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

OBJECTIVES: Suicide has become one of the most serious public health problems today in Korea. In this study, we investigated the demographic and social characteristics affecting the use of various suicide methods.METHODS: The data relating to the types of suicide deaths including factors such as the age, gender, education level, the time of death, the place of death, and the method of death reported from 2008 to 2014 in Yeoungdeungpo-gu, Seoul, which were reviewed and analyzed in this study. The variants of each suicide method were compared using a Chi square and the Fisher's exact test. Additionally, a Spearman correlation analysis and a logistic regression analysis were also performed.RESULTS: The results noted that more than half of suicide victims (68.4%) were male. The most frequent suicide deaths were in the spring (29.1%), and were performed during the afternoon (33.4%). In this review, it is noted that the methods of hanging (59.4%), leaping (17.0%), and gas intoxication (8.9%) were the most frequent suicide methods used by the suicide victims. A logistic regression analysis showed that poisoning had a lower risk of occurrence in night/morning time. In fact, gas poisoning was more dangerous in males, especially males who were younger, and occurred more frequently in the winter months. In this respect, the method of hanging was found to be higher in the low-educated group of people who committed suicide as reviewed. It is noted that drowning was a riskier factor in females, who were elderly and who committed suicide more frequently in the summer. The risk of leaping was increased in elderly populations who were also noted to be highly-educated.CONCLUSION: There was a significant difference in sex, age, educational level, season, suicide time, and suicide location according to each suicide method as reviewed and utilized in this study. The results note that it is necessary to emphasize the prevention of different suicide methods according to population groups.
Aged ; Drowning ; Education ; Female ; Gas Poisoning ; Humans ; Korea ; Logistic Models ; Male ; Methods ; Mortality ; Poisoning ; Population Groups ; Public Health ; Seasons ; Seoul ; Sociological Factors ; Suicide

PURPOSE: We evaluated the power of the Rapid Emergency Medicine Score (REMS) for predicting hospital mortality in trauma patients. Then, we compared the REMS with two other scoring systems, the Emergency Trauma Score (EMTRAS) and the Injury Severity Score (ISS) for predicting prognosis. METHODS: We examined data from a prospectively collected registry in a single trauma center from January 2010 to November 2011. Patients enrolled in the registry were trauma patients who were predicted to have an ISS>15 or who required urgent multiple surgical consultations as soon as possible. Pediatric patients (<18-years-old) who were referred after initial care or death on arrival, and those with injuries due to burns, asphyxia, or drowning were excluded. The study population was divided into two subgroups according to hospital mortality, and the differences in clinical characteristics and calculated scores were examined. The odds ratio (OR) of REMS for predicting In-hospital mortality was calculated and the prognostic power of the three scoring systems for predicting hospital mortality by drawing receiver operating characteristic (ROC) curves was compared. RESULTS: A total of 103 patients were included in the analysis. Of these, 44 died during hospitalization. All three prognostic scores were significantly higher in the hospital mortality subgroup. The OR of the REMS for predicting hospital mortality was 1.35 (p<0.001). The areas under the ROC curves of the REMS, EMTRAS, and ISS were 0.815 (95% confidence interval [CI], 0.727-0.884), 0.872 (95% CI, 0.793-0.930), and 0.693 (95% CI, 0.595-0.780), respectively. The area under the ROC curve of the REMS was not different from that of the EMTRAS or ISS. CONCLUSION: The REMS showed good prognostic power for predicting hospital mortality in severely injured patients. Consecutive prospective studies are warranted to determine the utility of this scoring system for trauma patients.
Asphyxia ; Burns ; Drowning ; Emergencies* ; Emergency Medicine* ; Hospital Mortality* ; Hospitalization ; Humans ; Injury Severity Score ; Mortality ; Odds Ratio ; Prognosis ; Prospective Studies ; Referral and Consultation ; ROC Curve ; Trauma Centers ; Trauma Severity Indices ; Triage ; Wounds and Injuries

PURPOSE: This study aimed to evaluate the clinical features of children who have survived a water submersion incident, and to identify risk factors for prognosis. METHODS: We retrospectively reviewed the medical records of patients who experienced submersion between January 2005 and December 2014. The patients were classified into 2 groups, according to complications, and prognostic factors were evaluated. RESULTS: During the study period, 29 children experienced submersion (20 boys and 9 girls; mean age, 83.8±46.4 months). Submersion occurred most commonly in the summer, with the peak incidence in August. The most frequent Szpilman clinical score was grade 5 (13 patients; 44.8%), followed by grade 6 (7 patients; 24.1%), and grades 1 or 2 (3 patients; 10.3%). Five children (17.2%) in the poor prognosis group died or had hypoxic ischemic encephalopathy, and the overall mortality rate was 6.9%. Poor prognosis after submersion was associated with lower consciousness levels (P=0.003), higher Szpilman scores (P=0.007), greater need for intubation and mechanical ventilator support (P=0.001), and longer duration of oxygen therapy (P=0.015). Poor prognosis was also associated with lower bicarbonate levels (P=0.038), as well as higher sodium, aspartate transaminase (AST), and alanine transaminase (ALT) levels (P=0.034, P=0.006, and P=0.005, respectively). Szpilman clinical scores were positively correlated with consciousness levels (r=0.489, P=0.002) and serum liver enzyme levels (AST and ALT; r=0.521, P=0.004). CONCLUSION: We characterized the prognostic factors associated with submersion outcomes, using the Szpilman clinical score, which is comparable to consciousness level for predicting mortality.
Alanine Transaminase ; Aspartate Aminotransferases ; Child* ; Consciousness ; Drowning* ; Female ; Humans ; Hypoxia-Ischemia, Brain ; Immersion ; Incidence ; Intubation ; Liver ; Medical Records ; Mortality ; Oxygen ; Prognosis ; Retrospective Studies ; Risk Factors ; Sodium ; Ventilators, Mechanical ; Water

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

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

OBJECTIVETo understand the age-specific and cause-specific mortality rate among children under 5 years old in Beijing from 2003 to 2012.

METHODSDeath surveillance data of children under the age of 5 were obtained from Beijing children mortality surveillance network from 2003 to 2012. Neonatal mortality rate (NMR), infant mortality rate (IMR), under 5-year old children mortality rate (U5MR) and the leading cause of death for under 5-year old children in urban, suburbs, and outer suburbs in Beijing were analyzed.

RESULTSThe NMR, IMR and U5MR in Beijing were 2.08 (253/121 747), 3.11 (379/121 747) and 3.57 (435/121 747) per 1000 live births in 2012, respectively, which declined 54.88%, 50.24% and 54.75% compared with the level in 2003 respectively. The children mortality rates showed a decreasing trend in urban, suburb, and outer suburbs during 2003 and 2012 (NMR was decreased from 0.53%, 0.42%, and 0.48% in 2003 to 0.20%, 0.19%, and 0.23% in 2012; IMR was decreased from 0.73%, 0.58%, and 0.63% in 2003 to 0.30%, 0.29%, and 0.35% in 2012; U5MR was decreased from 0.90%, 0.72%, and 0.82% to 0.33%, 0.34%, and 0.39% in 2012, P < 0.01). There was a steady decline in the U5MR due to congenital heart disease, birth asphyxia, premature birth or low birth weight and traffic accident in Beijing from 2003 to 2012. The mortality rate of congenital heart disease declined from 140.63 to 41.89 per 100 000 live births, birth asphyxia declined from 109.38 to 59.96 per 100 000 live births, premature birth or low birth weight declined from 85.94 to 52.57 per 100 000 live births, traffic accident declined from 26.04 to 6.57 per 100 000 live births (P < 0.01). The mortality rate of congenital heart disease declined remarkably from 216.56 to 52.47, from 119.75 to 23.50, and from 134.58 to 63.11 per 100 000 live births in urban, suburb, and outer suburbs(P < 0.01). Six of the top 8 leading causes of death among children under 5 years old declined remarkably in rural areas. They were congenital heart disease, birth asphyxia, premature birth or low birth weight, traffic accident, drowning, and septicemia, and the mortality rate of them declined from 134.58 to 63.11, from 127.85 to 65.54, from 100.94 to 60.69, from 33.65 to 12.14, from 33.65 to 0.00, and from 26.92 to 4.85 per 100 000 live births, respectively (P < 0.05). There was no drowning death case in rural areas in recent 4 years. The top 5 leading causes of death among children under 5 years old in Beijing in 2012 were birth asphyxia, premature birth or low birth weight, congenital heart disease, pneumonia, and accidental suffocation. The mortality rate of these top 5 leading causes were 59.96, 52.57, 41.89, 24.64, and 15.61 per 100 000 live births in 2012.

CONCLUSIONFrom 2003 to 2012, the NMR, IMR, U5MR and mortality rate of congenital heart disease declined remarkably in urban, suburb, and outer suburb areas in Beijing. There was a decrease trend for the six of the top 8 leading causes of death among children under 5 years old. The mortality rate of drowning dropped markedly in outer suburbs.

Accidents, Traffic ; Asphyxia ; Asphyxia Neonatorum ; Cause of Death ; Child Mortality ; Child, Preschool ; China ; Drowning ; Female ; Heart Defects, Congenital ; Humans ; Infant ; Infant Death ; Infant Mortality ; Pneumonia ; Pregnancy ; Premature Birth ; Rural Population ; Sepsis ; Suburban Population ; Urban Population

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

OBJECTIVE: To explore the unidentified corpses in Shaoxing city in recent years to provide the experience for these types of corpse examination and forensic identification. METHODS: One hundred and twenty-seven unidentified corpses were collected and analyzed in the period from January 2009 to June 2011. The scene investigation, clothing examination and information of forensic investigation were collected and analyzed. RESULTS: Most of the unidentified corpses are the young male. Of them, there are 3 homicide cases. There are 92 cases (72.44%) of the corpses was found with all clothes and 72 cases (56.69%) with the belongings. There are 63 cases (49.61%) of the cases was died from downing and 15 cases (11.81%) was died from hypothermia and starvation. Cause of death in 25 cases (19.69%) was undetermined. CONCLUSION The most of unidentified corpses in Shaoxing are found in water and died from accidents. The degree of corpse putrefaction is the principal factor to analyze the cause of death.
Accidents/mortality* ; Adult ; Age Distribution ; Aged ; Cadaver ; Cause of Death ; Child, Preschool ; China ; Clothing ; Drowning/mortality* ; Female ; Forensic Medicine/methods* ; Homicide/statistics & numerical data* ; Humans ; Infant ; Male ; Postmortem Changes ; Sex Distribution ; Suicide/statistics & numerical data* ; Wounds and Injuries/pathology*

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