PURPOSES: There have been many efforts to improve the service of emergency centers. In spite of these, no evidence is showing any landmark advancement of emergency services, especially in the hospital stage, exists. We need some efficient standard criteria to evaluate emergency service in the hospital stage, and a useful method might utilize the overcrowding index. We want to know the change in the overcrowding index at a regional emergency center after injury area administration. Injury area means an area in which only an assigned duty physician manages patients with injuries such as those from traffic accidents, falls, assualts, collisions, lacerations, amputations, burns, intoxication, asphyxia, drowning, animal bites, sexual assualts, etc. METHODS: We started to operate an injury area in our emergency department from late 2004, and from January to June in 2004 and in 2005, we collected patients' data, age, sex, assigned department, and result from hospital order communication system to figure out overcrowding indices and result indices. We found the daily number of patients, the turnover rate, the admission rate, the ICU admission rate, the emergency operation rate, the ED stay duration, and the ED patient volume to be overcrowding indices. Also we found the withdrawal rate, the transfer rate, and mortality to be result indices. We compared these indices between 2004 to 2005 by using a t-test. RESULTS: There was a significant increase in the daily number of visiting patients in 2005, overcrowding indices, such as the turnover rate, the admission rate, the ICU admission rate, and the emergency operation rate, also showed statistically significant increases in 2005 (P<0.001). As for the result indices, there was a noticeable decrease in the number of withdrawals (11.77/day in 2004 to 4.53/day in 2005). CONCLUSION: Operating an injury area in a mildly overcrowded local emergency center is beneficial. Evaluating the effect of operating an injury area and it's impact on hospital finances by conducting a similar study analyziing patients for a longer duration would be valuable.
Accidents, Traffic ; Amputation ; Animals ; Asphyxia ; Burns ; Drowning ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Lacerations ; Mortality

PURPOSE: This study was conducted to analysis the trends and states of external auses of mortality in Korea from 1985 to 1998. METHODS: This study was based on data published in 1985-1998 from the annual report of cause of death statistics of National Statistical Office. RESULTS: In the proportion of total death cases during 1985-1998, External causes of mortality was ranged from 11 percent to 15 percent. Death rate(per 100,000) of external causes of mortality(ECM) decreased recently from 85.7 in 1991 to 68.9 in 1998. Death rate of ECM in male was 2.6 times higher than that of female. Among total cases of ECM, the first leading cause of death was transport accidents. intentional self-harm was the second leading cause of death(26.8 percent in 1998). In trends of death rate(per 100,000) for ECM during 1885-1998, there were decreased for following causes of death; transport accidents, falls, accidental drowning and submersion, exposure to smoke, fire and flames, accidential poisoning by and exposure to noxious substances, Death rates of ententional self-harm and assault were increased during the periods. The age specific death rate increased with age for all ECM except for assault. The risk of death caused by ECM was higher in aged 65 and over than in ages 0-19 years among all ECM. The risk of death for male aged 65 and over were 6.9 times in transport accidents, 26 times in fall, 37 times in accidential poisoning by and exposure to noxious substances, and 18 times in intentional self-harm compared with 0-19 years. The risk of death for female aged 65 and over were 27 times in fall, 22 times in accidential poisoning by and exposure to noxious substances compared with 0-19 years. In seasonal variation of ECM cases for 1998. There was highest proportion in August(10.4 percent). The highest proportion by death seasion were winter(32.7 percent) in exposure to smoke, fire and flames, summer(27,7 percent) in fall, summer(52.4 percent) in accidental drowning and submersion, summer in 32.0 percent) in accidential poisoning by and exposure to noxious substances, spring(28.2 percent) in intentional self-harm, assault. and autumn(28.2 percent) in transport accidents. CONCLUSION: Above results suggest that a preventive education program for safety accidents should be developed by considering gender and age of the objecties and seasons of the year.
Accidental Falls ; Cause of Death ; Drowning ; Education ; Female ; Fires ; Humans ; Immersion ; Korea* ; Male ; Mortality* ; Poisoning ; Seasons ; Smoke

OBJECTIVETo study the trend of accidental death among children under 5 years of age in Beijing.

METHODSCases of death in children under 5 years old in Beijing, during 2003-2012 were collected, to analyze the strength and trends of accidental death, main causes of accident and its epidemiological features.

RESULTSThe overall accidental death was 8.47% of all death among children under 5 years old in Beijing during 2003-2012. During these 10 years, data showed a downward trend on the mortality rates on injuries (P < 0.05), especially on drowning, in 1-4 year old and rural children under five years of age. In 2012, the accidental death rate of children under five was 6.37/105. The 5 main causes of accidental deaths were suffocation, traffic accident, falling, poisoning and drowning, in order of size. The main causes of death were suffocation in the 0-1 year group, suffocation and traffic accident in the 1-2 year group and traffic accident in the 3-4 year group. The proportion of deaths due to traffic accident increased gradually with age. Area distribution showed that accidental deaths mainly happened in rural area (52.19%), with two main types as traffic accident and suffocation.

CONCLUSIONThe reduction of accidental death rate among children under 5 years old in Beijing mainly was caused by the decline of accident mortality in 1-4 year old and children in the rural areas. Our data suggested that the focus in reducing the accidental death rate among children under 5 years old in Beijing should target on the prevention of infant suffocation and traffic accidents among the 1-4 year old, with rural areas in particular.

Accidents ; mortality ; Accidents, Traffic ; mortality ; Asphyxia ; mortality ; Cause of Death ; Child Mortality ; Child, Preschool ; China ; epidemiology ; Drowning ; mortality ; Female ; Humans ; Infant ; Male ; Suicide

OBJECTIVETo study the epidemiological transition of injuries in Ningxia.

METHODSDemographic and mortality data during 1990s in Ningxia were collected and analyzed for temporal trend with linear regression model.

RESULTSDuring the past decade, mortality of injury raised by 28.22% among the residents in Ningxia and ranked the 3rd place in the causes of deaths. In 1999, the top four leading causes of injury deaths were traffic accident, suicide, drowning and poisoning. Overall injury mortality and mortalities of traffic accident and suicide increased, but mortality of drowning decreased during the past decade. As predicted, suicide will rank the 1st place in the causes of deaths among the residents in Ningxia by 2005.

CONCLUSIONSInjury was one of major risk factors influencing health and death among the residents in Ningxia, with a temporal trend in its incidence. Effective research, prevention and control of traffic accident, suicide, drowning and poisoning should be focused.

Accidents, Traffic ; Cause of Death ; China ; epidemiology ; Drowning ; Humans ; Mortality ; trends ; Poisoning ; Suicide ; Survival Rate ; Wounds and Injuries ; epidemiology ; mortality

Medicolegal autopsies are a vital tool for obtaining reliable injury mortality data. This study statistically analyzed the data obtained from medicolegal autopsies performed in Korea in 2014. A total of 5,324 deaths were analyzed by sex, age, manner of death, and cause of death. With respect to the manner of death, 56.3% were recorded as unnatural deaths, 38.4% were natural deaths, and 5.3% had unknown causes. Of the 2,998 unnatural deaths, 41.0% were determined to be accidental deaths; 28.1%, suicidal; 16.1%, homicidal; and 14.8%, undetermined. Of the total number of unnatural deaths, 38.8% were trauma-related, wherein falls accounted for 32.7%. Asphyxiation accounted for 16.3% of unnatural deaths; of these, the predominant cause was hanging (59.4%). In addition, 15.0% of the unnatural deaths were due to drowning; 14.8%, poisoning; 11.3%, thermal injuries; 2.5%, complications arising from medical procedures; and 0.4%, electrocution, starvation, or neglect. Among the 2,042 natural deaths, heart diseases accounted for 49.0% and vascular diseases accounted for 17.3%. Of the 170 deaths among children under the age of 10, 38.8% were recorded as unnatural deaths, 54.1% were natural deaths, and 7.1% had unknown causes.
Autopsy* ; Cause of Death ; Child ; Data Interpretation, Statistical ; Drowning ; Heart Diseases ; Humans ; Korea* ; Mortality ; Poisoning ; Starvation ; Vascular Diseases

PURPOSE: Historically, acute respiratory failure is the most common cause of death in drowning patients. However, there are an increasing number of severe drowning cases where patients die of circulatory failure or cardiovascular collapse. The aim of this study was to analyze the causes of death in severe drowning patients and evaluate the data in terms of survival curves in order to propose a treatment plan for severe drowning patients in the future. METHODS: The subjects were 58 patients that visited St. Mary's Hospital from January 2000 to September 2006 who had drowned and required CPR and mechanical ventilation. Univariate analysis was performed to evaluate factors known to be predictive of severity. Survival analysis was done to determine the degrees of correlation with acute respiratory distress syndrome (ARDS) and refractory shock. RESULTS: Thirty-nine out of 58 severely drowning patients expired in all, with most deaths occurring in the early stages - 45% expired on the first day, 55% on the second day, and 60% on the third day. Cause of death analysis yielded the following results: the correlation coefficient for the existence of ARDS was 2.96 (p=0.086), which did not achieve statistical significance, but, the coefficient for refractory shock was 9.23 (p=0.002) and was statistically significant. CONCLUSION: Most severe drowning patients expired in the first three days after drowning, and refractory shock was a more significant contributor to patients death than ARDS. This result underscores the need for treatment protocols that includes active management of hemodynamic instability combined with mechanical ventilatory management in the initial stages of treatment.
Cardiopulmonary Resuscitation ; Cause of Death ; Clinical Protocols ; Drowning* ; Hemodynamics ; Humans ; Mortality ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; Respiratory Insufficiency ; Shock

Medicolegal autopsy is a vital tool for obtaining reliable injury mortality data. This study statistically analyzed data obtained from medicolegal autopsies performed in Korea in 2013. The aim of this study was to analyze various aspects of the 4,861 deaths that were categorized as unusual in Korea in 2013. A total of 4,861 deaths were analyzed by gender, age, manner of death, and cause of death. Of the 4,861 deaths, 3,542 (73.3%) were of men and 1,302 (26.7%) were of women. With respect to the manner of death, 54.4% were recorded as unnatural deaths, 38.8% were natural deaths, and 6.9% had unknown causes. Of the 2,642 unnatural deaths, 45.0% were determined to be accidental deaths, 26.3% suicidal, 16.9% homicidal, and 11.8% undetermined. Of the total number of unnatural deaths, 42.1% were trauma-related deaths, for which falling down accounted for 33.8%. Asphyxiation accounted for 16.0% of unnatural deaths, and of these, the predominant cause was hanging (58.8%). In addition, 14.4% of deaths were due to drowning, 12.9% poisoning, 11.0% thermal injuries, 1.8% complications arising from medical procedures, and 0.8% electrocution, starvation, or neglect. Among the 1,886 natural deaths, heart diseases accounted for 52.0% and vascular diseases accounted for 16.9%. Of the 196 deaths among children under the age of 10 years, 41.8% were recorded as unnatural deaths, 45.1% were natural deaths, and 1.5% had unknown causes.
Autopsy* ; Cause of Death ; Child ; Data Interpretation, Statistical ; Drowning ; Female ; Heart Diseases ; Humans ; Korea ; Male ; Mortality ; Poisoning ; Starvation ; Vascular Diseases

OBJECTIVE: This paper aims to quantify the magnitude of drowning injury related deaths among children in the Philippines, to form the evidence base for national policies for drowning prevention.

METHOD: Retrospective review and analysis of published data on child drowning injury (1963-2003) in the Philippines.

RESULTS: At least 3,000 Filipinos of all ages die annually from drowning injury (0.43% of deaths), more than a third of which (35.6%) are children under 14 years. Mortality is highest among children ages 1-4 years compared to other age groups [Mortality Rate (MR) 6.4 vs. 3.8 per 100,000]. Child drowning mortality rates have remained largely unchanged from 1963 to 2003, belying its under recognition as a public health priority. There is also a paucity of local data to adequately describe the epidemiology of child drowning in the Philippines.

CONCLUSION: In the Philippines, drowning deaths disproportionately account for 5% of deaths for 1-4 year olds. Drowning prevention could be a 'low-hanging fruit' in the quest to meet the Millenium Development Goals (MDG's) set for 2015. There is a need for better surveillance of child drowning deaths to guide policy formulation for its prevention and treatment in the Philippines.

Human ; Male ; Female ; Adolescent ; Child ; Child Preschool ; Infant ; Drowning ; Retrospective Studies ; Philippines ; Goals ; Health Priorities ; Child Mortality ; Asphyxia

This paper describes the incidence and some epidemiological features of drowning accident out of a series of our study on the epidemiology of various accidents in Korea. By the daily press it is apparent from the frequent reporting of swimming accidents that the incidence would be high. In the rural areas, there are, at present about 1,250 artificial lakes and farm ponds to be utilized for rice production. The reservoirs, irrigation ditches and riversides are also used for recreation. In most places facilities for aquatic activities is meager, and safety measures for the prevention of drowning is not sufficiently enforced. In the survey crude data on drowning were collected from the concerned governmental statistic books for the period 1955 to 1967 which were compiled not in a uniform way. Drowning were classified into two categories, one is accidental drowning, E929 and the other is due to cataclysm, E934, according to the WHO international classification of diseases. Epidemiological variables in relation to drowning accident were obtained through qualitative analysis of informations from the popular newspapers. The following summary may be drawn; 1. The average number of deaths due to accidental drowning totaled 1,088 annually and the mortality rate per 100,000 population was 3.4. The 42.0% of all drowning were rescued and the remaining were not saved. 2. The sex ration(M/F) of the victims for all ages was 5 to 1, which had a wide range of difference among the age groups. The young ages less than 20 years occupied 68.0% of all deaths. 3. The percentage distribution of the causes of accidents revealed 31.9% for careless swimming, 45.5% for unskilled, 16.6% for swimmer's cramp and 6.0% for drunken. The distribution of places where accidents occurred showed 88.0% for rivers, water reservoirs, irrigation ditches and 12.0% for regular swimming pools. The seasonal distribution of cases indicated 85.0% of the total were seen during the summer months, June-August, and 50.0% of them occurred on Sundays. 4. The average annual deaths due to cataclysm were 402 and mortality rate per 100,000 population was 1.6, but the number of victims due to cataclysm varied greatly each year. 5. The accident cases due to cataclysm were classified into 60.0% for injuries, 40.0% for deaths. The 26.8% of all deaths were missing cases. 6. The deaths due to either accidental drowning or cataclysm totaled 1,490, and the death rate per 100,000 for the whole country was 5.0.
Drowning* ; Epidemiology ; Humans ; Incidence* ; International Classification of Diseases ; Korea* ; Lakes ; Mortality ; Muscle Cramp ; Newspapers ; Ponds ; Recreation ; Rivers ; Seasons ; Swimming ; Swimming Pools ; Water ; Periodicals

This study aimed to analyze changing trends in child injury deaths from 2006 to 2016 and to provide basic data for initiatives to help prevent child injury deaths through improvements in social systems and education. Specific causes of death were analyzed using micro-data of the death statistics of Korea from 2006 to 2016, which were made available by Statistics Korea. Types and place of death were classified according to the KCD-7 (Korean Standard Classification of Diseases and Causes of Death). The data were compared to those of other Organization for Economic Cooperation and Development countries. Changing trends were presented. The number of child deaths by injury was 270 in 2016. The death rate was 8.1 per 100,000 population in 2006, while it was 3.9 in 2016. The death rate of boys was 1.7 times greater than that of girls. Unintentional injury deaths comprised 72.6% of all child injury deaths in 2016, while intentional injury deaths comprised 27.4%. The first leading cause of unintentional injury deaths in infants (less than 1-year-old) was suffocation, while that of children aged 1 to 14 years was transport accidents. The second leading cause of death in infants was transport accidents, that of children aged 1 to 4 was falling, and that of children aged 5 to 14 was drowning. Pedestrian accidents comprised 43.7% of the transport accidents from 2014 to 2016. To prevent child injury deaths by both unintentional and intentional causes, nation-wide policy measures and more specific interventions according to cause are required.
Accidental Falls ; Asphyxia ; Cause of Death ; Child ; Classification ; Drowning ; Education ; Female ; Humans ; Infant ; Korea ; Mortality ; Organisation for Economic Co-Operation and Development ; Republic of Korea ; Self-Injurious Behavior