OBJECTIVE: To analyze the clinical characteristics of patients with severe fall injury and explore the prehospital factors affecting the injury severity score (ISS). METHODS: Clinical data of severe trauma patients with fall injury and ISS≥16 from January 2018 to December 2020 were retrieved from trauma database of Peking University People' s Hospital. The patients' age, gender, suicidal tendencies, psychiatric disorders, fall height, properties of the impact surface, the body part hitting the ground, abbreviated injury scale, Glasgow coma scale (GCS), length of stay in intensive care unit (ICU), operation were collected. And the in-hospital mortality were calculated. Univariate analysis and multiple linear regression models were used to analyze the relationship between the above factors and ISS. The patients' GCS, length of stay in ICU, surgery, and in-hospital mortality were collected to analyze the general clinical characteristics of patients. RESULTS: A total of 160 patients were finally eligible, including 138 males and 22 females, with an average age of (45.56±15.85) years. Among the 160 patients, there were 36 cases (22.50%) with suicidal tendencies, 12 cases (7.50%) with psychiatric disorders. Their average fall height was (7.20±8.33) meters, and 48 cases (30.00%) hit the soft contact medium. 40 cases (25.00%) with impact on the head at the ground, lower limbs in 26 cases (16.25%), ventral in 16 cases (10.00%), dorsal in 40 cases (25.00%), lateral in 38 cases (23.75%). The patients' ISS was 22.8±6.85, GCS was 13.49±3.39, lengths of ICU stays were (9.96±8.12) days, and 142 (88.75%) patients underwent surgery, 8 in-hospital deaths were all due to head trauma, with an in-hospital mortality rate of 5.00%. Univariate analysis suggested that the main factors influencing ISS were the presence of suicidal tendencies (P=0.01) and the site of impact on the ground (P=0.02). Multiple linear regression analysis indicated that suicidal tendencies and head impact on the ground were in-fluential factors for high ISS. CONCLUSION Collecting prehospital information of patients with fall injuries, such as whether they have suicidal tendencies and whether they hit the ground with their heads, can effectively predict the severity of patients' injuries, which is conducive to early diagnosis, early care, and early treatment, thus reducing preventable death.
Humans ; Male ; Female ; Middle Aged ; Injury Severity Score ; Hospital Mortality ; Adult ; Accidental Falls/statistics & numerical data* ; Glasgow Coma Scale ; Intensive Care Units ; Length of Stay/statistics & numerical data* ; Wounds and Injuries/psychology* ; Abbreviated Injury Scale

PURPOSEThe epidemiology of pediatric trauma is different in different parts of the world. Some re- searchers suggest falls as the most common mechanism, whereas others report road traffic accidents (RTAs) as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India.

METHODSInpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21.

RESULTSWe had 300 patients over a 33 month period. Among them, 236 (78.6%) were males and 64 (21.3%) females. Overall the predominant cause was RTAs in 132 (43%) patients. On subgroup analysis of up to 12 years age group (n = 147), the most common cause was found to be RTAs again. However, falls showed an incremental upward trend (36.05% in up to 12 age group versus 27% overall), catching up with RTAs (44.89%). Pediatric Trauma Score (PTS) ranged from 0 to 12 with a mean of 8.12 ± 2.022. 223 (74.33%) patients experienced trauma limited to one anatomic region only, whereas 77 (25.66%) patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days (range 1-182).

CONCLUSIONPediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs (43%) as compared to falls from height (27%); however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatric trauma and local injury patterns must be taken into account when formulating policies to address this unique challenge.

Accidental Falls ; mortality ; statistics & numerical data ; Accidents, Traffic ; mortality ; statistics & numerical data ; Adolescent ; Child ; Child, Preschool ; Databases, Factual ; Developing Countries ; Female ; Humans ; Incidence ; India ; Injury Severity Score ; Length of Stay ; Male ; Pediatrics ; Registries ; Risk Assessment ; Survival Rate ; Trauma Centers ; Wounds and Injuries ; diagnosis ; epidemiology ; surgery

OBJECTIVETo study age and educational level and their relationship with fall-related injuries in Shanghai and to analyze the relevant costs.

METHODSMultistage cluster sampling was used for the selection of participants and standardized questionnaires were used for the information collection in 2006. Information on cases and deaths caused by fall-related injuries were obtained from 494 hospitals as well as from the mortality registry systems from 2001 till 2010.

RESULTSOf 45 857 participates, 674 suffered from fall-related injuries with the largest proportion among all injuries. The fall-related mortality increased from 10.63 per 100 000 in 2001 to 14.11 per 100 000 in 2010. The under-five mortality rate was the highest among children aged 0-14 years. Mortality increased dramatically among those aged 55 or above for the female and aged 60 or older for the male. Individuals with an educational level under the primary school were more likely to suffer fall-related injuries, accounting for 72.66% of all deaths and 49.24% of nonfatal cases respectively. The annual burden of fall-related injuries equated to 25.90% of the share of GDP for the healthcare, social security and welfare industries in 2006.

CONCLUSIONFall-related injuries were inversely related to victims' educational level. Children under the age of 5, women over 55 years old and men over 60 years old with an educational level lower than the primary school are the most risky groups of populations for intervention measures.

Accidental Falls ; mortality ; statistics & numerical data ; Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Educational Status ; Female ; Humans ; Male ; Middle Aged ; Sex Distribution ; Young Adult

OBJECTIVES: Recently injury has become a major world-wide health problem. But studies in Korea about injuries were very few. Thus, this study was conducted to analyze the trend of major injuries from 1991 to 2006 and to provide basic data for preventing injuries. METHODS: This study was based on the National Statistical Office data from 1991 to 2006 and calculated to estimate the burden of major injuries by using the standard expected years of life lost (SEYLL) and total lost earnings equation. RESULTS: For transport accidents, mortality, SEYLL and total lost earnings were increased from 1991 to 1996 and decreased from 2000 to 2006. On the other hand, for suicides, these were increased gradually. Since 2003, falls were included in ten leading causes of death. This study showed that injury causes major social and economical losses. CONCLUSIONS: We could reduce injury related premature death through active interest in injury prevention program.
Accident Prevention ; Accidental Falls/mortality/statistics & numerical data ; Accidents/*mortality/*statistics & numerical data ; Accidents, Traffic/mortality/statistics & numerical data ; Adolescent ; Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Cause of Death/trends ; Child ; Female ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Mortality/*trends ; Sex Distribution ; Suicide/trends ; Wounds and Injuries/*epidemiology ; Young Adult

OBJECTIVETo study the incidence of injuries among residents living in the communities in Zhejiang.

METHODSA household questionnaire survey was conducted to 16 899 residents in four communities.

RESULTSThe incidence of injuries was 16.11% in total, higher in urban area than in rural area and higher in men than in women. The leading causes of injuries were falls (4.80%), knife-cutting or by sharp articles (3.86%), traffic accident (2.07%), collision (1.99%), scalds (1.13%) and animal bites (1.06%). Peak incidence of age group was different in different injuries, such as traffic accident was high in 45 - 60 age group and falls was high in 5 and 60 age group. Direct economic loss for each case with injury would cost 324.21 RMB yuan.

CONCLUSIONInjury was common and frequently occurred among residents at the community level which seriously on danger their health and families.

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Animals ; Bites and Stings ; epidemiology ; Burns ; epidemiology ; Child ; China ; epidemiology ; Community Health Services ; Dogs ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Wounds and Injuries ; epidemiology ; mortality