Injuries In Iran Research Articles

Understanding road accident injury dynamics in Iran: a growth mixture modelling perspective.

Road traffic injuries represent a significant public health concern globally. In Iran, road accidents have become a leading cause of death and disability, necessitating urgent attention to injury prevention strategies. This study aims to analyse the trends in injuries resulting from road accidents over a decade. Understanding these trends is crucial for informing targeted interventions and resource allocation, ultimately contributing to the reduction of road traffic injuries. Ecological study. The data were obtained from the official database of the Iranian Legal Medicine Organization, which includes the injury rates of all provinces due to road accidents, from 2012 to 2021. All records registered with injuries due to road traffic accidents across Iranian provinces. The incidence and average annual percentage of injury rates across provinces were illustrated using a map. A piecewise linear mixed-effects model was employed to estimate trends in injury rates, by gender. To identify distinct clusters of provinces exhibiting similar trends in injury rates, a growth mixture model was used over the 10 years. Among provinces, Qom (95% CI 18.99 to 37.21) and Sistan and Baluchestan (95% CI 5.41 to 7.66) had the highest and lowest injury rates over the decade, respectively. The annual rate of injuries in Iran increased by 0.52% from 2012 to 2018 and then gradually decreased by 1.16% after 2018. Four distinct classes were identified for the trend of injury rates over the decade: one cluster exhibited a significant decline, two clusters showed sharp increases and the last one had a steady trend. These results contribute valuable insights into the dynamics of road accident-related injuries in Iran, offering a nuanced understanding of both overarching national trends and the unique patterns observed across provinces. Such knowledge can serve as a foundation for targeted interventions and policy formulations aimed at mitigating the impact of road accidents on public health and safety.

The Burden of Head Injuries in Iran from 1990 to 2019: Findings from The Global Burden of Disease Study 2019.

Head injuries (HI) pose a significant public health concern globally, impacting morbidity, mortality, and economic burden. This study aimed to evaluate the epidemiology and trends associated with head injuries in Iran from 1990 to 2019. Our study, based on data from the Global Burden of Diseases (GBD) Study 2019, undertook a comprehensive comparison of the burden of HI in Iran with the Middle East and North Africa (MENA) and global benchmarks. We assessed the incidence, prevalence, and years lived with disability (YLD) through various metrics, including absolute numbers, age-standardized rates (ASR), percentage changes, and estimated annual percentage changes (EAPC) from 1990 to 2019. The incidence of HI in Iran decreased significantly from 1990 to 2019, with a notable reduction compared to MENA and global trends (EAPC: -1.44, 0.71, and -0.11, respectively). Prevalence showed a declining trend (EAPC: -1.00), with a slight increase in YLDs (EAPC: 0.12). Notable peaks in HI incidence coincided with natural disasters, notably the 1990 Manjil-Rudbar earthquake and the 2003 Bam earthquake. Our study reveals a decline in the overall burden of HI in Iran over the study period. To sustain this positive trend and minimize the impact of HI on public health and socioeconomic well-being, policy efforts should be directed toward ongoing prevention, early detection, and preparedness for natural disasters.

Impact of COVID-19 pandemic on road traffic injuries in Iran: An interrupted time-series analysis.

Globally, the COVID-19 pandemic has affected the number of road accidents and deaths caused by them. The present study aimed to identify the effect of this epidemic on traffic accidents and their casualties in Iran. In this study, Interrupted Time Series Analysis (ITSA) was used in a semi-experimental design to measure the impact of the restrictive policies of COVID-19 on road accidents. Data were collected retrospectively from the Iran Red Crescent Society data set for 31 provinces from March 2017 to February 2022. The information related to the number of road accidents, injuries, deaths, and deaths in the hospital was collected. The Newey-West method is used for estimation. Statistical analyses were carried out using R software version 3.6.1. Since February 2020 in Iran, the reduction in the number of road accidents and the number of injuries and deaths in these accidents was significant at 5% but the reduction of deaths in the scene and hospital was significant at 10%. In general, for all variables, the reduction trend was established only in the first months, and then it had an upward trend. In the early months of the COVID-19 epidemic in Iran, the number of road accidents and their casualties decreased. Policies restricting traffic, quarantine, and fines for violators can be reasons for changing people's behavior and travel patterns and also lead to a reduction in traffic accidents and fatalities. Such studies can explain the importance of the policies in changing behavioural patterns and can be used as a guide in future policies.

Prediction of the burden of road traffic injuries in Iran by 2030: Prevalence, death, and disability-adjusted life years

PurposeRoad traffic accidents pose a global challenge with substantial human and economic costs. Iran experiences a high incidence of road traffic injuries, leading to a significant burden on society. This study aims to predict the future burden of road traffic injuries in Iran until 2030, providing valuable insights for policy-making and interventions to improve road safety and reduce the associated human and economic costs. MethodsThis analytical study utilized time series models, specifically autoregressive integrated moving average (ARIMA) and artificial neural networks (ANNs), to predict the burden of road traffic accidents by analyzing past data to identify patterns and trends in Iran until 2030. The required data related to prevalence, death, and disability-adjusted life years (DALYs) rates were collected from the Institute for Health Metrics and Evaluation database and analyzed using R software and relevant modeling and statistical analysis packages. ResultsBoth prediction models, ARIMA and ANNs indicate that the prevalence rates (per 100,000) of all road traffic injuries, except for motorcyclist road injuries which have an almost flat trend, remaining at around 430, increase by 2030. Based on estimations of both models, the rates of death and DALYs due to motor vehicle and pedestrian road traffic injuries decrease. For motor vehicle road injuries, estimated trends decrease to approximately 520 DALYs and 10 deaths. Also, for pedestrian road injuries these rates reached approximately 300 DALYs and 6 deaths, according to the models. For cyclists and other road traffic injuries, the predicted DALY rates by the ANN model increase to almost 50 and 8, while predictions conducted by the ARIMA model show a static trend, remaining at 40 and approximately 6.5. Moreover, these rates for the prediction of death rate by the ANN model increased to 0.6 and 0.1, while predictions conducted by the ARIMA model show a static trend, remaining at 0.43 and 0.07. According to the ANN model, the predicted rates of DALY and death for motorcyclists decrease to 100 and approximately 2.7, respectively. On the other hand, predictions made by the ARIMA model show a static trend, with rates remaining at 200 and approximately 3.2, respectively. ConclusionThe prevalence of road traffic injuries is predicted to increase, while the death and DALY rates of road traffic injuries show different patterns. Effective intervention programs and safety measures are necessary to prevent and reduce road traffic accidents. Different interventions should be designed and implemented specifically for different groups of pedestrians, cyclists, motorcyclists, and motor vehicle drivers.

Economic Burden of Trauma-Related Injuries in Iran in 2019.

Trauma-related injuries are the leading cause of death and disability in the active population, with devastating economic, health, and social consequences for nations. TThis study aimed to assess the economic burden of injuries in Iran. In this study, the economic impact of trauma in Iran in 2019 was estimated using a prevalence-based approach. The prevalence was estimated based on available statistics in Iran and the GBD website. Direct medical expenditures were calculated using a top-down approach. The cost of lost production due to injuries and premature death was also estimated using the DALY value. Microsoft Excel 2019 and Stata software version 13.0 were used for the analysis. In Iran, approximately 16,500,000 individuals were estimated to have sustained injuries in a single year. The average direct medical expenses for each trauma patient were around $226. Fractures contributed to 39% of the financial impact of trauma. The overall economic burden of trauma in Iran was calculated to be $10,214,403,423. Approximately 66% of this economic burden was attributed to lost productivity and premature death resulting from trauma, while direct medical costs made up 34%. The economic burden of trauma in Iran is expected to significantly rise in the future. It may be necessary to enhance awareness of injury-related mortality and disability, improve therapies, and expand evidence-based interventions to reduce the economic impact of injuries.

Road Traffic Injuries in Iran: Epidemiology and Equitable Distribution of Emergency Services.

This study emphasized the importance of providing equal access to rescue and emergency services for all individuals involved in road accidents, regardless of their geographical location or socioeconomic status. This study involved gathering data on the number of Iranian Red Crescent Society (IRCS) and Emergency Medical Services (EMS) stations in 31 provinces of Iran. It entailed calculating the Gini coefficient and creating the Lorenz curve to assess the station distribution. To present road traffic injuries (RTIs) mortality, Disability-Adjusted Life Years (DALYs), and prevalence in Iran from 1990 to 2019, the Global Burden of Disease (GBD) 2019 estimates were utilized. The findings revealed that Tehran, Khorasan Razavi, Isfahan, Fars, and Khuzestan provinces were equipped with the most stations; whereas, Ilam, Semnan, and Kohgiluyeh and Boyer Ahmad had the fewest. The Gini coefficient for the distribution of RCS and EMS stations was found to be 0.23 and 0.38, respectively. Additionally, the study examined the prevalence, DALYs, and mortalities caused by road injuries across the 31 provinces and presented the findings in the form of a geographical representation. The results of this study highlighted the importance of ongoing efforts to ensure the equitable allocation of RCS and emergency services, with a particular emphasis on road accidents and disaster management scenarios.

Comorbidity in spinal cord injury in Iran: A narrative review.

Spinal cord injury (SCI) is a severe medical condition that affects millions of people worldwide each year. In Iran, an estimated 9 out of every 100,000 individuals experience traumatic SCI occurrences. Long-term disabilities and comorbidities stemming from SCI often necessitate multiple therapeutic interventions. The aim of this study is to evaluate the morbidity in Iranian SCI patients. In this study, a four-step process was used to select, extract, analyze, and synthesize relevant literature. The search covered 750 records from five databases, resulting in 25 articles included in the review. These articles, published between 2000 and 2023, utilized cross-sectional, qualitative, or cohort designs. The findings explored the prevalence, risk factors, and consequences of comorbidities associated with SCI, categorized into four themes: physical, sexual, psychological, and metabolic morbidity. Physical morbidity refers to medical conditions or complications affecting body functions or structures in SCI patients. The most frequently reported cases include pressure ulcers, pain, osteoporosis, fractures, impaired pulmonary function, renal failure, and obesity. Metabolic morbidity includes conditions such as vitamin D deficiency and cardiometabolic risk factors. Psychological morbidity encompasses depression, anxiety, and adjustment disorders. Sexual morbidity refers to conditions or complications affecting the sexual function or satisfaction of SCI patients. This narrative literature review offers a comprehensive examination of various aspects of SCI in Iranian patients. The review identifies numerous challenges and difficulties faced by SCI patients while also highlighting protective factors that can improve their well-being. Additionally, the review acknowledges gaps and limitations within the current literature and suggests possible avenues for future research.

Latent toxoplasmosis, Cytomegalovirus, and Herpes Simplex Virus infections and risk of motorcycle accidents: A case-control study in a county with a high rate of motorcycle injuries in Iran.

Road traffic injuries (RTIs) are among the most important issues worldwide. Several studies reported that infection with the neurotropic parasite Toxoplasma gondii (T. gondii) increased the risk of car accidents. In this study, our objective was to investigate the possible associations among latent T. gondii, Cytomegalovirus (CMV), and Herpes Simplex Virus (HSV) infections with the risk of motorcycle accidents in Jahrom (Fars Province), which is a county with a high rate of motorcycle accidents in Iran. In the setting of a case-control study; 176 motorcyclist men, including 88 survivors of motorcycle accidents and 88 motorcyclist without accidents, were considered as case and control groups, respectively. Rates of latent infections with T. gondii, CMV, and HSV were assessed by an enzyme-linked immunosorbent assay (ELISA). Eleven of 88 (12.5%) in the case group and 22 of 88 (25.0%) in controls were positive for anti-T. gondii IgG antibodies, this difference was statistically significant (OR = 0.42; CI: 0.19-0.95, p = 0.03). The general seroprevalence of CMV (94.3% in the case group vs. 87.5% in the control group, OR = 2.37; CI: 0.78-7.13, p = 0.12) and HSV (63.6% in the case group vs. 62.5% in the control group, OR = 1.05; CI: 0.57-1.94, p = 0.87) were not significantly different between the case and control groups. Although latent toxoplasmosis has been associated with traffic accidents in recent reports, we found a negative association between latent toxoplasmosis and motorcycle accidents among survivors of these accidents. As such, latent CMV and HSV infections did not differ significantly between the cases compared to the control groups.

“Current incidence of injuries in Iran; findings of STEPS survey 2021”

BackgroundThe updated epidemiology of injuries at the national and sub-national levels are required for policymakers to effectively handle the burden of injuries. This paper aimed to assess the incidence and risk factors of different injuries in Iran based on a recent national survey. MethodsWe used data from Iran Stepwise approach to surveillance (STEPS) Survey 2021, a population-based study in urban and rural areas of Iran's 31 provinces. A multistage clustered probability design and weighting adjustments were used to select eligible individuals and generate estimations. We estimated the incidence of injuries, assessed sociodemographic variables, and identified potential behavioral risk factors associated with injuries, and results were reported for sociodemographic and geographic stratifications. ResultData from 27,874 participants of the STEPS survey were assessed, of which 1538 (5.5 %, 95 % CI: [5.2–5.8]) reported having an injury in the past 12 months. Falls (44.4 %) were the most common cause of injury, followed by road traffic injury (21.7 %) and exposure to mechanical forces (16.5 %). Except for falls and burns, males had a higher proportion of all types of injuries. Logistic regression analysis showed that being male (OR: 1.7, [1.5, 2.0]) and being an occasional or heavy alcohol drinker (OR: 2.0, [1.3, 3.0] and OR: 2.7, [1.7, 4.1] respectively) were significant risk factors associated with road traffic injuries. Seatbelt use was 90.0 % among both drivers and front-seat passengers, while the use of safety car seats for children was as low as 9.4 %. Injury incidence varied significantly among provinces, with the highest incidence among males observed in Razavi Khorasan (11.2 %) and among females observed in Tehran (12.0 %). ConclusionThis study investigated the updated epidemiology of injuries in Iran and revealed socioeconomic and geographic disparities across country. This epidemiological information can be used to modify injury prevention programs.

Pre-Hospital and Post-Hospital Quality of Care in Traumatic Spinal Column and Cord Injuries in Iran.

A retrospective study. The quality of care (QoC) for spinal column/cord injury patients is a major health care concern. This study aimed to implement the QoC assessment tool (QoCAT) in the National Spinal Cord/Column Injury Registry of Iran (NSCIR-IR) to define the current state of pre- and post-hospital QoC of individuals with Traumatic Spinal Column and Spinal Cord Injuries (TSC/SCIs). The QoCAT, previously developed by our team to measure the QoC in patients with TSC/SCIs, was implemented in the NSCIR-IR. The pre-hospital QoC was evaluated through a retrospective analysis of NSCIR-IR registry data. Telephone interviews and follow-ups of patients with SCI evaluated the QoC in the post-hospital phase. In the pre-hospital phase, cervical collars and immobilization were implemented in 46.4% and 48.5% of the cases, respectively. Transport time from the scene to the hospital was documented as <1hour and <8hours in 33.4% and 93.9% of the patients, respectively. Post-hospital indicators in patients with SCI revealed a first-year mortality rate of 12.5% (20/160), a high incidence of secondary complications, reduced access to electrical wheelchairs (4.2%) and modified cars (7.7%), and low employment rate (21.4%). These findings revealed a significant delay in transport time to the first care facilities, low use of immobilization equipment indicating low pre-hospital QoC. Further, the high incidence of secondary complications, low employment rate, and low access to electrical wheelchairs and modified cars indicate lower post-hospital QoC in patients with SCI. These findings imply the need for further planning to improve the QoC for patients with TSC/SCIs.

Epidemiology of Traumatic Brain Injury in Iran: A Systematic Review and Meta-Analysis.

Traumatic brain injury (TBI) is one of leading cause of death and disability in Iran that has serious consequences on people's health. Understanding of epidemiology of TBI can be helpful for policy making in health care management. Therefore, this study aimed to examine the epidemiology of TBI in Iran. PubMed, Web of Science, Scopus, Google scholar, and internal databases including, SID, Magiran, and IranMedex were searched to identify the relevant published studies up to Feb 2022. Moreover, the references list of key studies was scanned to find more records. The Joanna Briggs Institute (JBI) tool was used to assess the quality of included studies. The Excel and Comprehensive Meta-Analysis software were to analyze the data. Overall, 23,446 patients from 15 studies were included in the study. The overall mean age of the patients was 31.36 ± 0.13 yr (95%CI: 31.10 to 31.61). The majority of the patients were male (74.37%), with a male to female ratio of 3:1. The incidence rate of TBI was 15.3 to 144 per 100,000 population. The mortality rate of TBI was estimated to be 10.4% (95%CI: 5% to 19%). The most common causes of injury were road traffic accidents (RTAs) (60%; 95%CI: 49% to 70%), and falling (20%; 95%CI: 16% to 26%), respectively. The most frequent type of head injury was subdural hematoma. Our findings highlight that appropriate control and prevention strategies should be focused on male, road traffic accidents, and the group under 40 yr.

A demographic study of death caused by unintentional injuries in Iran during 2011–2018

IntroductionThe rate of deaths and injuries caused by unintentional injuries, especially driving accidents, in Iran is globally high. This study aims to explore the rate of the death due to unintentional injuries. Material and MethodsThis quantitative research used the secondary analysis of the data on death caused by unintentional injuries obtained from the civil registration statistics based on ICD10 from 2011 to 2018. Excel 2016 software was used for the analysis, and indices of rate, percentage, sex ratio, and years of life lost (YLL) were taken into consideration. ResultsThe rate of death caused by unintentional injuries in Iran during the years 2011–2018 was almost constant but slightly decreased. The main decrease was for women and older people. In 2016, the rate of death due to unintentional injuries in men was 3.3 times that of women, and the highest rate of years of life lost (YLL) due to premature mortality was for men aged 14 to 49. The results also show that the death rate is high in less developed provinces with poor road conditions. ConclusionDespite the policies adapted about the deaths caused by accidents and the reduction of them, the results of the study show that one of the main groups and the target of these policies, namely young men, has not been affected much yet, and the death caused by accidents in young men is still high. Focusing on this population group, policies should be made to reduce the death of young men caused by accidents.

Burden of injury due to occupational accidents and its spatiotemporal trend at the national and subnational levels in Iran, 2011-2018.

The spatiotemporal trend of the burden of injury due to occupational accidents in Iran, 2011-2018 were assessed at the national and subnational levels. The burden of occupational injury was estimated using three datasets of occupational injury data, the employed population, and duration and disability weight of injuries. The disability-adjusted life years (DALYs), deaths, DALY rate, and death rate (per 100,000 workers) of occupational injury in Iran drastically decreased from 169,523, 2,280, 827, and 11 in 2011 to 86,235, 1,151, 362, and 5 in 2018, respectively. The DALY rates of occupational injury were significantly different by gender and age in a manner that the DALY rate of men was much higher than that of women and the DALY rates by age group in 2018 ranged from 98 for 50 y and over to 901 for 15-19 y. The shares of injury outcomes in the total DALYs in 2018 were as follows: 63.6% for fatal injuries, 17.4% for fracture, 7.9% for open wound, 7.3% for amputation, and 3.8% for other injuries. Over 83% of the DALYs was observed in three economic activity groups of construction, manufacturing, and community, social, and personal service activities. The three provinces with the highest DALY rates in 2018 were Markazi, West Azarbaijan, and East Azarbaijan, respectively. Despite the decreasing temporal trend, the burden of occupational injury in Iran in 2018 was high. The high-risk groups and hot spot provinces should be taken into more consideration for further reduction of the injury burden.

Epidemiology of work-related burn injuries: A ten-year retrospective study of 429 patients at a referral burn centre in the north of Iran.

Work-related burns can have a destructive impact; however, knowledge of the epidemiology of work-related burn injuries in Iran is limited. This study aimed to describe epidemiological characteristics of work-related burn injuries in a burn centre in the north of Iran. This study was a retrospective single-centre study of the medical records of work-related burns between 2011 and 2020. Data collection was done using the hospital information system (HIS). The data were analysed by using descriptive statistical methods and SPSS 24.0 software. Of the 9220 cases treated in the burn centre, 429 (4.65%) had work-related burns. There was an increasing trend of work-related burns during the ten years. The mean age of patients was 37.53 (SD = 13.72). Most patients were male (n = 377, 87.9%), with a male-to-female ratio of 7.25/1. The mean total body surface area burn was 23.39% (SD = 20.03). Most work-related burns occurred in the summer season (46.9%, n = 201), and the upper limb was the most common anatomical site of burns (n = 123, 28.7%). The most common mechanism of injury was fire & flames (266, 62.0%). Inhalation injury was observed in 52 (12.1%) patients, and mechanical ventilation was undertaken in 71 (16.6%) patients. The mean length of stay in the hospital was 10.38 (SD = 10.37) days, and the overall mortality rate was 11.2%. The most common activities associated with burns at the time of the incidents were food preparation and serving related (108, 25.2%), followed by welders (n = 71, 16.6%) and electricians (n = 61, 14.2%). This research is the basis for evaluating work-related burns and identifying the causes of these injuries to develop education and prevention programmes, especially for young male workers.

Epidemiology of Sexual Dysfunction in Patients with Spinal Cord Injury in Iran: A Systematic Review and Meta-analysis

Context: One of the changes that occur in a person and lead to a change in the patient’s sexual desire is chronic diseases, including spinal cord injury (SCI). Objectives: This study aimed to evaluate the epidemiology of sexual dysfunction (SD) in patients with SCI in Iran by a systematic review and meta-analysis. Methods: In the present systematic review and meta-analysis, using the keywords “spinal cord injury”, “sexual dysfunction”, and “Iran” a list of related articles were extracted from national and international databases. The search was conducted by two researchers in the national databases (SID, Magiran, and Irandoc) and international databases (Web of Science, PubMed, and Scopus). The necessary data were collected using a specialized checklist and analyzed using CMA v.2.0 software. Results: The result showed 183 articles were extracted in the initial search, and after reviewing the articles, six articles were included in the systematic review and meta-analysis stage. The prevalence of SD in patients with SCI was equal to 45.9%, 95% (CI: 30.2 - 62.4). Conclusions: The prevalence of SD and sexual dissatisfaction in patients with SCI was reported to be high. For this reason, it is suggested to do necessary interventions to improve the sexual satisfaction of these patients.

Measuring Catastrophic Costs in Families Facing Traumatic Brain Injury in Iran.

Traumatic brain injury (TBI) is preventable and expensive. The medical costs of TBI can be too high for some households and might lead to poverty, malnutrition, and loss of assets, which are called catastrophic expenditures. In this study, we investigated the incidence of catastrophic costs associated with TBI caused by road accidents in a province in northern Iran. This prospective study involved a 1-year follow-up after the accident. Data of 220 patients were collected from the medical records of the Poursina Hospital, Rasht, Iran from March 2018 to February 2020. Direct and indirect costs faced by the households of patients with TBI and catastrophic costs related to TBI were calculated. Regression models were obtained and sensitivity analyses were performed at the end of the study. In total, the prevalence of households TBI-related catastrophic costs (TBICC) was 45.5% . Households of female patients (odds ratio [OR]: 0.289, p=0.042), households of retired patients (OR: 0.053, p=0.005), and households falling in the fifth quintile of wealth (OR: 0.370, p=0.050) faced lower TBICC compared to other groups. The Activities of Daily Living scores had a significant negative relationship with TBICC. Political interventions such as implementation of insurance schemes, exemptions from payment for certain groups, identification of poor households, and coverage of assistance services can protect households from catastrophic health expenditures.

Risk Factors of Work-Related Head and Neck Injuries: A National Survey.

Occupational accidents made injuries in different parts of the body; two important parts of them are head and neck. We aimed to identify the risk factors of work-related head and neck injuries with using of a nationwide occupational accident data. This analytical cross-sectional study was conducted on the nationwide data that was gathered in 2013-2018. The target population was industrialized and non-industrialized adults, aged 18 yr or older. Dependent variable was the head and neck injuries. The independent variables were included, age, sex, education level, work experience, job, shift work, injury cause, referred center, season, accident day, accident time, and action after accident. Univariate logistic regression analyses and subsequently, a multivariate logistic regression model was used for analysis. Out of the 17066 injured workers, 4072 (23.86%) subjects had head and neck injuries. The results of multivariate logistic regressions model showed, age ranges 30-39 (OR = 1.218; 95% CI: 1.036,1.433; P= 0.017), 40-49 (OR = 1.313; 95% CI: 1.044,1.652; P= 0.020), and >= 60 (OR=1.620; 95%CI: 1.028,2.553; P=0.038) and having male sex (OR = 1.657; 95% CI: 1.075,2.555; P= 0.022) were final work-related risk factors of head and neck injuries in Iran. Also winter season (OR = 1.212; 95% CI: 1.00,1.469; P= 0.050) could increase the head and neck injuries odds. Older workers in Iran are more vulnerable against the occupational head and neck injuries. Moreover, having male sex was other risk factor of the head and neck injuries.

Burden of road traffic injuries in Iran: a national and subnational perspective, 1990−2019

ObjectivesReliable and valid information on burden of road traffic injuries (RTIs) is essential for short-term and long-term planning. We designed the present study to describe the levels and trends of...

Economic Evaluation of Rehabilitation of Spinal Cord Injury Patients in Iran in 2019

Objective Despite the evidence that rehabilitation interventions are effective for spinal cord injury (SCI) patients, these interventions usually impose costs on the health system. Therefore, it is necessary to examine the cost-effectiveness of these interventions for the health system of countries through economic evaluation. In this study, we examined the cost-effectiveness and net financial benefits of rehabilitation services in treating spinal cord injuries in Iran. Materials &amp; Methods Considering that this research is the first economic evaluation study related to spinal cord injury rehabilitation, the first stage of the economic evaluation was dedicated to designing an economic evaluation model. The model was designed based on disease groups, the natural course of the disease, the details of rehabilitation interventions for spinal cord injury patients in different disease groups, clinical outcomes, probability of occurrence of outcomes, and related costs. The structure of the economic evaluation model of this study is based on the design of a lifetime Markov model with a 1-year cycle length for each strategy and two groups of patients (paraplegia and tetraplegia). In this study, we also used the incremental cost-effectiveness ratio (ICER) to determine the cost of the most effective strategy. All findings were analyzed using Excel 2016 and TreeAge 2011 software. Results According to the annual incidence of spinal cord injury patients in need of rehabilitation services in the country, which is about 2000 people, based on public sector tariffs, the total annual cost of SCI rehabilitation in Iran in the paraplegia group ranges from 32997 to 40200 million Iranian Rials (IRR) and in the tetraplegia group from 25476 to 26119 million IRR in mild to very severe conditions. Also, the total rehabilitation costs of SCI patients based on public sector tariffs in one year were calculated to equal 256847 million IRR. Similarly, based on private sector tariffs, the total annual costs of SCI rehabilitation in the paraplegia group were estimated from 86374 to 103122 million IRR and in the tetraplegia group from 67509 to 68997 million IRR in mild to very severe cases. Meanwhile, the total rehabilitation costs of SCI patients were calculated based on private sector tariffs in one year, equivalent to 668847 million IRR. Also, the average lifetime of SCI patients undergoing rehabilitation is lower compared to non-rehabilitation and also has higher QALY (The quality-adjusted life year) values, which indicates the dominance of the rehabilitation strategy. The amount of ICER, in this case, is estimated based on public sector tariffs equal to negative 674 million IRR and based on private sector tariffs equal to negative 629 million IRR per QALY unit. Possible sensitivity analysis of the results and Monte Carlo simulation in both scenarios confirmed the initial analysis findings with high probability. Based on the public sector tariff, the net amount of incremental financial benefits of rehabilitation for the total annual incidence is estimated at 8991 billion IRR. These amounts were calculated based on private sector tariffs of 8579 billion IRR. Conclusion Generally, the results of this economic evaluation showed that the rehabilitation of spinal cord injury patients in Iran, based on public and private sector tariffs, is quite cost-effective and has significant net positive financial benefits. The results of the sensitivity analysis also confirmed this finding.

Factors Affecting Children’s Mortality Due to Traffic Accidents Using Haddon Model and Statistical Process Control in Ardabil Province, Iran

Background: The under-five mortality rate is one of the most important indicators of sustainable development, and accidents and injuries are the leading causes of child mortality. Objectives: The purpose of this study was to investigate the factors affecting child mortality from road traffic accidents in Ardabil province, Iran. Methods: This descriptive-analytical study investigated all mortalities of children under 5 years from road traffic accidents and injuries that occurred in Ardabil within 2013 and 2021. Standard questionnaires of the Child Health Department of the Iran Ministry of Health and Medical Education were used to collect data. Based on the Haddon matrix, the data were classified into three groups, namely Pre-event, Event, and Post-event. P-charts were used in statistical process control to control the care process in the system and identify specific and general causes. The data were analyzed in SPSS software (version 24). Results: A total of 64 mortalities occurred in the period under review. According to the Haddon Matrix analysis, environmental factors had the greatest impact in the Pre-event phase (41.6%); nevertheless, human factors had the greatest impact in the Event phase (62%) and the Post-event phase (46.8%). Conclusions: Given that road traffic accidents are the leading cause of accidents and unintentional injuries in Iran, with a rate of 38.3%, it is necessary to enhance safety-related knowledge and skills, develop safe streets and roads, ensure child safety in cars, and promote safe vehicle use. As for the regulatory bodies, enforcing strict driving rules and regulations, providing necessary monitoring and control, and facilitating access to emergency centers should be the top priorities.