Specific Injury Research Articles

Self-reported Side-effects of Ultraviolet-C Disinfection Devices.

The COVID-19 pandemic increased sales of portable UV-C devices as a means of inactivating the SARS-CoV-2 virus. Research suggests that excessive UV-C exposure to the eyes and skin can lead to side-effects, primarily photokeratitis and erythema, but these findings are limited to case studies. This study explores self-reported side-effects of UV-C devices by collating five waves of UK consumer survey data from April 2020-December 2021 (N=26 864). 30%-46% of owners report a side-effect after using a device claiming to emit UV-C. However, detailed analysis of Wave 4 data (N =309) highlights inconsistencies between reported and plausible side-effect(s) associated with skin or eye exposure from UV-C devices. Alternative explanations are considered, namely that the reported side-effect(s) were psychosomatic or misattributed to direct exposure of UV-C radiation. Data regarding awareness of warnings about device side-effect(s) supports the misattribution explanation. For risk assessment purposes, limited reliable information about specific irritation or injury to the eye and skin was found from self-reporting surveys. To optimize future data collection, we recommend addressing recall errors by: reducing the period under investigation, supplementing responses with empirical measures, and incentivizing respondents to provide accurate information about the make and model of the UV-C device.

Baseball injuries in adolescent athletes with ADHD.

At the intersection of injury-prone sports such as baseball and conditions like ADHD that affect all aspects of life, there is a lack of research. This limits the availability of preventive care programs designed to target potential risks and promote a safe experience. In this retrospective cohort study, we assess the frequency of injury in youth baseball players with and without ADHD, along with further investigation into how treatment with stimulant medication may modify risk factors. The data for this study were obtained in deidentified, aggregate format from the TriNetX research database. We identified all patients under 25 years of age with a designation of baseball activity. Within this population, we separated patients by presence or absence of ADHD diagnosis, and then by stimulant usage. The studied outcomes were injuries commonly occurring in baseball, including fractures, sprains, and specific injury patterns. We identified 17,710 patients under 25 years old with designated baseball activity, 1,183 of which had a diagnosis of ADHD. Of these, 511 had a history of stimulant medication and 470 had no history of stimulant use. For most events (i.e., injuries), there were no statistical differences between cohorts. The overall ADHD cohort significantly differed from the Not ADHD cohort in 3 events: "thorax, abdomen, pelvis injuries," "ankle sprain," and "concussion." When athletes with ADHD received treatment, this trend reversed for select injuries: "any fracture", "head or neck injuries", "upper limb injuries", and "lower limb injuries" were less likely in ADHD athletes on stimulants. Given the ongoing debate around stimulant use in athletics, our study is relevant to many patients, providers, and the baseball community.

Injuries in Physical Education Teacher Students: Differences between Sex, Curriculum Year, Setting, and Sports.

Injury risk is high in Physical Education Teacher Education (PETE) students. Insights into specific injury locations per sex, setting, sports, and curriculum year are needed to develop preventive measures. To compare injury distributions by body locations in PETE students and how these distributions differ by sex, type, onset, curriculum year, settings, or sports. In a historical cohort study over 14 years, data from 2899 students (male 76.2%, n = 1947) enlisted in the first three years of a PETE curriculum were analysed. Injuries reported at the institution's medical facility were categorised per sex, body location, onset, type, setting, sports, and curriculum year. Forty-three percent (n = 1247) of all students (female 54.9%, n = 523, male 37.2%, and n = 429) reported a total of 2129 injuries (freshmen 56.4%; 2nd year 28.2%; 3rd year 15.5%). The most prevalent sudden onset injury locations (63.4% of all injuries) were the ankle (32.5%) and knee (16.6). The most prevalent gradual onset injuries were the lower leg (27.8%) and knee (25.2%). Joint/ligament injuries (45.8%) and muscle/tendon injuries (23.4%) were the most prevalent injury types. Proportions for injury locations and injury types differed significantly between curriculum years. Injury prevalence per setting and sport differed significantly between the sexes. Injury locations differed significantly between sports and between the sexes per sport. A differential approach per injury location, onset, type, sex, setting, sports, and curriculum year is needed to develop adequate preventive measures in PETE studies. The engagement of precurricular, intracurricular, and extracurricular stakeholders is needed in the development of these measures.

Temperature-related mortality in China from specific injury

Injury poses heavy burden on public health, accounting for nearly 8% of all deaths globally, but little evidence on the role of climate change on injury exists. We collect data during 2013-2019 in six provinces of China to examine the effects of temperature on injury mortality, and to project future mortality burden attributable to temperature change driven by climate change based on the assumption of constant injury mortality and population scenario. The results show that a 0.50% (95% confident interval (CI): 0.13%–0.88%) increase of injury mortality risk for each 1 °C rise in daily temperature, with higher risk for intentional injury (1.13%, 0.55%–1.71%) than that for unintentional injury (0.40%, 0.04%–0.77%). Compared to the 2010s, total injury deaths attributable to temperature change in China would increase 156,586 (37,654–272,316) in the 2090 s under representative concentration pathways 8.5 scenario with the highest for transport injury (64,764, 8,517–115,743). Populations living in Western China, people aged 15–69 years, and male may suffer more injury mortality burden from increased temperature caused by climate change. Our findings may be informative for public health policy development to effectively adapt to climate change.

Study on Chest Injuries Due to Blunt Object in Road Accident

In India, people use local transport for travel. Since accidents prevail in these developing countries, India is not exceptional. The number of vehicle increases daily, and road accident occurs every two minutes. Chest injuries are widespread during accidental cases. This significantly contributed to the trauma during unintentional cases. Trauma generally affects young adults. Based on the above facts, the present study aims to determine the pathologies associated with chest injuries due to blunt objects in road accidents and to assess the blunt chest injuries among accident victims traveling in different road transportation modes and furthermore, to observe the injury pattern and its correlation with the victim's position during the road traffic accident. The study was carried out in the Branch of FMT, Raj Rajeswari Medical College and Hospital Bangalore. Data were collected from 100 cases of death caused by a road traffic accident that was presented for medico-legal post-mortem at the mortuary in the FMT department from December 2013 to May 2015. The study reports the maximum number (42%) of chest injuries occurred between the age group of 21-30 years, followed by 24% in the age group 31 � 40, with a maximum (62%) accidental cases in two-wheeler riders. The result showed that 48% of patients had rib fractures, 12% vertebral fractures, 10% sternum fractures, and 4% clavicle fractures during accidental cases, with haemothorax in 56% of cases. The result also showed that death was due to shock and hemorrhage in 92 patients and 6% due to coma. Specific injury prevention programs focusing on road safety should be implemented to limit and control the incidence of such injuries in light of our results.�

Characteristics of Neurovascular Injury Associated with Tendon Injury of Hand: A Retrospective Study

Introduction: Normal function of a hand depends much on the integrity of its anatomical structures. Musculotendinous injuries of the hand are frequently associated with neurovascular injury. Repair or reconstruction of all structures is important for optimal restoration of hand function. Aim: To determine the characteristics of neurovascular injury associated with musculotendinous injuries of the hand. Materials and Methods: The present study was a retrospective observational study conducted in the trauma care centre of a tertiary care teaching hospital from September 2020 to August 2021. Patients sustaining acute tendon injury of the hand of all age group and both sexes were included (n=38). Various epidemiological data like age, sex, occupation etc., and clinical and operative findings were collected and were analysed. Descriptive statistics were used and results were expressed in terms of frequency and percentages. Results: The mean age of the study population was 24 years with male patients being 30 and female patients was eight. As far as side of involvement was concerned, 17 (44.7%) patients had left-side of injury and 21 (55.3%) patients had right-side of injury. Majority of the patients, 27 (71.1%) sustained flexor Zone V injury. As to the neurovascular involvement, isolated median nerve, i.e., 10 (41.7%) and radial artery i.e., 8 (44.4%) injuries were more common. Conclusion: Neurovascular injuries associated with tendon injury of the hand is common finding. Prior knowledge of their presence and association with specific tendon injuries are beneficial for their identification and management, which ultimately leads to optimal restoration of hand function.

Effects of FIFA 11+ injury prevention program in reducing the Non-Specific knee injuries incidence rate among soccer players. A systematic review and meta-analysis

Soccer players most frequently suffer from severe leg injuries, particularly effecting the knee. Soccer players worldwide, of all ages, genders, and levels of expertise, frequently encounter with knee injuries. These injuries have a negative influence on physical activity and lost workdays, as well as high medical expenses. Therefore, it is imperative to assess the effectiveness of various injury prevention programs in lowering the number of knee injuries related to soccer. The main aim of this study is to assess the potential effects of Federation Internationale de Football Association (FIFA) 11+ injury prevention program in reducing the non-specific knee injuries in soccer players. Methodology: A systematic search was conducted in the PubMed, PubMed Central, Cochrane central library, Ovid Medline, Worldwide science (Organization), and APA Psycnet databases from February 2002 to February 2022. A total of 65,232 records were in databases, with 98 records from organizations, and after removing duplicate entries and completing the screening procedure, this meta-analysis included three cluster randomized control trials with 3,833 participants that matched our inclusion criteria. The major criteria for inclusion and exclusion were randomized control trials that used the FIFA 11 + injury prevention program for not less than 6 months and reported the overall incidence rate of knee injuries without addressing individual knee injuries. Results: The FIFA11+ injury prevention program was found to be effective based on total injuries per 1000 hours of exposure, according to pooled statistics. There was significant statistical reduction in knee injury risk ratio (IRR) of 0.477 (95% confidence interval (CI), 0.367- 0621 p=0.000). Teams using FIFA 11+ injury prevention program demonstrated up to 47% of reduction in knee injuries as compared to the control group which performed usual warm up exercises as intervention. Conclusion: This comprehensive review and meta-analysis show how effective the FIFA 11+ injury prevention program is at preventing non- specific knee injuries in soccer players. This protocol is registered in international prospective register of systematic reviews PROSPERO (CRD42022298748).

Musculoskeletal Injuries in Ice Hockey: A Review of Epidemiology, Risk Factors, Mechanisms, and Rehabilitation

Hockey players must have good coordination skills, agility, and control of their body movements. The main movement pattern is the skating, which consists of a support and a swing phase. Those who skate effectively can reach speeds up to 48 km/h. Traumatic injuries predominate in hockey, with medial collateral ligament injury being the most common injury in both genders (44/1,000 h). Overuse injuries account for a smaller proportion of injuries, with the hip joint being the most affected area. One of the most important internal risk factors is a previous injury. External risk factors relate to the level of play, player position, and the characteristics of the game. Repetitive skating patterns can cause femoroacetabular impingement syndrome. Inadequate skating technique results in a knee valgus position, which can damage the medial collateral ligament. Rapid changes of direction cause an injury of the hip adductor muscles. Torsional forces in the ankle during skating can lead to high ankle fractures, and shear forces between the tendons and the stiff tongue of the skate can lead to tendon inflammation. Prevention activities should include strengthening of the hip, knee and shoulder girdle muscles, and sport-specific exercises early in the season. At the end of the article, rehabilitation strategies for specific injuries are also discussed.

Futsal injuries: A 7-season incidence and characteristics

Most literatures describe the injury incidence in futsal during the matches, however, the true injury incidence in matches and trainings through the season is unclear. Descriptive Epidemiology Study. We investigated all injuries suffered by one futsal team in Japan after each match or training session. The number of injuries, player position, circumstances, severity, incidence and burden per 1000 player hours, locations and types of injuries were examined. A total of 518 injuries were reported during the trainings (302, 58.3%) and matches (216, 41.7%). Overall, injury incidence per 1000 player hours was 16.4 and incidence during the match (90.4) was nearly 9 times higher than during training (10.4). Total injury burden per 1000 player hours was 124.7. Injury burden was approximately 10 times higher during matches (725.8) than during training (75.4). Winger had a higher rate of injuries (267, 51.5%) and Goalkeeper had a lower injury rate (50, 9.7%). Contact injuries (278, 53.7%) and non-contact injuries (240, 46.3%) each accounted for nearly half of all injuries. More than a third of the injuries were caused by time-loss injuries (194, 37.5%). The most common injuries sustained during matches and trainings were to the lower limbs (375, 72.4%). During matches, there were more contusions and less overuse than during trainings. Ankle sprain/ligament injuries were the most common diagnoses (59, 11.4%). This study clarified the injury incidence and characteristics that occurred in futsal through trainings and matches. Based on this finding, preventive interventions for specific injury risks may be possible in the future.

Management of thoracic trauma

Managing major thoracic trauma begins with identifying and anticipating injuries associated with the mechanism of injury. The key aims are to reduce early mortality and the impact of associated complications to expedite recovery and restore the patient to their pre-injury state. While imaging is imperative to identify the extent of thoracic trauma, some pathology may require immediate treatment. The majority can be managed with adequate pleural drainage, but respiratory failure and poor gas exchange may require either non-invasive or invasive ventilation. Ventilation strategies to protect from complications such as barotrauma, volutrauma and ventilator-induced lung injury are important to consider. The management of pain is vital in reducing respiratory complications. A multimodal strategy using local, regional and systemic analgesia may mitigate respiratory side effects of opioid use. With optimal pain management, physiotherapy can be fully utilised to reduce respiratory complications and enhance early recovery. Thoracic surgeons should be consulted early for consideration of surgical management of specific injuries. With a greater understanding of the mechanisms of injury and the appropriate use of available resources, favourable outcomes can be reached in this cohort of patients. Overall, a multidisciplinary and holistic approach results in the best patient outcomes.

Vascular injury arising from lateral skull base fractures

PurposeAlthough uncommon, vascular injury can be seen in patients with lateral skull base fractures (LSBF). However, little is known about this potentially life-threatening comorbidity. The objective of this study is to better characterize the vascular injuries associated with temporal and lateral sphenoid bone fractures. Basic proceduresRetrospective review of all patients with computed tomography angiography (CTA) performed specifically to evaluate for vascular injury following LSBF. In addition to patient demographics (age, gender, race), the mechanism of injury, the location of fracture(s), and the nature of vascular injury diagnosed by CTA was recorded. Two-way ANOVA was performed to determine if any variables were predictive of vascular injury. Main findingsFrom 2011 to 2021, 143 patients with 333 subsite fractures met inclusion criteria. Of all patients, 46 (32.2 %) had CTA evidence of at least one vascular injury, the most common type being venous thrombosis/filling defect (41.7 %). Evidence of vascular injury was unclear in 14 patients (9.8 %). Fractures most associated with vascular injury ranged from 0.7 % (otic capsule fractures) to 26.7 % (mastoid, lateral sphenoid fractures). Risk of vascular injury was no different between patients with single vs multiple fractures. There were no fracture locations that could reliably predict specific vascular injury. ConclusionsOver 40 % of all CTAs ordered following LSBF identified were suspicious for associated vascular injury. Yet fracture location and number cannot reliably predict vascular injury. Until such determinants can be better identified, clinicians should have a low threshold to obtain CTA to rule out associated vascular injury.

The Clinical Features of Patients with Alzheimer’s Disease and a History of Traumatic Brain Injury

AbstractBackgroundTraumatic brain injury (TBI) has been associated with a greater risk of developing Alzheimer’s disease (AD). Previous studies have argued that AD patients with TBI history have a differences in age of disease onset, cognitive features and neuropsychiatric symptoms (NPS), but current evidence is still limited and did not always take into account injury characteristics, such as age at injury, TBI frequency, and severity. The primary objective of this study is to examine whether a history of TBI and specific injury characteristics are associated with differences in age of disease onset, cognitive features and NPS in biomarker proven AD patients.MethodBiomarker proven AD patients (CSF or amyloid PET, stage MCI or dementia) were selected from the Amsterdam Dementia Cohort. TBI events were classified by severity, frequency and age at injury (TBI <25 or ≥25 years). Cognitive composite scores were calculated from results of a neuropsychological test battery. Neuropsychiatric symptoms (NPS) were assessed with the Neuropsychiatric Inventory Questionnaire (NPI‐Q). Linear regression analyses were utilized to examine the association between TBI, injury characteristics and clinical outcome measures.ResultAmong the 1755 selected AD patients (mean age 65.2), 166 patients (9.5%) reported ≥1 TBI in their history. Overall, a history of TBI was not related to differences in age at AD, but age at injury <25 years old was associated with a 2.3 years earlier age at diagnosis (β = ‐2.34 P = 0.031), which was independent of APOE e4 status. No significant associations were found between TBI history or age at injury and differences in cognitive functioning or NPS.ConclusionThe findings of our study indicate that TBI during childhood, adolescence or early adulthood may influence age of disease onset in AD patients. This underscores previous findings on vulnerability of the brain during critical development and maturation phases and suggest that an early TBI may contribute to lower resilience or higher vulnerability to neurodegenerative changes. TBI history does not seem to affect cognitive characteristics and NPS profiles in AD patients.

Death Due to Acrylic Adhesive (Dichloromethane): A Case Report

Deaths due to dichloromethane (DCM) poisoning are mainly caused due to accidents at industrial sites, and suicidal cases are known to be rare. Herein, we report a case of a 56-year-old man who worked as a technician and died after consuming DCM for suicidal motive. According to the investigations, he had left a recorded message on his phone for his wife, which suggested he committed suicide. At the scene, opened DCM and whiskey bottles were found; approximately 120 mL of the DCM was still in the bottle. No specific injuries were externally observed during the autopsy. Microscopic examination showed denudation of epithelium in the esophageal and gastric mucosa, and no inflammatory reaction proceeded. The denudation was accompanied by pulmonary edema, acute tubular necrosis in the kidneys, and microvesicular steatosis in the liver. The DCM was detected in blood, gastric contents, and nasal cavity fluid. The concentration of alcohol in the blood was found to be 0.487%. It was presumed that he died of acute DCM poisoning while drunk. In cases of suspicious acute and chronic DCM poisoning deaths, investigations of carboxyhemoglobin and the clinical chemistry of blood or body fluids are warranted to determine the cause and mechanism of death.

High sensitivity troponins: A potential biomarkers of cardiovascular risk for primary prevention.

There have been several approaches to building charts for CV risk, all of which have both strengths and limitations. Identifying early organ damage provides relevant information and should be included in risk charts, although the direct relationship with risk is imprecise, variability between operators at the time to assess, and low availability in some healthcare systems, limits its use. Biomarkers, like troponin (cTns) isoforms cTnI and cTnT, a cardiac specific myocyte injury marker, have the great advantage of being relatively reproducible, more readily accessible, and applicable to different populations. New and improved troponin assays have good analytical performance, can measure very low levels of circulating troponin, and have low intra individual variation, below 10 %. Several studies have analyzed the blood levels in healthy subjects and their predictive value for cardiovascular events in observational, prospective and post-hoc studies. All of them offered relevant information and shown that high sensitivity hs-cTnI has a place as an additional clinical marker to add to current charts, and it also reflects sex- and age-dependent differences. Although few more questions need to be answered before recommend cTnI for assessing CV risk in primary prevention, seems to be a potential strong marker to complement CV risk charts.

Longitudinal study of six seasons of match injuries in elite female rugby union

ObjectiveTo establish match injury rates and patterns in elite female rugby union players in England.MethodWe conducted a six-season (2011/2012–2013/2014 and 2017/2018–2019/2020) prospective cohort study of time-loss match injuries in elite-level...

Rising Mortality in Pediatric Self-Inflicted Firearm Trauma Associated With Distinct Anatomic Injury

IntroductionSelf-inflicted injuries are the second leading cause of pediatric (10-18 y old) mortality. Self-inflicted firearm trauma (SIFT) was responsible for up to half of these deaths in certain age groups. We hypothesized that SIFT prevalence has increased and is associated with specific demographics, injury patterns, and outcomes. Materials and methodsData were abstracted from the 2007-2018 American College of Surgeons (ACS) Trauma Quality Programs Participant Use Files (TQP-PUF). Pediatric (1-17 yold) victims of firearm violence were eligible. Age, race, gender, anatomic region, and intent were abstracted. Variables were analyzed using chi-squared tests, t-tests, and single-variate linear regression models. Temporal trends were analyzed using ANCOVA tests. Multivariate logistic regressions were conducted to identify factors influencing mortality. Significance was P < 0.05. ResultsThere were 41,239 pediatric firearm trauma patients (SIFT: 5.5% [n = 2272]). SIFT incidence increased over the 12-y period (2007 (n = 67) versus 2018 (n = 232), P < 0.05). SIFT was significantly associated with Caucasian race, 67% (n = 1537), teenagers, 90% (n = 2056), male gender, 87% (n = 1978), and a higher median injury severity score (ISS) than other intents of injury (SIFT: 20.0 (IQR: 9.0, 25.0) versus other: 9.0 (IQR: 1.0-13.0), P < 0.001). The SIFT mortality rate was 44% (n = 1005). On multivariate regression head gunshot wounds (OR: 21.1, 95% C.I.: 9.9-45.2, P = 0.001), and ISS (OR:1.1, 95% C.I.: 1.1-1.1, P = 0.001) were significantly associated with mortality. Compared to other intents, SIFT mortality rates increased at a higher annual rate (P < 0.001). ConclusionsComprehensive local and federal policy changes to reduce firearms access and increase pediatric mental health support may mitigate these injuries.

Effectiveness of WeChat-group-based parental health education in preventing unintentional injuries among children aged 0–3: randomized controlled trial in Shanghai

BackgroundUnintentional injuries to children are a major public health problem. The online social media is a potential way to implement health education for caregivers in online communities. Using WeChat, a free and popular social media service in China, this study evaluated the effectiveness of social online community-based parental health education in preventing unintentional injuries in children aged 0–3.MethodsWe recruited 365 parents from two community health centers in Shanghai and allocated them into intervention and control groups randomly. Follow-up lasted for one year. The intervention group received and followed their WeChat group and a WeChat official account for dissemination of reliable medical information. The control group received only the WeChat group.ResultsBetween the intervention and control groups, changes in unintentional injuries (OR = 1.71, 95% CI: 1.02–2.87, P = .04), preventability (β = 0.344, 95% CI: 0.152–0.537, P < .001), daily supervision behavior (β = 0.503, 95% CI: 0.036–0.970, P = .04), and behaviors for preventing specific injuries (β = 2.198, 95% CI: 1.530–2.865, P < .001) were significantly different, and change in first-aid skills for treating a tracheal foreign body were nearly significant (P = .06).ConclusionsThe WeChat-group-based parental health education can reduce the occurrence of unintentional child injuries by improving parents’ skills, beliefs, and behaviors. Online social communities promote health education and reduce unintentional injuries among children.Trial registrationChiCTR1900020753. Registered on January 17, 2019.

Cognitive functions and symptoms predicting later use of psychiatric services following mild traumatic brain injury in school-age

ABSTRACT Objective To investigate whether neuropsychological test performance or presence of some specific injury symptoms at 1–3 months following pediatric mild traumatic brain injury (mTBI) can help to identify the children at risk for developing post-traumatic psychiatric symptoms. Methods Data from 120 children and adolescents aged 7–15 years, treated at Turku University Hospital between 2010 and 2016 due to mTBI, and who had undergone neuropsychological evaluation at 1–3 months following injury, were enrolled from the hospital records. Neuropsychological test performancesand injury symptom reports were retrospectively retrieved from the patient files. Results Slow information processing speed (p = 0.044), emotion regulation deficit (p = 0.014), impulsivity (p = 0.013), verbal processing difficulties (p = 0.042) and headache (p = 0.026) were independent predictors for having later contact in psychiatric care. Conclusions Neuropsychological examination containing measure of information processing speed, injury symptom interview, and parental questionnaires on behavioural issues of the child at 1–3 months following mTBI seems to be useful in detecting children with risk for post traumatic psychiatric symptoms. Targeted support and guidance for this group of children and adolescents and their families are recommended to prevent the development of an unfavorable psychosocial outcome.

Management of Traumatic Atlantooccipital Dissociation at a Level 1 Trauma Center: A Retrospective Case Series

Atlantooccipital dislocation (AOD) is a highly unstable and often neurologically devastating injury to the craniocervical junction that typically results from high-energy trauma. Management of these devastating injuries is complex, with prognostication difficult due to high rates of concomitant intracranial and systemic injuries. This report highlights advances in management of AOD andappropriate implementation of operative adjuncts including neuronavigation and the use of intraoperative neuromonitoring. All patients with AOD presenting to a high-volume, level 1 trauma center between January 2015 and August 2021 were retrospectively identified through a prospectively maintained database of patients presenting with traumatic spine injuries. Medical records, including imaging reports, clinical documentation, and intraoperative neurophysiological reports were reviewed. A total of 11 patients were identified with patterns of injury consistent with AOD. Fifty-five percent of patients survived until discharge. 73% of patients underwent surgery for stabilization. All 4 patients with preoperative neurologic deficits who underwent surgery had monitorable transcranial motor evoked potentials and somatosensory evoked potentials. Two experienced significant motor recovery postoperatively, and 2 did not survive to discharge. Blunt cerebrovascular injuries were identified in 73% of patients. AOD is encountered with increasing frequency. The identification and management of this specific injury is complicated by the volume and severity of associated injuries, especially concomitant traumatic brain injury. Timely recognition is critical and the use of surgical adjuncts including intraoperative neurophysiologic monitoring and surgical navigation can increase the safety and success of these procedures while also providing prognostic information on potential for motor recovery.

Injury mortality and morbidity changes due to the COVID-19 pandemic in the United States.

The COVID-19 pandemic significantly changed society. We aimed to examine the systematic impact of the COVID-19 on injury burden in the United States. We extracted mortality and morbidity data from CDC WONDER and WISQARS. We estimated age-standardized injury mortality rate ratio and morbidity rate ratio (MtRR and MbRR) with 95% confidence interval (95% CI) for all injuries, all unintentional injuries, homicide/assault by all methods, suicide/self-harm by all methods, as well as other 11 specific unintentional or intentional injury categories. Injury rate ratios were compared for 2020 vs. 2019 to those of 2019 vs. 2018 to demonstrate the influence of the COVID-19 pandemic on fatal and nonfatal injury burden. The ratio of MtRRs (RMtRR) and the ratio of MbRRs (RMbRR) with 95% CI between 2020 vs. 2019 and 2019 vs. 2018 were calculated separately. The COVID-19 pandemic was associated with an increase in injury mortality (RMtRR = 1.12, 95% CI: 1.11, 1.13) but injury morbidity decreased (RMbRR = 0.88, 95% CI: 0.88, 0.89) when the changes of these rates from 2019 to 2020 were compared to those from 2018 to 2019. Mortality disparities between the two time periods were primarily driven by greater mortality during the COVID-influenced 2020 vs. 2019 from road traffic crashes (particularly motorcyclist mortality), drug poisoning, and homicide by firearm. Similar patterns were not present from 2019 vs. 2018. There were morbidity reductions from road traffic crashes (particularly occupant and pedestrian morbidity from motor vehicle crashes), unintentional falls, and self-harm by suffocation from 2019 to 2020 compared to the previous period. Change patterns in sexes and age groups were generally similar, but exceptions were observed for some injury types. The COVID-19 pandemic significantly changed specific injury burden in the United States. Some discrepancies also existed across sex and age groups, meriting attention of injury researchers and policymakers to tailor injury prevention strategies to particular populations and the environmental contexts citizens face.