Retrospective Epidemiological Study Research Articles

042 Atopic dermatitis and the risk of eating disorders

Evaluation of psychiatric morbidity in atopic dermatitis (AD) patients is essential for comprehensive care. AD is known to be associated with multiple mental disorders. Until now, a possible association between AD and eating disorders has remained unknown. We aimed to investigate the relationship between AD, eating disorders (ED) and food allergies. This retrospective epidemiological Finnish hospital registry-based study was conducted by identifying all cases of AD under the age of 18 at the time of diagnosis between 1987 and 2018.

Sex and gender differences in COVID-19: an Italian local register-based study

ObjectivesThe present study aimed to explore differences in COVID-19 outcomes between male and female cases in the Apulian District of Foggia, Italy.Design and settingWe performed a retrospective epidemiological study among...

Injuries in underwater rugby: a retrospective cross-sectional epidemiological study.

Underwater rugby (UWR) is a team sport which combines swimming sprints, apnoea diving, a good overview of the three-dimensional underwater space and wrestling for the ball.This was the first epidemiological study of UWR injuries in a large international collective. A questionnaire containing 124 questions was distributed to 198 active UWR players and completed under the supervision of medical staff. Demographic data and information about injuries in ten different body regions were collected. Of the 198 respondents, 106 (53.5%) were male and 92 (46.5%) were female. On average, each UWR player suffered a median of 19.5 (IQR 44) injuries. Based on the exposure time, means of 37.7 (SD 90.0) injuries per 1000 playing hours per player and 9.9 (20.1) injuries per year were found. Significant injuries mainly occurred to the head region (45.7%). Bruises and sprains were observed more often than fractures and dislocations. Male athletes had a longer total injury break time (median 4.8 [IQR 10.5] days), than female athletes (4 [8.6] days). Female athletes had more injuries (median 20 [IQR 26.8]) than male athletes (18.5 [63]). The length of the injury-related break time increased with the rise in body mass index. The risk of severe injury in UWR is low compared to other ball sports like water polo and rugby. UWR is played under water and the impact of tackles is lessened by the water. Further studies should record chronic injuries in UWR and establish measures to prevent injury.

Epidemiology of pediatric hand surgery emergencies. Retrospective study of 245 patients seen over 10 months in two referral centers

BackgroundThe primary objective of this retrospective study was to analyse the epidemiology and assess the characteristics of all paediatric hand injuries requiring emergent surgery. HypothesisPaediatric hand emergencies that require surgical treatment have a specific epidemiological distribution. MethodsWe conducted a multicentre retrospective descriptive epidemiological study of surgical paediatric hand emergencies seen over 10 consecutive months. ResultsWe included 245 patients between the 1st of January and the 31st of October 2016. Irrespective of age, most injuries (69%) occurred at home; 11% (n=26) occurred at school and 4% in a sports centre. Overall, most injuries involved the dorsal aspect and affected the fingers more often than the hand. The most common lesion was crush injury of a distal phalanx (36% of cases). Door guards were in use in only 9% of homes (n=8), and mean age of the patients in this group was 5 years Paronychia/acute infections accounted for 27% of cases. Wounds of the hands of fingers made up 23% of cases, with the palmar aspect being involved in 70% of cases. The wound was often due to the use of a sharp-edged object. Fractures/dislocations accounted for 12% of cases and bites or scratches for 2%. DiscussionThis study showed that the most common hand injuries requiring emergent surgery in a paediatric population are crush injuries of the fingertip such as door-crush injuries, which most often occur at home. Reinforcing prevention strategies should be the main priority in order to decrease the incidence of hand lesions in children. Raising awareness among parents and improving the education of the public could significantly decrease the incidence of these injuries. Level of evidenceIV; retrospective cohort.

Impact of COVID-19 on Orthopaedic Surgery: Comparison Between Before and During COVID-19 Pandemic

Introduction: Orthopaedic surgical activity has been significantly affected by COVID-19 pandemic. The decision to perform operative interventions is based on balancing risk to benefit to the patient and health care workers. Though different guidelines have been published, there is a lack of reliable data on orthopaedic surgical activities. Our study aimed to evaluate the impact of the COVID-19 pandemic on Orthopaedic surgeries comparing with the previous year. 
 Methods: This was an epidemiological retrospective comparative study conducted at Shree Birendra Hospital, Nepal after taking ethical approval from the Institutional Review Committee of NAIHS. Data of the first four month of orthopaedic surgeries after National lockdown (from March 24 to July 23, 2020) and the same four month period of the previous year (The year 2019) were retrieved. The demographic profiles and operations categories (trauma, elective and infections) were compared between two periods using SPSS 21.
 Result: Out of total of 651 patients enrolled, 169 patients operated during the pandemic compared with 482 patients before the pandemic. There was a 65% reduction in total surgical procedures, 94% reduction in elective cases and trauma cases were reduced by 29% (P < 0.05). Implant removal (107, 42.8%) constituted the highest elective cases in the year 2019.
 Conclusions: The orthopaedic surgical procedures were decreased in frequency during COVID-19 because of a decrease in elective cases. The total trauma patients remained more equable during pandemic despite strict lock-down. Health care facilities should consider this during post pandemic recovery.

Snakebites in Rural Areas of Brazil by Race: Indigenous the Most Exposed Group.

Animal stings are environmental hazards that threaten millions annually and cause a significant socioeconomic impact. Snakebite envenoming affects 2.7 million people globally every year, mostly the poorest and rural communities, with approximately 27,000 annual cases in Brazil. This study’s objective is to identify the most exposed racial group for snakebites in rural areas of Brazil and analyze possible differences in the outcome of an accident. A retrospective epidemiological study was conducted using a database of rural snakebite cases from Brazil’s Ministry of Health (2017). Descriptive analysis and a regression model were performed to examine the association of bad outcomes after a snakebite with several covariables. While mixed-race individuals presented the highest number of cases (61.79%), indigenous and white populations were the racial groups with the highest and lowest exposure rates (194.3 and 34.1 per 100,000 population, respectively). The fatality rate was 3.5 times higher in the indigenous population compared to the white population. In the multivariable model, the number of hours between the accident and health care received and the case classification suggested an association with a bad outcome. Snakebite is prominent in Brazil, particularly among indigenous groups. Antivenom is available in the Brazilian Health System; however, efforts need to be made for decentralization.

Epidemiological Analysis of the Effectiveness of Rabies Post-Exposure Prophylaxis in the Russian Federation (2001–2018)

Relevance. Post-exposure prophylaxis (PEP) is the most effective method for reducing the morbidity and mortality of human rabies. Since 2000, in Russia, domestically produced cultural purified and concentrated rabies vaccine (COCAV) and equine immunoglobulin (AIG) are used as the main drugs for PEP.Aims. To assess the epidemiological effectiveness of post-exposure rabies prophylaxis and possible causes of failure in the Russian Federation in 2001–2018.Materials & methods. A comprehensive retrospective epidemiological study of 167 cases of rabies in humans and PEP statistics in the Russian Federation was carried out. To test the hypotheses about the relationship between PEP failures and risk factors, namely (gender, age, place of residence of the sick, nature of the injuries received, source of infection), two main comparison groups were formed: «vaccinated» (n = 28) and «not vaccinated» (n = 139). In addition, we compared the groups who received PEP correctly and those vaccinated with violations of instructions. The failure rate was assessed in relation to the total number of vaccinated and the number of vaccinated after contact with rabid animals.Results. During the analyzed period, the incidence of human rabies decreased from 0.015 to 0.0013 per 100 thousand population. Of the patients, 83.2% did not receive PEP (did not apply, vaccinations were not prescribed, refused). In the group «vaccinated» in 53.6% (n = 15), the schemes of PEP prescribing and administering were violated, including in 35.7% (n = 10) of cases AIG was not administered. The rest 46.4% (n = 13), received vaccinations in accordance with the instructions. Before the end of the vaccination course, 85.7% (n = 24) fell ill; the rest fell ill with an incubation period of more than three months. Only one person received AIG and all 6 vaccine injections. The group «vaccinated» differed from the group «not vaccinated» by a higher frequency of category III injuries (χ2 = 9.99, p = 0.019) and injuries caused by wild animals, especially wolves (χ2 = 22.24, p < 0.001).Conclusions. Among people who developed rabies in 2001–2018, 16.8% received PEP. The proportion of the number of cases and the total number of those who received PEP was 1: 240.0 thousand. The failure rate of PEP after contact with rabid animals was 0.03% (excluding the nature of the contact and the animal species). More than 70% of all failures are associated with wolf and fox bites, more than 85% with category III injuries.

Clinical, epidemiological and climatic factors related to the occurrence of cutaneous leishmaniasis in an endemic area in northeastern Brazil.

Cutaneous leishmaniasis (CL) is a neglected tropical disease with a wide distribution in the Americas. Brazil is an endemic country and present cases in all states. This study aimed to describe the occurrence, the underlying clinical and epidemiological factors, and the correlation of climatic variables with the frequency of reported CL cases in the municipality of Caxias, state of Maranhão, Brazil. This is a retrospective and descriptive epidemiological study based on data extracted from the Brazilian Information System of Diseases Notification, from 2007 to 2017. Maximum and minimum temperature, precipitation, and relative air humidity data were provided by the Brazilian National Institute of Meteorology. A total of 201 reported autochthonous CL cases were analyzed. The predominance of cases was observed in males (70.1%). The age range between 31 and 60 years old was the most affected, with 96 cases (47.9%). Of the total number of registered cases, 38.8% of the affected individuals were engaged in agriculture-related activities. The georeferenced distribution revealed the heterogeneity of disease occurrence, with cases concentrated in the Western and Southern regions of the municipality. An association was detected between relative air humidity (monthly mean) and the number of CL cases per month (p = 0.04). CL continues to be a concerning public health issue in Caxias. In this context, there is a pressing need to strengthen measures of prevention and control of the disease through the network of health services of the municipality, considering local and regional particularities.

Demographic and prognostic factors of optic nerve astrocytoma: a retrospective study of surveillance, epidemiology, and end results (SEER)

BackgroundOptic nerve astrocytomas (ONAs) are neurological neoplasms in the central nervous system (CNS), and they have the highest incidence rate among all the tumor types in the visual pathway. In this study, we conducted a Surveillance, Epidemiology, and End Results (SEER) -based research to explore the demographic, survival, and prognostic factors of patients diagnosed with ONAs.MethodsUtilizing the SEER database, we retrospectively evaluated data of patients diagnosed with ONAs of all ages from 1984 to 2016. We used the Student’s t distribution to test variables of patients and various characteristics, and Kaplan-Meier curve to illustrate overall survival (OS) with 95.0% confidence intervals (CIs). We also performed univariate and multivariate analyses to evaluate various variables’ validity on overall survival.ResultsA total of 1004 cases were analyzed, and revealed that age (P<0.001, hazard ratio (HR) = 8.830, 95% CI: 4.088–19.073), tumor grade (P<0.001, HR = 1.927, 95% CI: 1.516–2.450), diagnostic confirmation (P<0.001, HR = 2.444, 95% CI: 1.632–3.660), and histology type (P = 0.046, HR = 1.563, 95% CI: 1.008–2.424) of the tumor were associated with decreased survival.ConclusionsFrom this large, comparative study of ONAs, we found that younger age may be considered as a protective indicator, while high-grade astrocytic tumors have a worse prognosis. We also found that diagnostic confirmation and tumor grade were independent prognostic factors in this patient population.

IBCL-151: Epidemiological Data on Marginal Zone B-Cell Lymphoma in the Republic of Kosovo During the Period of 2016-2020

Context Marginal zone B-cell lymphomas (MZLs) are a group of clinically indolent B-cell lymphomas postulated to derive from memory B lymphocytes in the 'marginal zone’ of secondary lymphoid tissue. It has several distinct entities including extra nodal marginal zone B-cell lymphoma (EMZL) or mucosa-associated lymphoid tissue (MALT) lymphoma, splenic MZL, and nodal MZL. This type of lymphoma is one of the most common lymphoma types in Kosovo. This epidemiological study will reveal new data on the success of treatment of this disease in Kosovo and how we can improve our treatment in the future. Design Retrospective descriptive epidemiological study. The data was collected during the 5 year period of 2016-2020 from patient files. Setting The data was collected from the patient files in the hematology clinic of the university clinical center of Kosovo. Patients Adults, age 18 and older, both genders diagnosed with marginal zone B-cell lymphoma in the hematology clinic of the university clinical center of Kosovo. Interventions None. Main Outcomes Measures No main outcome because it is an epidemiological study. Results During the period of January 2016 to December 2020, 31 patients were diagnosed and treated with marginal zone B-cell lymphoma. The median age of the patients was 59.2 years old. 14 (45.2%) were male and 17 (54.8%) were female. MALT marginal zone B-cell lymphoma was the most common entity with 10 patients, 10 were splenic marginal zone lymphoma, 6 were nodal and 4 were EMZL. Conclusions The majority of patients (30) were treated with R-CHOP chemotherapy protocol. Only one was not treated at all after a PET scan showed no metabolically active lesions and the watch and wait method was applied. 24 patients went into remission and received rituximab maintenance therapy every 3 months, 3 patients had progressive disease after 6 cycles of R-CHOP, and there is no data on the outcome of 2 patients.

Epidemiology and Outcome in Electrical Burn Injury: Retrospective Study of 282 Patients in a Tertiary Care Hospital of Western Uttar Pradesh, India

Electrical burns account for a small percentage of all burn injuries. However, in burn patients, they are a major source of disability. They put socioeconomic burden on the society. This is a retrospective epidemiological study of 282 electrical burn patients admitted in burn unit of a tertiary care hospital of North India. Majority of the electrical burn was due to accidental touching of uncovered wires and occupation-related burns in laborers and industrial workers who were mainly young males in the age group 20 to 40 years. Most of the cases were of high-voltage (≥1000 V) electrical burns. More severe burns, longer hospital stays, and more problems and operations were all linked to high-voltage burns. Amputation rates for high-voltage burns were significantly higher (37.3%) as compared to low-voltage burns (13.6%). Electrical burn injuries can be prevented by awareness programs, proper training, and safety measures both by public and government.

Comparative Study of Some Parameters in The Diagnosis of Diabetic Nephropathy

Objective: Our objective is to conduct a comparative retrospective epidemiological study of some specific biochemical and physiological parameters in the diagnosis of diabetic nephropathy. Materials and Methods: 217 diabetic patients (DT1, DT2) aged 15 to 89 years were recruited, they were classified into three groups according to the degree of renal complications. The following blood parameters were studied: glucose, HbA1C, urea, creatinine, creatinine clearance, microalbuminuria, total cholesterol, HDL, LDL, and potassium ions, sodium, chlorine. Results: 51% of our diabetic patients are men, type 2 diabetes is more common than type 1 with a percentage of 82% (177 cases) against 18% (40 cases). The age group most affected is that of 65-89 years (47%). the male sex was most affected by chronic kidney failure (61%). 59% of diabetes cases are affected by hypertension. An unbalanced blood glucose was recorded in all of our patients included in this study. Urea, creatinine, creatinine clearance, microalbuminuria are biochemical markers and parameters for estimating renal function. The rate of urea, creatinine, microalbuminuria is very high in patients with diabetic nephropathy including chronic renal failure compared to other groups, which lead to the decrease in creatinine clearance [urea: 4.15 ± 14.66, creatinine: 71.77 ± 43.46, creat cl: 10.75 ± 7.98, microalbuminuria: 3507.11 ± 4080.39]. Conclusion: Diabetic nephropathy is one of the complications of diabetes and requires optimal management to slow the progression of renal disease.

Potential contribution of HIV during first-line tuberculosis treatment to subsequent rifampicin-monoresistant tuberculosis and acquired tuberculosis drug resistance in South Africa: a retrospective molecular epidemiology study

SummaryBackgroundSouth Africa has a high burden of rifampicin-resistant tuberculosis (including multidrug-resistant [MDR] tuberculosis), with increasing rifampicin-monoresistant (RMR) tuberculosis over time. Resistance acquisition during first-line tuberculosis treatment could be a key contributor to this burden, and HIV might increase the risk of acquiring rifampicin resistance. We assessed whether HIV during previous treatment was associated with RMR tuberculosis and resistance acquisition among a retrospective cohort of patients with MDR or rifampicin-resistant tuberculosis.MethodsIn this retrospective cohort study, we included all patients routinely diagnosed with MDR or rifampicin-resistant tuberculosis in Khayelitsha, Cape Town, South Africa, between Jan 1, 2008, and Dec 31, 2017. Patient-level data were obtained from a prospective database, complemented by data on previous tuberculosis treatment and HIV from a provincial health data exchange. Stored MDR or rifampicin-resistant tuberculosis isolates from patients underwent whole-genome sequencing (WGS). WGS data were used to infer resistance acquisition versus transmission, by identifying genomically unique isolates (single nucleotide polymorphism threshold of five). Logistic regression analyses were used to assess factors associated with RMR tuberculosis and genomic uniqueness.FindingsThe cohort included 2041 patients diagnosed with MDR or rifampicin-resistant tuberculosis between Jan 1, 2008, and Dec 31, 2017; of those, 463 (22·7%) with RMR tuberculosis and 1354 (66·3%) with previous tuberculosis treatment. In previously treated patients, HIV positivity during previous tuberculosis treatment versus HIV negativity (adjusted odds ratio [OR] 2·07, 95% CI 1·35–3·18), and three or more previous tuberculosis treatment episodes versus one (1·96, 1·21–3·17) were associated with RMR tuberculosis. WGS data showing MDR or rifampicin-resistant tuberculosis were available for 1169 patients; 360 (30·8%) isolates were identified as unique. In previously treated patients, RMR tuberculosis versus MDR tuberculosis (adjusted OR 4·96, 3·40–7·23), HIV positivity during previous tuberculosis treatment (1·71, 1·03–2·84), and diagnosis in 2013–17 (1·42, 1·02–1·99) versus 2008–12, were associated with uniqueness. In previously treated patients with RMR tuberculosis, HIV positivity during previous treatment (adjusted OR 5·13, 1·61–16·32) was associated with uniqueness as was female sex (2·50 [1·18–5·26]).InterpretationThese data suggest that HIV contributes to rifampicin-resistance acquisition during first-line tuberculosis treatment and that this might be driving increasing RMR tuberculosis over time. Large-scale prospective cohort studies are required to further quantify this risk.FundingSwiss National Science Foundation, South African National Research Foundation, and Wellcome Trust.

Pediatric surgical site infection (SSI) following ambulatory surgery: Incidence, risk factors and patient outcomes.

Inpatient surgical site infections (SSIs) cause morbidity in children. The SSI rate among pediatric ambulatory surgery patients is less clear. To fill this gap, we conducted a multiple-institution, retrospective epidemiologic study to identify incidence, risk factors, and outcomes. We identified patients aged <22 years with ambulatory visits between October 2010 and September 2015 via electronic queries at 3 medical centers. We performed sample chart reviews to confirm ambulatory surgery and adjudicate SSIs. Weighted Poisson incidence rates were calculated. Separately, we used case-control methodology using multivariate backward logistical regression to assess risk-factor association with SSI. In total, 65,056 patients were identified by queries, and we performed complete chart reviews for 13,795 patients; we identified 45 SSIs following ambulatory surgery. The weighted SSI incidence following pediatric ambulatory surgery was 2.00 SSI per 1,000 ambulatory surgeries (95% confidence interval [CI], 1.37-3.00). Integumentary surgeries had the highest weighted SSI incidence, 3.24 per 1,000 ambulatory surgeries (95% CI, 0.32-12). The following variables carried significantly increased odds of infection: clean contaminated or contaminated wound class compared to clean (odds ratio [OR], 9.8; 95% CI, 2.0-48), other insurance type compared to private (OR, 4.0; 95% CI, 1.6-9.8), and surgery on weekend day compared to weekday (OR, 30; 95% CI, 2.9-315). Of the 45 instances of SSI following pediatric ambulatory surgery, 40% of patients were admitted to the hospital and 36% required a new operative procedure or bedside incision and drainage. Our findings suggest that morbidity is associated with SSI following ambulatory surgery in children, and we also identified possible targets for intervention.

Kawasaki Disease and Pediatric Infectious Diseases During the Coronavirus Disease 2019 Pandemic

ObjectiveTo assess the epidemiologic association between Kawasaki disease and common pediatric infectious diseases (PIDs) identified during the coronavirus disease 2019 (COVID-19) pandemic period to confirm whether the infection-triggered theory is a plausible hypothesis for the pathogenesis of Kawasaki disease.Study designA retrospective epidemiologic study was conducted using datasets obtained from Web-based surveillance of Kawasaki disease and PIDs in Japan. We compared weekly numbers of patients who developed Kawasaki disease and specific PIDs between 2020 and 2017-2019 and evaluated the association between the percent reduction in the number of patients with these diseases.ResultsA total of 868 patients developed Kawasaki disease in 2020. During the social distancing period in 2020, the number of patients with Kawasaki disease was approximately 35% lower than in 2017-2019. Time from the onset of Kawasaki disease until the first hospital visit did not differ significantly among the examined years. The proportion of older children with Kawasaki disease decreased more than that of infants with Kawasaki disease (age <1 year), resulting in a significant difference in the proportion of infant patients between 2020 and 2017-2019 (24% vs 19%; P < .01). The number of patients with incomplete Kawasaki disease was unchanged from that of previous years. The weekly percent reduction in patient numbers differed between Kawasaki disease and PIDs during 2020, with no strong correlation between the 2 diseases.ConclusionsOur data indicate that parents of patients with Kawasaki disease did not avoid hospital visits during the COVID-19 pandemic period. The findings indicate the possibility that triggering Kawasaki disease might be associated with presently unidentified respiratory pathogen(s) that potentially might be acquired from both within and outside the household.

Current epidemiological profile and characteristics of traumatic cervical spinal cord injury in Nanchang, China

Study design A hospital-based retrospective epidemiological study. Objective To describe the recent epidemiological profile and characteristics of traumatic cervical spinal cord injury (TCSCI) in Nanchang, Jiangxi Province, China. Setting The First Affiliated Hospital of Nanchang University, The Second Affiliated Hospital of Nanchang University and The Third Affiliated Hospital of Nanchang University. Methods We retrieved the medical records of 1290 persons with TCSCI admitted to The First Affiliated Hospital of Nanchang University, The Second Affiliated Hospital of Nanchang University and The Third Affiliated Hospital of Nanchang University between January 2012 and December 2018. The characteristics recorded were age, sex, aetiology of the injury, neurological level, American Spinal Injury Association (ASIA) impairment scale, patient source, and associated trauma. Categorical data were reported as frequency and proportions and compared using the Fisher’s exact or Chi-square test. P < 0.05 was considered to be statistically significant. Results A total of 1290 persons with TCSCI were included in the present study. The largest age group was 46–60 years, accounting for 31.6% of the patients; the mean age was 53.1 ± 16.2 years, and the male/female ratio was 7.06:1. More than 87.4% of persons were transferred from a primary or secondary hospital. The leading cause of injury was motor vehicle collision (41.3%), followed by low fall (26.5%). The most common cervical spine injury level was the C5 segment, accounting for 24.3% of cases. As for severity, ASIA grade D was encountered most frequently, with a total of 518 persons (40.2%). Among all participants, 56.8% had associated trauma, the most common being head injuries (18.2%). Surgery was the major treatment choice (51.2%), and the number of patients undergoing surgery is increasing from 2012 to 2018, P = 0.02. Conclusion Persons with TCSCI in Nanchang had specific epidemiological characteristics, and preventive measures should focus on middle-aged and older adults. In addition, more attention should be paid to balancing development of medical resources and technology between urban and rural areas.

Maternal immune activation as a risk factor for psychiatric illness in the context of the SARS-CoV-2 pandemic

Inflammation, due to infectious pathogens or other non-infectious stimuli, during pregnancy is associated with elevated risk for neurodevelopmental disorders such as schizophrenia and autism in the offspring. Although historically identified through retrospective epidemiologic studies, the relationship between maternal immune activation and offspring neurodevelopmental disease risk is now well established because of clinical studies which utilized prospective birth cohorts, serologically confirmed infection records, and subsequent long-term offspring follow-up. These efforts have been corroborated by preclinical research which demonstrates anatomical, biochemical, and behavioural alterations that resemble the clinical features of psychiatric illnesses. Intervention studies further demonstrate causal roles of inflammatory mediators, such as cytokines, in these long-lasting changes in behaviour and brain. This review summarizes a selection of maternal immune activation literature that explores the relationship between these inflammatory mediators and the neuropsychiatric-like effects later observed in the offspring. This literature is presented alongside emerging information regarding SARS-CoV-2 infection in pregnancy, with discussion of how these data may inform future research regarding the effects of the present coronavirus pandemic on emerging birth cohorts.

Paediatric pelvic injuries: a retrospective epidemiological study from four level 1 trauma centers.

Epidemiologic evaluation of pelvic ring injuries in children. Retrospective analysis over a period of 13years, excluding pathological fractures. AO/OTA type, epidemiological data, type of treatment, and complications were recorded. Data were assessed using Fisher's exact test and Wilcoxon test. 243 boys, 115 girls, mean age (SD) 14.1 ± 3.0years, AO/OTA types: 281 A, 52 B, 25 C. Multiple trauma: 62, combined trauma: 59, mono-trauma: 237. 281 patients were treated non-operatively, 97 surgically. traffic accidents 88, falls from a great height 37, crushing injuries four, and sports injuries 192, simple falls 30, others seven. High-energy mechanisms prevailed in types B and C. Low-energy mechanism in type A (p < 0.0001). Similar differences were found between type A (p = 0.0009) and in case type C requiring surgery and cases treated non-operatively (p < 0.0001). Twenty-six patients (7.3%) had complications (pelvic asymmetry 5, neurological deficits 5, non-union 1, ectopic calcification 4, others 7). Higher complication rates were associated with types B and C (p = 0.0015), with surgically treated cases (p < 0.0001) and multiple trauma (p = 0.0305). Results of this trial were comparable with other studies. Sports injuries accounted for most type A injuries, while types B and C tended to be associated with high-energy trauma. Complications were associated with the severity of pelvic trauma, more common in surgically treated group of patients; this is primarily linked to the surgical cases being more serious as well as the associated injuries.

Sport-related injuries in Iranian basketball players: evidence from a retrospective epidemiologic study (2019–20)

ABSTRACT Objectives Basketball is a contact sport with complex movements that include jumps, turns, and changes in direction, which cause frequent musculoskeletal injuries in all regions of the body. Also, injury patterns among athletes, particularly basketball players, continue to evolve and change. The current retrospective epidemiologic study aimed to investigate the incidence, severity, and sports-related risk factors of injuries in Iranian basketball players from 2019 to 2020. Methods Using the Information Retrospective Injury Questionnaire (online version), data on basketball-related injuries were collected retrospectively for 204 basketball players of the Iranian league (professional super league and first-division league) during the 2019/2020 season. Results A total of 628 injuries were reported, which was equivalent to 6.07 injuries/1000 h. The ankle was the location of most injuries (n = 116 or 26.9%; overuse injuries (n = 40 or 20.3%)), followed by lower back/pelvis injuries (acute injury n = 67 (15.5%) and overuse injuries (n = 23; 11.6%)), knee injuries (acute injury n = 62 (15.7%) and overuse injuries (n = 31 (14.3%)), wrist/fingers injuries (acute injury (n = 85 (13.4%)) and overuse injuries (n = 8; 4.0%)), and shin/calf injuries (acute injury (n = 35; 8.1%) and overuse injuries (n = 28; 14.2%)). Mean time loss in first-division league players was much higher than professional super league players (7.84/1000 h exposure vs. 4.30/1000 h exposure), respectively. Conclusion The ankle sprain was the most common injury in our study. Lower back/pelvis injuries had the longest time loss. Injury was more frequent among first-division league players than those in the professional super league. Injuries during practice were notably more frequent than during competition with different patterns of injuries.

Epidemiology of firearm injuries in Sweden

BackgroundGun violence is a global health problem. Population-based research on firearm-related injuries has been relatively limited considering the burden of disease. The aim of this study was to analyze nationwide epidemiological trends of firearm injuries.MethodsThis is a retrospective nationwide epidemiological study including all patients with firearm injuries from the Swedish Trauma Registry (SweTrau) during the period 2011 and 2019. Registry data were merged with data from the Swedish National Council for Crime Prevention and the Swedish Police Authority.ResultsThere were 1010 patients admitted with firearm injuries, 96.6% men and 3.4% women, median age 26.0 years [IQR 22.0–36.3]. The overall number of firearm injuries increased on a yearly basis (P < 0.001). The most common anatomical injury location was lower extremity (29.7%) followed by upper extremity (13.8%), abdomen (13.8%), and chest (12.5%). The head was the most severely injured body region with a median abbreviated injury scale (AIS) of 5 [IQR 3.2–5]. Vascular injuries were mainly located to the lower extremity (42%; 74/175). Majority of patients (51.3%) had more than one anatomic injury location. The median hospital length of stay was 3 days [IQR 2–8]. 154 patients (15.2%) died within 24 h of admission. The 30-day and 90-day mortality was 16.7% (169/1010) and 17.5% (177/1010), respectively. There was an association between 24-h mortality and emergency department systolic blood pressure < 90 mmHg [OR 30.3, 95% CI 16.1–56.9] as well as the following injuries with AIS ≥ 3; head [OR 11.8, 95% CI 7.5–18.5], chest [OR 2.3, 95% CI 1.3–4.1], and upper extremity [OR 3.6, CI 1.3–10.1].ConclusionsThis nationwide study shows an annual increase of firearm-related injuries and fatalities. Firearm injuries affect people of all ages but more frequently young males in major cities. One in six patients succumbed from their injuries within 30 days with most deaths occurring within 24 h of hospital admission. Given the impact of firearm-related injuries on society additional research on a national level is critical.