence rates (IR) were calculated with 95% CIs. The total number of HIIs was 1,362 corresponding to an IR of 134.9/1000 match hours (95% CI 127.9–142.2). In 123 HII (IR 12.2, 95% CI 10.2–14.5) the contact was classified as severe. Head contact with the opponent was the most frequent cause (85%). The most frequent mechanism was in 44% (combined) the arm and elbow-to-head, followed by head-to-head and hand-to-head contacts (each 13%). In 58%, the HIIs occurred during header duels. Twenty-nine head injuries were recorded (IR 2.9, 95% CI 2.0–4.1). Concussions/traumatic brain injuries accounted for 48%, head/facial fractures 24%, head/facial contusions 21%, and lacerations/abrasions 7%. The number of HIIs not classified as concussions/more severe trauma was high. Identification of HIIs and head injury severity should be improved during on-field assessment as many head injuries might go unrecognised based on the large number of HIIs.

The effectiveness of different types of motorcycle helmets – A scoping review

BackgroundProtective helmets may reduce the risk of death and head injury in motorcycle collisions. However, there remains a large gap in knowledge regarding the effectiveness of different types of helmets in preventing injuries. ObjectiveTo explore and evaluate the effectiveness of different types of motorcycle helmets; that is the association between different helmet types and the incidence and severity of head, neck, and facial injuries among motorcyclists. Also, to explore the effect of different helmet types on riders. MethodsA systematic search of different scientific databases was conducted from 1965 to April 2019. A scoping review was performed on the included articles. Eligible articles were included regarding defined criteria. Study characteristics, helmet types, fixation status, retention system, the prevention of injury or reduction of its severity were extracted. ResultsA total of 137 studies were included. There was very limited evidence for the better protection of full-face helmets from head and facial injury compared to open-face and half-coverage helmets. There was however scarce evidence for the superiority of a certain helmet type over others in terms of protection from neck injury. The retention system and the fixation status of helmets were two important factors affecting the risk of head and brain injury in motorcyclists. Helmets could also affect and limit the riders in terms of vision, hearing, and ventilation. Multiple solutions have been discussed to mitigate these effects. ConclusionFull-face helmets may protect head and face in motorcycle riders more than open-face and half-coverage helmets, but there is not enough evidence for better neck protection among these three helmet types. Helmets can affect the rider’s vision, hearing, and ventilation. When designing a helmet, all of these factors should be taken into account.

COMPLEX FORENSIC MEDICAL EVALUATION OF THE TRAUMATIC BRAIN INJURY: CASE OF PRACTICE

&#x0D; &#x0D; &#x0D; The problem of studying the mechanisms of the occurrence of traumatic brain injury remains a very urgent issue for forensic medicine. The high incidence and high mortality rate of head injuries underlines its importance to experts. The article presents a case from the prac- tice of a forensic medical examination of a trau- matic brain injury. This case is indicative, since it clearly demonstrates the difficulties that forensic doctors face when examining craniocerebral inju- ries, when determining the mechanism of damage and the severity of bodily injuries. In this case, there is damage to the head and a concussion. The cited several conclusions of the experts of the bureau of forensic medical examination and the commission examination of the Main Bureau of Forensic Medical Examination of the Ministry of Health of Ukraine regarding the forensic medical assessment in the case of traumatic brain injury with damage to the head. When conducting an investigative experiment, it was determined that the simultaneous occurrence of an abrasion and a concussion of the brain with one traumatic effect in the glabellar region is unlikely. After all, a con- cussion of the brain and abrasions in the glabellar area were formed by different mechanisms. The results of this assessment of the characteristics of traumatic brain injury can be useful for prevent- ing difficulties in establishing the mechanism of damage in further expert practice.&#x0D; &#x0D; &#x0D;

Risk Factors, Pattern and Outcome of Motorcycle-associated Head Injury in Sokoto: An Analysis of 184 Cases

Abstract Background Road traffic accident (RTA) is the eighth leading cause of death worldwide. Motorcycle-associated head injury is the leading cause of road traffic associated morbidity and mortality in developing countries. Even though the incidence and mortality of head injury from motor cycle crash is on the increase in developing countries, especially in the African continent, most of the studies published in the literature on this subject matter took place in the developed Western countries. Materials and Methods This was a retrospective cross-sectional study of data from patients managed in our institution between December 2014 and November 2016. Results One hundred and eighty-four patients were analyzed. None of the patients used safety helmet for protection. The mean age was 27.6 ± 17.2 years with male female ratio of 6.7:1. Lone crash by cyclists and collisions accounted for 66.8% and 33.1% of the cases, respectively. Passengers and riders comprised 75% of the patients, while 25% were vulnerable pedestrians. The most frequently abused substance by the patients was tramadol (65.52%). Severe head injury and pupillary abnormality were found in 23.9% and 45.5% of the patients, respectively. Cranial CT scan showed abnormalities in 40.2% of the patients. Surgery was done in 28.3% of the patients with mortality rate of 20.7%. Conclusions The use of motorcycle as a mean of transportation has caused significant negative impact on the society. Young people, who constitute the workforce, are majorly affected, and this invariably leads to a serious economic burden on the concerned families and communities.

Injuries in elite level male beach soccer players: a prospective three year study

ABSTRACT Objectives The aim of this study was to investigate the incidence and characteristics of match and training injuries in elite-level national male beach soccer players. Method The incidence, mechanism, location, type, severity, and burden of injuries of the Turkish national beach soccer team were recorded between 2017 and 2019. Results A total of 136 injuries occurred during the study period. Total injury incidence was 238.9 injuries/1,000 match hours (MHs) and 37.7 injuries/1,000 training hours (THs) (p < 0.001). Twenty-seven injuries led to time-loss, and the incidences for match and training injuries were 36.7 and 7.9 per 1,000 hours, respectively. Of medical attention injuries (MAI) caused by trauma, 54.6% (n = 53) were due to another player and, 60.9% (n = 14) of time-loss injuries (TLI) caused by trauma were due to non-contact trauma (p < 0.001). While 82% (n = 91) of training injuries occurred in lower extremities, 29% (n = 9) of match injuries occurred in the head/neck region (p < 0.001). Head injury incidence was 45.9 per 1,000 match hours. Of MAI, 50% (n = 57) were contusion, and 32.1% (n = 9) of TLI were strain (p < 0.001). Also, the most common injury subtype was foot/toe contusion during match and training (19.4%; n = 6, 27.9%; n = 31, respectively). The majority of injuries 91.9% (n = 125) had slight severity. Conclusion Head trauma, tendon injury, and foot/toe contusion are important for clinical practice in beach soccer. Protective measures (rule regulation, use of protective equipment, etc.) should be considered to prevent these injuries.

Effects of Recurrent Mild Traumatic Brain Injuries on Incidence, Severity, and Recovery of Concussion in Young Student-Athletes.

To examine the effects of recurrent concussions on the incidence, severity, and recovery of significant neurocognitive dysfunction (SND) in young athletes. Various US youth sports organizations that utilize Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) for baseline and postinjury concussion testing. Data from 11 563 ImPACT baseline evaluations of US student-athletes aged 12 to 22 years were separated into 2 cohorts: subjects reporting 2 or more previous concussions (PC; n = 976 baseline evaluations) at baseline and a control group reporting zero previous concussions (CT; n = 7743 baseline evaluations). Subjects reporting 1 prior concussion were excluded. Retrospective cohort. Differences in SND incidence, severity, and recovery between the 2 cohorts were assessed using chi-squared tests, t tests, survival analyses, and multivariate regressions. The PC cohort had a higher incidence of head injury leading to ImPACT (436.7 per 1000 person-years vs 194.4 per 1000 person-years, P < .0001) and a higher incidence of SND (140.4 vs 71.8, P < .0001) than controls. However, the Severity Index (SI) demonstrated that SND severity was lower in the PC group (7.55 vs 8.59, P = .04). Adjusted analyses similarly demonstrated that the PC cohort had increased SND incidence (odds ratio = 1.93; 95% CI, 1.61 to 2.31; P < .0001), decreased SI (β = -1.37; 95% CI, -2.40 to -0.34; P = .009), and equivalent recovery (hazard ratio = 0.98; 95% CI, 0.76 to 1.72; P = .90). Participants with a history of concussion have a higher incidence of SND but present with lower severity SND, which may be a result of increased concussion education or symptom awareness. Recurrent concussion has no significant impact on acute neurocognitive recovery. Together, these results provide evidence against the supposition that a history of concussion increases the severity of future SND.

Assessment of magnitude and factors affecting outcomes of head injury at Addis Ababa burn emergency and trauma hospital, Ethiopia

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Head injury is the leading cause of death and disability worldwide and has become one of the highest community health problems worldwide including Ethiopia. This study aims to assess the magnitude and factors affecting the outcome of head injury patients at Addis Ababa burn and emergency treatment Hospital from 01 January 2018 to 31 December 2019.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A retrospective review was conducted on a patient who had a head injury and visited Addis Ababa burn and emergency treatment Hospital, from 01 January 2018 to 31 December 2019. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; There were 2163 head injury patients making the incidence of head injury 29.6%. The commonest cause of injury is road traffic accidents accounting for 89 (43.8%) and most patients sustained blunt injury 65 (32%).The commonest computed tomography (CT)-scan finding was intracerebral hemorrhage in 51 (25.1%) patients. Most head injury patients 112 (55.2%) stayed less than 1 week and the commonest complication was meningitis that occurred in 56 (27.6%) of patients. On presentation to hospital 90 (44.3%) had a mild type of traumatic brain injury. There is a significant correlation seen between gender, occupation, and severe traumatic brain injury (TBI) with the outcome of head injury (p&amp;lt;0.05).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Early diagnosis and interventions contributed to the good outcome of the patient. Establishing trauma centers at least in major cities can improve the outcome of head injury patients, by giving early treatment and using ambulances which are used for transportation of laboring mothers also might facilitate early referrals of patients to best centers.&lt;/p&gt;

Road injuries among older people in a tertiary care hospital in Sri Lanka – a comparative analysis

Introduction: With escalating incidence of road traffic crashes (RTCs), related injuries and deaths in Sri Lanka, understanding its burden on vulnerable road users such as older people and people with disability have important implications for traffic injury prevention and transport policy planning. Objectives: To determine crash characteristics and patterns of injuries sustained by victims of RTCs admitted to a tertiary-care hospital and investigate if these differ for older people Methods: Recorded data of all victims of RTCs admitted to the Colombo South Teaching Hospital from 1 January to 31 March 2017 were systematically extracted and analysed. Results: Of the 573 victims, 70 (12.2%) were older people aged 60 years and above. Pedestrians (46%) were the most common road user type injured among older people. In contrast, among younger victims, the motorcyclists dominated (54%). Older people were involved in RTC between 9.01 am and 12.00 noon more often than those who were younger (22% vs. 9.5%), and had significantly higher incidence of severe head injuries (13% vs. 3%), fractures (54% vs. 40%) and deaths (10% vs. 2%), and referrals to rehabilitation services at discharge (60% vs. 39%). Conclusions: Older road crash victims are at higher risk of head injuries, fractures, and deaths than younger people. Given the lack of documented data, the influence of pre-existing disability on road injury outcomes could not be investigated. Future injury surveillance, intervention and evaluative efforts should explicitly consider the needs of these vulnerable road users.

Cellular immune response following head injury

The incidence of head injuries is increasing particularly in cities. The aim was to study cellular immune response during the first 24 hours following head injuries among men aged 41-60 years and older. Methods: Altogether, 90 men aged 41-60 years were enrolled within 24 hours after head injury. Phenotypes of lymphocytes CD3+, CD4+, CD5+, CD71+, CD8+, CD16+, CD25+, CD95+, HLA-DR+, CD10+ were studied. Results. Proportion of mature T-lymphocytes increased in parallel with the increase of severity of trauma (11.1 % in mild traumas vs. 37.5 % in severe cases). In cases with average degree of trauma low concentrations of activators were detected (CD25+ = 0,23 ± 0,03 • 109 c/l; CD71+ = 0,24 ± 0,01 • 109 c/l and HLA-DR+ = 0,26 ± 0,02 • 109 c/l) combined with T-cells deficiency. Concentrations of CD8+ and CD95+ increase with the severity of the trauma: (0,64 ± 0,04) - (0,76 ± 0,01) • 109 c/l; (0,51 ± 0,02) - (0,56 ± 0,01) • 109 c/l, respectively. Conclusions: An increase in helper-suppressor ratio (k &gt; 2) due to T-helpers as a compensation for low concentrations of CD5+, CD3+, CD25+, CD71+ and HLA-DR+ seems to be associated with favorable prognosis. In severe head injuries a decrease in helpersuppressor ratio (k &lt; 2) accompanied by CD5+, CD3+ deficiency can be explained by an increase in CD8+. An increase in cytotoxic activity of lymphocytes during the first 24 hours after trauma may be associated with unfavorable prognosis.

Occupational vs Non-Occupational Equestrians: Differences in Demographics and Injury Patterns

ABSTRACT Introduction : Nineteen million people participate in horseback riding activities in the US, and the horse industry employs more than 460,000 full-time workers. Emergency department data suggest young female amateurs and male professionals are most at risk of death from horse-related injuries. However, there has been no investigation into factors that may increase severe injury and mortality risk in these populations. This study investigates demographics and injury pattern differences between occupational and non-occupational horse-related injuries in the US. Methods : The 2017 American College of Surgeons National Trauma Databank (ACS NTDB) was analyzed for horse-related injury using ICD 10 codes. Demographics, injury data, protective device use, and hospital procedures were analyzed. Occupational versus non-occupational injuries based on incident location (farm, sports, recreational, residential) were compared using ANOVA or Pearson's Chi-squared test. Results : Of 3,911 incidents, the most common injury mechanism was falling from the horse, but occupational and non-occupational farm injuries showed higher incidence of being struck by a horse. One-third required surgery. Upper extremity injuries were most common. Occupational injuries more often affected upper extremities of working age, minority males with commercial insurance. Non-occupational injuries most often affected heads of women at the extremes of age. Helmet use was higher in occupational sports, non-occupational sports, and non-occupational recreation injuries, and severe head injury incidence was decreased in these groups. Complications and discharge dispositions were not different across groups. Conclusions : In the largest trauma center study to date, we have shown equine-related trauma to be common and affect a predictable demographic that may permit injury prevention initiatives. Helmets may reduce severe head injury, but the efficacy of protective clothing remains to be validated.

Burden of Moderate and Severe Head Injury in Kashmir Valley

Abstract Background Head injury is a major health hazard throughout the world. Overall, the mortality/morbidity has not changed much in the last few decades. In developing nations, the situation is worse. Methods The study was conducted for a period of 1 year. The data collected include demographic profile, mode, circumstances and timing of the injury, neurological assessment using Glasgow Coma Scale (GCS) scoring, computed tomography (CT) scan findings, type of management, and outcome. Results Transport-related injuries and falls were the common cause of head injury, with more severe injuries seen in patients without wearing helmets and seat belts. The youth is at high risk of receiving head injuries. The summer season showed a maximum incidence of head injuries. The most common lesions on CT scan were linear fracture of the skull and brain contusion. Mortality rate was 26% and it correlated with the GCS at presentation. Conclusion Head injury mostly affects young people and males outnumber females. Road traffic accident is the major cause. People not abiding by the traffic rules, such as wearing helmets and seat belts, were at high risk of developing head injury and poor outcome.

Into the wild and on to the table: A Western Trauma Association multicenter analysis and comparison of wilderness falls in rock climbers and nonclimbers.

Wilderness activities expose outdoor enthusiasts to austere environments with injury potential, including falls from height. The majority of published data on falls while climbing or hiking are from emergency departments. We sought to more accurately describe the injury pattern of wilderness falls that lead to serious injury requiring trauma center evaluation and to further distinguish climbing as a unique pattern of injury. Data were collected from 17 centers in 11 states on all wilderness falls (fall from cliff: International Classification of Diseases, Ninth Revision, e884.1; International Classification of Diseases, 10th Revision, w15.xx) from 2006 to 2018 as a Western Trauma Association multicenter investigation. Demographics, injury characteristics, and care delivery were analyzed. Comparative analyses were performed for climbing versus nonclimbing mechanisms. Over the 13-year study period, 1,176 wilderness fall victims were analyzed (301 climbers, 875 nonclimbers). Fall victims were male (76%), young (33 years), and moderately injured (Injury Severity Score, 12.8). Average fall height was 48 ft, and average rescue/transport time was 4 hours. Nineteen percent were intoxicated. The most common injury regions were soft tissue (57%), lower extremity (47%), head (40%), and spine (36%). Nonclimbers had a higher incidence of severe head and facial injuries despite having equivalent overall Injury Severity Score. On multivariate analysis, climbing remained independently associated with increased need for surgery but lower odds of composite intensive care unit admission/death. Contrary to studies of urban falls, height of fall in wilderness falls was not independently associated with mortality or Injury Severity Score. Wilderness falls represent a unique population with distinct patterns of predominantly soft tissue, head, and lower extremity injury. Climbers are younger, usually male, more often discharged home, and require more surgery but less critical care. Epidemiological, Level IV.

Epidemiology of soccer-related head injury in children 5-14 years in Victoria, Australia.

Our aim was to use epidemiological data to determine the incidence of soccer-related head injuries in children aged 5-14 years who presented at emergency departments (EDs) or were admitted in hospitals in Victoria, Australia. ED presentation and hospital admission de-identified aggregate data were from the Victorian Injury Surveillance Unit. Soccer participation data were compared with the soccer-related head injury data to determine the incidence of this injury among these children. The incidence of ED presentations was 0.17% of children participating in soccer during the study period (financial years 2011-2012 to 2015-2016). The 10-14-years age group presented with more head injuries than the 5-9-years age group. For the admissions data, soccer had a significantly lower (P = 0.0379) incidence of head injury when compared with 'sport as a whole'. The low incidence of soccer-related head injuries presenting to an ED or admission to hospital is consistent with international findings.

Risk factor assessment and outcome analysis in elderly (≥60 years) patients of severe head injury

Background: Incidence of head injuries is rising all over the world. Only few studies have been performed regarding severe head injury in elderly people. We aimed to study the epidemiology, mode of injury, management, co-morbidity, associated injuries which affects the outcomes. Severe head injury is unconsciousness &gt;6 hours and GCS 3-8. In India 6.63% of the total population above 60 years is considered elderly. Falls are the major contributor to TBI in elderly but in India RTA is still the main contributor. Outcomes of TBI, both in terms of mortality and function, are significantly worse in the elderly.Methods: Objective of this study was to find the risk factors affecting the outcome in severe head injury. This was a prospective study and carried on 56 patient in Department of surgery of M. L. N. Medical College, Prayagraj from September 2018 to September 2019.Results: Male were most commonly affected but the gender had no significant prognostic effect on outcome. RTA were the most common cause of head injury. GCS at admission was directly related to outcome. Bilateral non-reactive pupils had poor outcome. Type of hematoma and midline shift had also affected the outcome. Operated cases had better outcome than non-operated cases. Any associated injury with TBI had worsened the outcome in patient. Any co-morbid condition associated with brain injury had slower recovery and worsen the outcome. Overall mortality in this series was 64.28% and unfavourable outcome was 76.79%.Conclusions: Severe head injury in elderly people had worst outcome.