Risk Factors For Serious Injury Research Articles

Prevalence of alcohol and other drug detections in non-transport injury events.

To measure the prevalence of alcohol and/or other drug (AOD) detections in suspected major trauma patients with non-transport injuries who presented to an adult major trauma centre. This registry-based cohort study examined the prevalence of AOD detections in patients aged ≥18 years who: (i) sustained non-transport injuries; and (ii) met predefined trauma call-out criteria and were therefore managed by an interdisciplinary trauma team between 1 July 2021 and 31 December 2022. Prevalence was measured using routine in-hospital blood alcohol and urine drug screens. A total of 1469 cases met the inclusion criteria. Of cases with a valid blood test (n = 1248, 85.0%), alcohol was detected in 313 (25.1%) patients. Of the 733 (49.9%) cases with urine drug screen results, cannabinoids were most commonly detected (n = 103, 14.1%), followed by benzodiazepines (n = 98, 13.4%), amphetamine-type substances (n = 80, 10.9%), opioids (n = 28, 3.8%) and cocaine (n = 17, 2.3%). Alcohol and/or at least one other drug was detected in 37.4% (n = 472) of cases with either a blood alcohol or urine drug test completed (n = 1263, 86.0%). Multiple substances were detected in 16.6% (n = 119) of cases with both blood alcohol and urine drug screens (n = 718, 48.9%). Detections were prevalent in cases of interpersonal violence (n = 123/179, 68.7%) and intentional self-harm (n = 50/106, 47.2%), and in those occurring on Friday and Saturday nights (n = 118/191, 61.8%). AOD detections were common in trauma patients with non-transport injury causes. Population-level surveillance is needed to inform prevention strategies that address AOD use as a significant risk factor for serious injury.

Comparison of routine blood alcohol tests and ICD-10-AM coding of alcohol involvement for major trauma patients.

Alcohol use is a key preventable risk factor for serious injury. To effectively prevent alcohol-related injuries, we rely on the accurate surveillance of alcohol involvement in injury events. This often involves the use of administrative data, such as International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) coding. To evaluate the completeness and accuracy of using administrative coding for the surveillance of alcohol involvement in major trauma injury events by comparing patient blood alcohol concentration (BAC) with ICD-10-AM coding. This retrospective cohort study examined 2918 injury patients aged ≥18 years who presented to a major trauma centre in Victoria, Australia, over a 2-year period, of which 78% (n = 2286) had BAC data available. While 15% of patients had a non-zero BAC, only 4% had an ICD-10-AM code suggesting acute alcohol involvement. The agreement between blood alcohol test results and ICD-10-AM coding of acute alcohol involvement was fair (κ = 0.33, 95% confidence interval: 0.27-0.38). Of the 341 patients with a non-zero BAC, 82 (24.0%) had ICD-10-AM codes related to acute alcohol involvement. Supplementary factors Y90 Evidence of alcohol involvement determined by blood alcohol level codes, which specifically describe patient BAC, were assigned to just 29% of eligible patients with a non-zero BAC. ICD-10-AM coding underestimated the proportion of alcohol-related injuries compared to patient BAC. Given the current role of administrative data in the surveillance of alcohol-related injuries, these findings may have significant implications for the implementation of cost-effective strategies for preventing alcohol-related injuries.

Injury risk factors to farm and ranch operators in the Central United States.

This study focused on risk factors for serious injuries in farm and ranch operators in the central United States. The Central States Center for Agricultural Safety and Health, in collaboration with the National Agricultural Statistics Service, sent mail surveys to 6953, 6912, and 6912 farms/ranches in 2011-2013, respectively, covering seven Midwestern states. The average survey response rate was 35%. The average annual incidence rate (injuries/100 workers) was 6.91 for all injuries and 2.40 for serious injuries. Univariate analyses determined several demographic and farm production-related risk factors for serious injury. Adjusted analysis showed a greater risk of serious injury for operators of age 45-54 years (vs. 65 and higher), those who worked 75-99% of their time (vs. less time), and those who operated larger land areas (vs. smaller). The identified risk factors should be considered when targeting injury prevention programs.

The association of long-term alcohol biomarkers with risk for alcohol-related injury: Implications for screening

Alcohol misuse is a leading risk factor for serious injury and death. For those experiencing trauma in emergency care settings, recent alcohol misuse history is typically assessed via self-report measures. Since underreporting may be a problem in these settings, objective indicators like long-term biomarkers may be useful for identifying hazardous drinkers who may need intervention. Recognizing this, we investigated (1) whether hazardous drinking was linked to reports of alcohol-related injury in a probability sample of over 600 college students from a large, Midwestern, urban university; (2) whether elevated long-term biomarkers showed similar associations in the same sample. Associations derived from responses to the Alcohol Use Disorder Identification Test-C (AUDIT-C) as well as from hair and fingernails tested for ethyl glucuronide, a direct alcohol biomarker, suggested that hazardous drinking is significantly associated with elevated risk for alcohol-related injury. Implications for screening and intervention in health care settings are discussed.

Trampoline-related injuries in children: a preliminary biomechanical model of multiple users

BackgroundThe recent popularity of domestic trampolines has seen a corresponding increase in injured children. Most injuries happen on the trampoline mat when there are multiple users present. This study sought...

A 10-Year Population Survey of Spinal Trauma and Spinal Cord Injuries after Road Accidents in the Rhône Area

Fatalities or injuries following motorized and non-motorized vehicle accidents (MNMVA) are reported by police or health care systems. However, limited data exist for spinal injuries. Using an epidemiological database of road accidents occurring in a defined geographic area, we measured the incidence of major spinal trauma (MST, Abbreviated Injury Scale [AIS] score 2 or more), spinal cord injury (SCI, AIS score 4 or more), and associated lesions over a 10-year period (1997-2006). Among the 97,341 victims included, 21,623 (22.2%) suffered spinal trauma, but only 1523 (1.6%) and 144 (0.2%) sustained an MST or SCI, respectively, and among those 10% and 43% died, respectively, before reaching hospital facilities. Men were more likely to have SCI and die. Cervical injuries were more frequently observed for SCI (58%) than for MST (39%; p < 0.001). Motorcyclists were overrepresented in SCI (33%) compared to MST (21%; p < 0.001), and were at significant risk for fatality. Non-restrained car occupants were at risk of MST and SCI, whereas motorcyclists wearing helmets were not. The chest was the most frequently-injured body region. Nearly half of MNMVA victims suffering SCI die quickly after the crash. Young age, male gender, a motorcyclist, and non-restrained car occupant were risk factors for serious injury. These groups should be targeted in specific programs to decrease fatalities, spinal trauma, and SCI after MNMVA.

Pedestrian Injuries in an Ageing Society: Insights From Hospital Trauma Registry

Traffic safety of the elderly is a growing public health issue. This study makes use of a linked hospital and police database. A total of 4,290 traffic casualty records were analyzed. The proportions of serious injury and mortality for different age groups are compared between pedestrian and nonpedestrian injuries. Logistic regression analysis is used to examine the relative significance of age, injury pattern, gender, crash time, and vehicle type on each dependent variable of hospital stay > or = 7 days, injury severity score (ISS) > 15, ISS > 30, and mortality. The shares of pedestrian casualties with serious injury increased with higher age groups. Among pedestrian casualties, aged > or = 65 years was the only statistically significant variable in accounting for ISS > 30 and mortality. Aged > or = 65 years, lower extremity injury and heavy vehicles were important in accounting for long hospital stay. For ISS > 15, aged > or = 65 years, head or face injury, and thorax or abdomen injury were significant risk factors. After adjusting for confounding factors, the risk of hospital stay > or = 7 days, ISS > 15, ISS > 30, and mortality for an elderly pedestrian injury was 4.24 times (95% CI, 2.46-7.29), 2.77 times (95% CI, 1.17-6.55), 5.16 times (95% CI, 1.38-19.34), and 3.61 times (95% CI, 1.16-11.25) higher than a younger adult (aged 15-64 years). In contrast, age was not a significant independent risk factor for serious injury and mortality among nonpedestrian injuries. Most developed economies are facing the problem of ageing. To develop an effective strategy to deal with elderly pedestrian trauma, a good quality linked database is a prerequisite.

Risk factors for serious injury in Finnish agriculture

Previous studies indicate 20% of injuries represent 80% of injury costs in agriculture. To help prevent the most costly injuries, we aimed to identify characteristics and risk factors associated with serious injuries. We analyzed insurance records of 93,550 self-employed Finnish farmers. We ranked injury causes by claim cost and used multiple logistic regressions to identify risk factors for (any) injury and serious injury (injuries exceeding claim costs of 2000 euros). A total of 5,507 compensated injuries occurred in 2002 (rate 5.9/100 person-years), and 1,167 or 21% of them (rate 1.25/100 person-years) were serious. The causes/sources resulting in highest average claim costs were motor vehicles; stairs, scaffoldings, and ladders; trailers and wagons; floors, walkways, and steps; other structures and obstacles; augers, mills, and grain handling equipment; horses; combines and harvesting equipment; tractor steps; and uneven and slippery terrain. Older age, male gender, higher income level, greater field size, residing on the farm, Finnish language (vs. Swedish), occupational health service (OHS) membership, and animal production were risk factors for injury. The risk factors for serious injury were similar; however, the effects of age, income level, and the raising of horses were more prominent. Language, residence, ownership status, and OHS membership were not risk factors for serious injury. Cost-effective prevention efforts should address the following risk factors: older age, male gender, larger income and operation size, livestock production (particularly dairy, swine, and horses), motor vehicle incidents, falls from elevation, and slips, trips and falls.

Use of Subjective and Physiological Indicators of Sleepiness to Predict Performance during a Vigilance Task

Sleepiness is a major risk factor for serious injury and death in accidents. Although it is important to develop countermeasures to sleepiness to reduce risks, it is equally important to determine the most effective timing for these countermeasures. To determine optimum timing for necessary countermeasures, we must be able to predict performance errors. This study examined the predictability of subjective and physiological indicators of sleepiness during a vigilance task. Thirteen healthy male volunteers (mean age, 26.9 yr; SD = 5.98 yr; range 22-43 yr) participated in the study. Participants used the Karolinska sleepiness scale (KSS) to rate their subjective sleepiness every 4 min during a 40-min Mackworth clock test. Electrophysiological and performance data were divided into 10 epochs (i.e., 1 epoch lasted for 4 min). To estimate predictability, the data from the sleepiness indicators used for the correlation analysis were preceded by one epoch to the performance data. Results showed that sleepiness indicators (KSS score and electroencephalographic [EEG] alpha activity) and standard deviation of heart rate (SDNN) were significantly correlated with succeeding performance on the vigilance test. These findings suggest that the KSS score, EEG alpha activity, and SDNN could be used to predict performance errors.

FiGHTS: A preliminary screening tool for adolescent firearms-carrying

Study objective Adolescent firearms-carrying is a risk factor for serious injury and death. Clinical screening tools for firearms-carrying have not yet been developed. We present the development of a preliminary screening test for adolescent firearms-carrying based on the growing body of knowledge of firearms-related risk factors. Methods A convenience sample of 15,000 high school students from the 1999 National Youth Risk Behavior Survey was analyzed for the purpose of model building. Known risk factors for firearms-carrying were candidates for 2 models predicting recent firearms-carrying. The “brief FiGHTS score” screening tool excluded terms related to sexual behavior, significant substance abuse, or criminal behavior (Fi=fighting, G=gender, H=hurt while fighting, T=threatened, S=smoker). An “extended FiGHTS score,” which included 13 items, was developed for more precise estimates. Results The brief FiGHTS score had a sensitivity of 82%, a specificity of 71%, and an area under the receiver operating characteristic (ROC) curve of 0.84. The extended FiGHTS score had an area under the ROC curve of 0.90. Both models performed well in a validation data set of 55,000 students. Conclusion The brief and extended FiGHTS scores have high sensitivity and specificity for predicting firearms-carrying and may be appropriate for clinical testing.

FiGHTS: a preliminary screening tool for adolescent firearms-carrying.

Adolescent firearms-carrying is a risk factor for serious injury and death. Clinical screening tools for firearms-carrying have not yet been developed. We present the development of a preliminary screening test for adolescent firearms-carrying based on the growing body of knowledge of firearms-related risk factors. A convenience sample of 15,000 high school students from the 1999 National Youth Risk Behavior Survey was analyzed for the purpose of model building. Known risk factors for firearms-carrying were candidates for 2 models predicting recent firearms-carrying. The "brief FiGHTS score" screening tool excluded terms related to sexual behavior, significant substance abuse, or criminal behavior (Fi=fighting, G=gender, H=hurt while fighting, T=threatened, S=smoker). An "extended FiGHTS score," which included 13 items, was developed for more precise estimates. The brief FiGHTS score had a sensitivity of 82%, a specificity of 71%, and an area under the receiver operating characteristic (ROC) curve of 0.84. The extended FiGHTS score had an area under the ROC curve of 0.90. Both models performed well in a validation data set of 55,000 students. The brief and extended FiGHTS scores have high sensitivity and specificity for predicting firearms-carrying and may be appropriate for clinical testing.

Epidemiology of bicycle injuries and risk factors for serious injury.

OBJECTIVE: To determine the risk factors for serious injury to bicyclists, aside from helmet use. DESIGN: Prospective case-control study. SETTING: Seven Seattle area hospital emergency departments and two county medical...

Risk factors for serious injury during falls by older persons in the community

Risk factors for serious injury during falls by older persons in the community

Risk factors for serious injury during falls by older persons in the community.

Serious fall injury represents a little studied, yet common and potentially preventable, cause of morbidity and mortality among older persons. We determined the frequency of, and risk factors for, experiencing serious fall injury events among older persons in the community. A representative sample of 1103 community-living persons aged 72 years and older underwent comprehensive baseline and 1-year evaluations. During a median 31 months of follow-up, fall data were obtained using fall calendars. Injury data were obtained from telephone interviews and from surveillance of emergency room and hospital records. At least one fall was experienced by 546 (49%) participants. A total of 123 participants, representing 23% of fallers and 12% of the cohort, experienced 183 serious fall injury events. The factors independently associated with experiencing a serious injury during a fall included cognitive impairment (adjusted odds ratios 2.2; 95% confidence interval 1.5, 3.2); presence of at least two chronic conditions (2.0; 1.4, 2.9); balance and gait impairment (1.8; 1.3, 2.7); and low body mass index (1.8; 1.2, 2.5). In a separate analysis, including only subjects who fell, female gender (1.8; 1.1, 2.9) as well as most of the above factors were associated with experiencing a fall injury. Several readily identifiable factors appeared to distinguish the subgroup of older fallers at risk for suffering a serious fall injury. These factors should help guide who and what to target in prevention efforts.