Injury mortality in Sweden; changes over time and the effect of age and injury mechanism

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Publisher : Linköping University Electronic Press
ISBN 13 : 9176854116
Total Pages : 49 pages
Book Rating : 4.12/5 ( download)

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Book Synopsis Injury mortality in Sweden; changes over time and the effect of age and injury mechanism by : Denise Bäckström

Download or read book Injury mortality in Sweden; changes over time and the effect of age and injury mechanism written by Denise Bäckström and published by Linköping University Electronic Press. This book was released on 2017-11-15 with total page 49 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background: Injuries are one of the most common causes of death in the world. Varying types of injuries dominate in different parts of the world, which also have separate influences mortality. In Scandinavia blunt injuries dominates and the majority of those who die do so pre hospital. Over time different injury pattern may vary and by analyzing this we can assess when, where and how preventive work can be reinforced. The aim of this thesis was to study injury epidemiology in Sweden and assess the contribution of different injury patters on mortality. Method: We used the Swedish cause of death and the national patient registries which have a complete national coverage. ICISS was calculated (based on ICD-10) in the in hospital population. We have chosen to do this investigation with a broad perspective using the term injury, which includes trauma but also other diagnoses like suffocation and drowning. Results: During the study period (1999-2012) the number of deaths because of injury was 1213, 25 388, and 18 332 among children, working age and elderly, respectively. Mortality declined in the children and in the working age but inclined in the elderly. Mortality increased with each age group except between the ages of 15–25 and 26–35 years. One thousand two hundred sixty four (97%) of those who died because of penetrating trauma (sharp objects and firearms) were killed by intentional trauma (assault and intentional self-harm). One thousand and seventeen (83%) of the children died prehospital. In the working age 22 211 (80%) of 25 388 died pre hospital. Nine thousand six hundred and eighteen (53%) of 18 332 of the elderly died prehospital. During 2001- 2011 the risk adjusted in hospital mortality decreased in traffic and assault but not in fall related injuries. Discussion: Largely, the anticipated injury mortality picture was found, with blunt injuries (traffic accidents) dominating in the working age and falls in elderly. Further a significant portion of the deaths occurred pre hospital. The intentional injuries are dominated by intentional selfharm. The decrease in child injury mortality is notable as Sweden already has one of the lowest incidences in child injury mortality in the world. The decrease in injury mortality in the working age also implies that preventive work has had an effect. The incline in injury mortality in elderly on the other hand needs to be further studied. Areas of particular importance for future preventive work is the incline in injury mortality in elderly and intentional injuries among children.

Risk-Adjustment for Swedish In-Hospital Trauma Mortality using International Classification of disease Injury Severity Score (ICISS)

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Publisher : Linköping University Electronic Press
ISBN 13 : 9176851400
Total Pages : 77 pages
Book Rating : 4.01/5 ( download)

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Book Synopsis Risk-Adjustment for Swedish In-Hospital Trauma Mortality using International Classification of disease Injury Severity Score (ICISS) by : Robert Larsen

Download or read book Risk-Adjustment for Swedish In-Hospital Trauma Mortality using International Classification of disease Injury Severity Score (ICISS) written by Robert Larsen and published by Linköping University Electronic Press. This book was released on 2019-02-11 with total page 77 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction Different methods have been used to describe the epidemiology of trauma with varying results. Crude mortality outcome data differ significantly from risk-adjusted information. A previous standard method for risk-adjustment in trauma was the Injury Severity Score (ISS), although it has several shortcomings. In this thesis I examine Swedish injury statistics from an epidemiological perspective using crude and risk-adjusted mortality, and to adjust for injury I used the International Classification of disease Injury Severity Score (ICISS). The groups of most lethal injuries (fall, traffic, and assault) were examined separately using an ICISS mortality prediction model that focused particularly on the effects on the prediction of mortality by adding coexisting conditions (comorbidity) to it. Differences in mortality between the sexes and changes over time were tested separately. Material and Methods Data from all patients with ICD-10 based diagnoses of injury (ICD-10: V01 to Y36) in the Swedish National Patient Registry and Cause of Death Registry were collected from 1999 to 2012 and used for assessment of mortality and comorbidity. A subgroup (patients in hospital) from 2001-2011 were selected as the study group. Their injuries were in the subgroups of falls, traffic, and assaults, and are the focus of this thesis. Mortality within 30 days of injury was used as the endpoint. The severity of injury was adjusted for using the ICISS, which was first described by Osler et al. The model was also adjusted for age, sex, and comorbidities. Results The study group comprised 815 846 patients (of whom 17 721 died). There was a decrease over time in injuries caused by falls and traffic (coefficient -4.71, p=0.047 and coefficient -5.37, p<0.001), whereas there was no change in assault-related injuries/100 000 inhabitants. The risk-adjusted 30-day mortality showed a decrease in injuries related to traffic and assault (OR 0.95, p<0.001 and OR 0.93, p=0.022) whereas for falls it remained unchanged. There was also a risk-adjusted survival benefit for women, which increased with increasing age. Adjusting for comorbidities made the prediction of 30-day mortality by the ICISS model better (accuracy, calibration, and discrimination). However, most of this effect was found to be the result of the other characteristics of the fall related injury group (they were older, and had more coexisting conditions). Conclusion During a 10-year period, there has been a significant overall decrease in crude as well as risk-adjusted mortality for these three injury groups combined. Within these groups there is a clear, risk-adjusted, female survival advantage. The ICISS model for the prediction of mortality improves when comorbidities are added, but this effect is minor and seen mainly among the injuries caused by falls, where comorbidity is significant. The ICISS method was a valuable adjunct in the investigation of data on Swedish mortality after injury that has been gathered from health care registry data. Introduktion Olika metoder har använts för att beskriva trauma, alla med varierande resultat. Riskjusterad respektive icke-justerad data skiljer sig markant åt. En metod som oftast används för riskjustering i traumasammanhang är Injury Severity Score (ISS) som tyvärr är belastad med ett antal praktiska tillkortakommande. I denna avhandling har jag undersökt de skadade i Sverige från ett epidemiologiskt perspektiv med både justerad och icke riskjusterad mortalitet. För att kunna justera för skadan använde jag International Classification of disease Injury Severity Score (ICISS). De dödligaste skademekanismerna i Sverige (fall, trafik och övergrepp) analyserades för sig med hjälp av en mortalitetsjusterad modell baserad på ICISS som fokuserade särskilt på mortalitetseffekterna av att lägga till tidigare sjukdomar (komorbiditet) i modellen. Skillnader i dödlighet mellan de olika könen samt förändringar över tid undersöktes. Material och Metod Information om alla patienter med en skadekod från ICD-10 systemet (ICD10: V01-Y36) i slutenvårdsregistret eller dödsorsaksregistrets under åren 1999–2012 samlades in för att användas för att kunna utvärdera mortalitet och komorbiditet. En undergrupp av sjukhusinlagda patienter från 2001–2011 valdes sedan som primär studiegrupp. De som i denna grupp hade drabbats av fall-, trafik- eller övergrepps-relaterade skador är det denna avhandling fokuserar på. Som mätpunkt (endpoint) användes avliden inom 30 dagar från skadan. Skadans allvarlighetsgrad bedömdes med ICISS som Osler var först att beskriva. Modellen justerades även för ålder, kön och komorbiditet. Resultat Studiegruppen innehöll 815 846 patienter (av vilka 17 721 avled). I gruppen med falloch trafik-relaterade skador var det en ren minskning över studietiden (koefficienten -4,71 med ett p=0,047 och med en koefficient på -5,37 med ett p <0,001), medans i övergreppsrelaterade skador kunde jag inte hitta någon minskning per 100 000 invånare. Den riskjusterade 30-dagars dödligheten hade en minskning i trafik- och övergreppsrelaterade skador (OR 0,95 med ett p <0,001 respektive OR 0,93 med ett p=0,022) men ingen minskning i fallrelaterade skador sågs. Riskjusterat gick det också att hitta en överlevnadsfördel för kvinnor, vilken ökade med ålder. När jag justerade för komorbiditeter blev prediktionsmodellen för ICISS med 30-dagars dödlighet bättre (detta gällde både precision, kalibrering och diskriminering). Det bör dock nämnas att det mesta av förbättringen vid eftergranskning var beroende på fall gruppens demografi (högre ålder och mer komorbiditeter). Konklusion Under denna tio-årsperiod har dödligheten minskat för dessa grupper, både riskjusterat och icke justerat. Inom dessa grupper finns en tydlig riskjusterad överlevnadsfördel för kvinnor. ICISS-modellen blir bättre på att förutspå 30-dagars dödlighet när man lägger till komorbiditet, men effekten är att betrakta som en mindre effekt och ses tydligast i fallrelaterade skador (där ålder och komorbiditet är högre). Metoden med ICISS är en värdefull metod för att undersöka stora datamaterial och dödlighet i stora grupper i Sverige. Detta kan göras med redan insamlade data i sjukvårdsregistren.

The Injury Chart Book

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Publisher : World Health Organization
ISBN 13 : 924156220X
Total Pages : 86 pages
Book Rating : 4.01/5 ( download)

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Book Synopsis The Injury Chart Book by :

Download or read book The Injury Chart Book written by and published by World Health Organization. This book was released on 2002 with total page 86 pages. Available in PDF, EPUB and Kindle. Book excerpt: This publication seeks to provide a global overview of the nature and extent of injury mortality and morbidity in the form of user-friendly tables and charts. It is hoped that the graphical representation of the main patterns of the burden of disease due to injury will raise awareness of the importance of injuries as a public health issue and facilitate the implementation of effective prevention programs.

European Report on Child Injury Prevention

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Publisher : WHO Regional Office Europe
ISBN 13 : 9289042958
Total Pages : 117 pages
Book Rating : 4.56/5 ( download)

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Book Synopsis European Report on Child Injury Prevention by : Dinesh Sethi

Download or read book European Report on Child Injury Prevention written by Dinesh Sethi and published by WHO Regional Office Europe. This book was released on 2008 with total page 117 pages. Available in PDF, EPUB and Kindle. Book excerpt: Injuries are a leading cause of death and disability in children. This report presents evidence on how they can be prevented and calls for greater commitment and action from policy-makers and practitioners to decrease the burden. Every year, unintentional injuries kill nearly 42,000 children and young people under the age of 20 in the WHO European Region. Injuries are the leading cause of death among those aged 5-19 years, and 5 out of 6 of these deaths occur in low- and middle-income countries. Irrespective of country income, the burden falls disproportionately on children from the most disadvantaged groups. The leading types of unintentional injuries are road traffic injuries, drowning, poisoning, burns and falls. All injury types have similar main causes and socioeconomic and environmental determinants. Children are particularly vulnerable to injuries and need special consideration to safeguard their rights to health and safe environments, free from injury. This report, companion to the World Report on Child Injury Prevention, presents the evidence on both the great potential for injury prevention and the effectiveness and value for money of measures already in use in European countries with low injury mortality. It shows why health systems and particularly programs for child health throughout the WHO European Region should give priority to preventing and controlling child injury.

Translational Research in Traumatic Brain Injury

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Publisher : CRC Press
ISBN 13 : 1498766579
Total Pages : 412 pages
Book Rating : 4.79/5 ( download)

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Book Synopsis Translational Research in Traumatic Brain Injury by : Daniel Laskowitz

Download or read book Translational Research in Traumatic Brain Injury written by Daniel Laskowitz and published by CRC Press. This book was released on 2015-12-01 with total page 412 pages. Available in PDF, EPUB and Kindle. Book excerpt: Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the development of new diagnostic and therapeutic approaches has been disappointingly slow. Translational Research in Traumatic Brain Injury attempts to integrate expertise from across specialties to address knowledge gaps in the field of TBI. Its chapters cover a wide scope of TBI research in five broad areas: Epidemiology Pathophysiology Diagnosis Current treatment strategies and sequelae Future therapies Specific topics discussed include the societal impact of TBI in both the civilian and military populations, neurobiology and molecular mechanisms of axonal and neuronal injury, biomarkers of traumatic brain injury and their relationship to pathology, neuroplasticity after TBI, neuroprotective and neurorestorative therapy, advanced neuroimaging of mild TBI, neurocognitive and psychiatric symptoms following mild TBI, sports-related TBI, epilepsy and PTSD following TBI, and more. The book integrates the perspectives of experts across disciplines to assist in the translation of new ideas to clinical practice and ultimately to improve the care of the brain injured patient.

Patient Safety and Quality

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Publisher : Department of Health and Human Services
ISBN 13 :
Total Pages : 592 pages
Book Rating : 4.98/5 ( download)

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Book Synopsis Patient Safety and Quality by : Ronda Hughes

Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Visualizing Mortality Dynamics in the Lexis Diagram

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Publisher : Springer
ISBN 13 : 3319648209
Total Pages : 169 pages
Book Rating : 4.00/5 ( download)

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Book Synopsis Visualizing Mortality Dynamics in the Lexis Diagram by : Roland Rau

Download or read book Visualizing Mortality Dynamics in the Lexis Diagram written by Roland Rau and published by Springer. This book was released on 2017-11-14 with total page 169 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book visualizes mortality dynamics in the Lexis diagram. While the standard approach of plotting death rates is also covered, the focus in this book is on the depiction of rates of mortality improvement over age and time. This rather novel approach offers a more intuitive understanding of the underlying dynamics, enabling readers to better understand whether period- or cohort-effects were instrumental for the development of mortality in a particular country. Besides maps for single countries, the book includes maps on the dynamics of selected causes of death in the United States, such as cardiovascular diseases or lung cancer. The book also features maps for age-specific contributions to the change in life expectancy, for cancer survival and for seasonality in mortality for selected causes of death in the United States. The book is accompanied by instructions on how to use the freely available R Software to produce these types of surface maps. Readers are encouraged to use the presented tools to visualize other demographic data or any event that can be measured by age and calendar time, allowing them to adapt the methods to their respective research interests. The intended audience is anyone who is interested in visualizing data by age and calendar time; no specialist knowledge is required. This book is open access under a CC BY license.

World Report on Road Traffic Injury Prevention

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Publisher : DIANE Publishing
ISBN 13 : 1437904068
Total Pages : 67 pages
Book Rating : 4.62/5 ( download)

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Book Synopsis World Report on Road Traffic Injury Prevention by : Marjorie Peden

Download or read book World Report on Road Traffic Injury Prevention written by Marjorie Peden and published by DIANE Publishing. This book was released on 2008-09 with total page 67 pages. Available in PDF, EPUB and Kindle. Book excerpt: Every day thousands of people are killed and injured on our roads. Millions of people each year will spend long weeks in the hospital after severe crashes and many will never be able to live, work or play as they used to do. Current efforts to address road safety are minimal in comparison to this growing human suffering. This report presents a comprehensive overview of what is known about the magnitude, risk factors and impact of road traffic injuries, and about ways to prevent and lessen the impact of road crashes. Over 100 experts, from all continents and different sectors -- including transport, engineering, health, police, education and civil society -- have worked to produce the report. Charts and tables.

World Report on Child Injury Prevention

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Publisher : World Health Organization
ISBN 13 : 9241563575
Total Pages : 233 pages
Book Rating : 4.74/5 ( download)

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Book Synopsis World Report on Child Injury Prevention by : M. M. Peden

Download or read book World Report on Child Injury Prevention written by M. M. Peden and published by World Health Organization. This book was released on 2008 with total page 233 pages. Available in PDF, EPUB and Kindle. Book excerpt: Child injuries are largely absent from child survival initiatives presently on the global agenda. Through this report, the World Health Organization, the United Nations Children's Fund and many partners have set out to elevate child injury to a priority for the global public health and development communities. It should be seen as a complement to the UN Secretary-General's study on violence against children released in late 2006 (that report addressed violence-related or intentional injuries). Both reports suggest that child injury and violence prevention programs need to be integrated into child survival and other broad strategies focused on improving the lives of children. Evidence demonstrates the dramatic successes in child injury prevention in countries which have made a concerted effort. These results make a case for increasing investments in human resources and institutional capacities. Implementing proven interventions could save more than a thousand children's lives a day.--p. vii.

Diseases of the Brain, Head and Neck, Spine 2020–2023

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Publisher : Springer Nature
ISBN 13 : 303038490X
Total Pages : 252 pages
Book Rating : 4.06/5 ( download)

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Book Synopsis Diseases of the Brain, Head and Neck, Spine 2020–2023 by : Juerg Hodler

Download or read book Diseases of the Brain, Head and Neck, Spine 2020–2023 written by Juerg Hodler and published by Springer Nature. This book was released on 2020-02-14 with total page 252 pages. Available in PDF, EPUB and Kindle. Book excerpt: This open access book offers an essential overview of brain, head and neck, and spine imaging. Over the last few years, there have been considerable advances in this area, driven by both clinical and technological developments. Written by leading international experts and teachers, the chapters are disease-oriented and cover all relevant imaging modalities, with a focus on magnetic resonance imaging and computed tomography. The book also includes a synopsis of pediatric imaging. IDKD books are rewritten (not merely updated) every four years, which means they offer a comprehensive review of the state-of-the-art in imaging. The book is clearly structured and features learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers navigate the text. It will particularly appeal to general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic expertise, as well as clinicians from other specialties who are interested in imaging for their patient care.