scholarly journals Descriptive Epidemiology of Fall-Related Injuries Among Older Adults in Ontario, Canada

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 790-790
Author(s):  
Nicolette Lappan ◽  
Aleksandra Zecevic ◽  
Yu Ming ◽  
Susan Hunter ◽  
Andrew Johnson

Abstract The number of older adults is growing rapidly in the province of Ontario meaning there will be more fall-related injuries (FRIs) in coming decades. Falls are the leading cause of injury-related hospitalizations in Canada. The purpose of this study was to describe the prevalence, circumstances, types, and locations of FRIs among older adults in Ontario. Using a population-based retrospective design, we analyzed secondary data from three health administrative databases (NACRS, DAD, RPDB) for 2010-2014. Older adults (≥ 65 years) admitted to an emergency department (ED) with a combined diagnosis of ICD-10-CA codes for a fall (W00-W19) and injury (S00-S99 or T00-T14) were selected. Descriptive statistics were performed in R and rates were reported per 100,000 population. There were 304,610 FRI ED admissions (3,089/100,000) and 143,210 patients (47.0%) were subsequently hospitalized (1,452/100,000). Females accounted for 63.0% ED and 61.2% hospital admissions. Age-specific rates increased with age at both ED (2,208/100,000 in 65-69 group, 6,552/100,000 in 90+ years old) and hospital (698/100,000 in 65-69 group, 4,364/100,000 in 90+ years old). Females had higher rates of ED (3,503 vs. 2,572/100,000) and hospital (1,598 vs. 1,270/100,000) admissions than males. The most common injury types at the ED were fractures (1,234/100,000), superficial injuries (719/100,000), other or unspecified injuries (572/100,000), open wounds (498/100,000), and sprains, strains, and tears (162/100,000). FRIs are a considerable problem for older adults and better injury prevention strategies are needed for all female age groups, the 90+ year age group of both genders, and fractures.

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 59
Author(s):  
Andrew Kampfschulte ◽  
Matthew Oram ◽  
Alejandra M. Escobar Vasco ◽  
Brittany Essenmacher ◽  
Amy Herbig ◽  
...  

Suicide frequency has tripled for some pediatric age groups over the last decade, of which, serious attempts result in pediatric intensive care unit (PICU) admissions. We paired clinical, aggregate geospatial, and temporal demographics to understand local community variables to determine if epidemiological patterns emerge that associate with risk for PICU admission. Data were extracted at an urban, high-volume, quaternary care facility from January 2011 to December 2017 via ICD 10 codes associated with suicide. Clinical, socioeconomic, geographical, and temporal variables were reviewed. In total, 1036 patients over the age of 9 were included, of which n = 161 were PICU admissions. Females represented higher proportions of all suicide-related hospital admissions (67.9%). Looking at race/ethnicity, PICU admissions were largely Caucasian (83.2%); Blacks and Hispanics had lower odds of PICU admissions (OR: 0.49; 0.17, respectively). PICU-admitted patients were older (16.0 vs. 15.5; p = 0.0001), with lower basal metabolic index (23.0 vs. 22.0; p = 0.0013), and presented in summer months (OR: 1.51, p = 0.044). Time-series decomposition showed seasonal peaks in June and August. Local regions outside the city limits identified higher numbers of PICU admissions. PICUs serve discrete geographical regions and are a source of information, when paired with clinical geospatial/seasonal analyses, highlighting clinical and societal risk factors associated with PICU admissions.


Author(s):  
Olena Seminog ◽  
Uy Hoang ◽  
Michael Goldacre ◽  
Anthony James

Abstract Background There is a lack of information on changes in hospital admission rates for childhood-onset schizophrenia (COS), or on patient characteristics, to inform clinical research and health service provision. Aims To report age- and sex-specific incidence rates of hospital admissions and day patient care for schizophrenia (ICD-10 F20) and non-affective psychosis (ICD-10 F20-29), by year of occurrence and age, in childhood and adolescence. Methods Population-based study using person-linked data for England (available 2001–2016); time-periods in single years and 4-year groups. Results Hospitalised incidence for schizophrenia increased with increasing age, from 0.03 (95% confidence interval (CI) 0.02–0.05) and 0.01 (0–0.01) per 100,000 in, respectively, males and females aged 5–12 years, to 3.67 (3.44–3.91) in males and 1.58 (1.43–1.75) in females aged 13–17 years. There was no gender difference in hospitalised incidence rates in children aged 5–12, but in 13–17 years old, there was a male excess. Rates for schizophrenia were stable over time in 5–12 years old. In ages 13–17, rates for schizophrenia decreased between 2001–2004 and 2013–2016 in males, from 6.65 (6.04–7.31) down to 1.40 (1.13–1.73), and in females from 2.42 (2.05–2.83) to 1.18 (0.92–1.48). The hospitalisation rates for schizophrenia and non-affective psychosis, combined, in 13–17 years old decreased in males from 14.20 (13.30–15.14) in 2001–2004 to 10.77 (9.97–11.60) in 2013–2016, but increased in females from 7.49 (6.83–8.20) to 10.16 (9.38–11.00). Conclusions The study confirms that childhood-onset schizophrenia is extremely rare, with only 32 cases identified over a 15-year period in the whole of England. The incidence of schizophrenia and non-affective psychosis increased substantially in adolescence; however, the marked reduction in the proportion of those diagnosed with schizophrenia in this age group suggests a possible change in diagnostic practice.


Author(s):  
Ana Cristina Viana Campos ◽  
Efigênia Ferreira e Ferreira ◽  
Andréa Maria Duarte Vargas ◽  
Lúcia Hisako Takase Gonçalves

ABSTRACT Objective: to identify the healthy aging profile in octogenarians in Brazil. Method: this population-based epidemiological study was conducted using household interviews of 335 octogenarians in a Brazilian municipality. The decision-tree model was used to assess the healthy aging profile in relation to the socioeconomic characteristics evaluated at baseline. All of the tests used a p-value < 0.05. Results: the majority of the 335 participating older adults were women (62.1%), were aged between 80 and 84 years (50.4%), were widowed (53.4%), were illiterate (59.1%), had a monthly income of less than one minimum wage (59.1%), were retired (85.7%), lived with their spouse (63.8%), did not have a caregiver (60.3%), had two or more children (82.7%), and had two or more grandchildren (78.8%). The results indicate three age groups with a healthier aging profile: older adults aged 80 to 84 years (55.6%), older adults aged 85 years and older who are married (64.9%), and older adults aged 85 and older who do not have a partner or a caregiver (54.2%). Conclusion: the healthy aging profile of octogenarians can be explained by age group, marital status, and the presence of a caregiver.


Author(s):  
Jane McChesney-Corbeil ◽  
Karen Barlow ◽  
Hude Quan ◽  
Guanmin Chen ◽  
Samuel Wiebe ◽  
...  

AbstractBackground: Health administrative data are a common population-based data source for traumatic brain injury (TBI) surveillance and research; however, before using these data for surveillance, it is important to develop a validated case definition. The objective of this study was to identify the optimal International Classification of Disease , edition 10 (ICD-10), case definition to ascertain children with TBI in emergency room (ER) or hospital administrative data. We tested multiple case definitions. Methods: Children who visited the ER were identified from the Regional Emergency Department Information System at Alberta Children’s Hospital. Secondary data were collected for children with trauma, musculoskeletal, or central nervous system complaints who visited the ER between October 5, 2005, and June 6, 2007. TBI status was determined based on chart review. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each case definition. Results: Of 6639 patients, 1343 had a TBI. The best case definition was, “1 hospital or 1 ER encounter coded with an ICD-10 code for TBI in 1 year” (sensitivity 69.8% [95% confidence interval (CI), 67.3-72.2], specificity 96.7% [95% CI, 96.2-97.2], PPV 84.2% [95% CI 82.0-86.3], NPV 92.7% [95% CI, 92.0-93.3]). The nonspecific code S09.9 identified >80% of TBI cases in our study. Conclusions: The optimal ICD-10–based case definition for pediatric TBI in this study is valid and should be considered for future pediatric TBI surveillance studies. However, external validation is recommended before use in other jurisdictions, particularly because it is plausible that a larger proportion of patients in our cohort had milder injuries.


2019 ◽  
Vol 26 (5) ◽  
pp. 463-470 ◽  
Author(s):  
Janneke Berecki-Gisolf ◽  
Bosco Rowland ◽  
Nicola Reavley ◽  
Barbara Minuzzo ◽  
John Toumbourou

BackgroundInjuries are one of the three leading causes of morbidity and mortality for young people internationally. Although community risk factors are modifiable causes of youth injury, there has been limited evaluation of community interventions. Communities That Care (CTC) offers a coalition training process to increase evidence-based practices that reduce youth injury risk factors.MethodUsing a non-experimental design, this study made use of population-based hospital admissions data to evaluate the impact on injuries for 15 communities that implemented CTC between 2001 and 2017 in Victoria, Australia. Negative binomial regression models evaluated trends in injury admissions (all, unintentional and transport), comparing CTC and non-CTC communities across different age groups.ResultsStatistically significant relative reductions in all hospital injury admissions in 0–4 year olds were associated with communities completing the CTC process and in 0–19 year olds when communities began their second cycle of CTC. When analysed by subgroup, a similar pattern was observed with unintentional injuries but not with transport injuries.ConclusionThe findings support CTC coalition training as an intervention strategy for preventing youth hospital injury admissions. However, future studies should consider stronger research designs, confirm findings in different community contexts, use other data sources and evaluate intervention mechanisms.


2001 ◽  
Vol 179 (3) ◽  
pp. 250-254 ◽  
Author(s):  
Steffi G. Riedel-Heller ◽  
Anja Busse ◽  
Conny Aurich ◽  
Herbert Matschinger ◽  
Matthias C. Angermeyer

BackgroundThe prevalence of dementia diagnosis according to ICD–10 and DSM–III–R in population surveys remains poorly understood.AimsTo report and compare prevalence rates according to DSM–III–R and ICD–10.MethodA population-based sample (n=1692, age 75+ years) was investigated by a Structured Interview for Diagnosis of Dementia of Alzheimer Type, Multiinfarct Dementia and Dementia of other Aetiology according to DSM–III–R and ICD–10 (SIDAM).ResultsWhereas 17.4% (95% CI=15.9–19.5) of individuals aged 75+ years suffer from dementia according to DSM–III–R, only 12.4% (95% CI=10.6–14.2) are diagnosed as having dementia according to ICD–10. The results revealed lower ICD–10 rates in all investigated age groups. The largest differences appear in the oldest of the elderly.ConclusionsThe ICD–10 sets a higher threshold for dementia diagnosis. Larger differences in the eldest age groups might reflect difficulties in applying case definitions, especially in those beyond 90 years old.


Author(s):  
Noreen Kamal ◽  
M. Patrice Lindsay ◽  
Robert Côté ◽  
Jiming Fang ◽  
Moira K. Kapral ◽  
...  

AbstractBackgroundWe analyzed a 10-year stroke administrative dataset to examine trends in admissions, mortality, and discharge destination in Canada.MethodsWe conducted an analysis of hospital administrative data from April 1st 2003 to March 31st 2013 from the Canadian Institute of Health Information’s Discharge Abstract Database. Ten-year trends for population-based age- and sex-standardized admission rates were calculated. We reviewed 10-year trends in absolute stroke admissions for differences between provinces and age groups. Stroke 30-day in-hospital mortality rates were calculated and adjusted for sex, age, stroke type and comorbidities. We documented changes in discharge location for ischemic and hemorrhagic stroke patients discharged from acute care.ResultsThe rate of hospital admissions has declined from 140.2 to 117.5 (per 100,000 people). The number of absolute stroke admissions within provinces increased in Alberta and British Columbia (21.7% and 16.2% respectively). The proportion of stroke patients aged 40-69 years old increased by 4.8% (p<0.0001) over the 10 years, whereas the proportion aged over 70 decreased by 4.9% (p<0.0001). Risk-adjusted 30-day in-hospital mortality decreased from: 18.5% to 14.9% for all strokes; 15.2% to 12.1% for ischemic strokes; 35.6% to 29.7% for intracerebral hemorrhage; and 25.1% to 18.0% for subarachnoid hemorrhage. The absolute increase in patients requiring inpatient and outpatient support increased by 4% (p<0.0001).ConclusionThe rate of admissions for stroke is decreasing but there is an increase in stroke admissions for younger patients. In-hospital mortality is decreasing; fewer patients are going directly home without services and more are requiring support services.


2014 ◽  
Vol 26 (11) ◽  
pp. 1929-1930 ◽  
Author(s):  
Kim-Michelle Gilson ◽  
Christina Bryant ◽  
Fiona Judd

Estimates from population-based studies indicate that older adults drink more frequently than younger age groups. Data from the 2010 Australian national household survey reported that daily drinking was evident in 13.3% of older adults aged 60–69 years and in 14.8% of older adults aged 70+ years. These findings are compared to daily drinking rates reported by 10.1% of adults aged 50–59 years and 7.5% in the 40–49 years age range (Australian Institute of Health and Welfare, 2011). The study of alcohol consumption in older adults is particularly important because of their increased sensitivity to alcohol-related harms. With age, the body's ability to process alcohol decreases as a result of physiological changes, such as decreases in body mass and higher levels of fatty tissue, leading to a higher blood alcohol concentration for a given dose compared with younger adults (National Institute on Alcohol Abuse and Alcoholism, 1998). This greater vulnerability to the effects of alcohol necessitates a stronger understanding of drinking practices in older adults.


2020 ◽  
Author(s):  
Andrew Kampfschulte ◽  
Matthew Oram ◽  
Alejandra M. Escobar Vasco ◽  
Brittany Essenmacher ◽  
Amy Herbig ◽  
...  

AbstractSuicide frequency has tripled for some pediatric age groups over the last decade, of which, serious attempts result in pediatric intensive care unit (PICU) admissions. We paired clinical, aggregate geospatial, and temporal demographics to understand local community variables to determine if epidemiological patterns emerge that associate with risk for PICU admission. Data was extracted at an urban, high-volume, quaternary care facility from January 2011 to December 2017 via ICD 10 codes associated with suicide. Clinical, socioeconomic, geographical, and temporal variables were reviewed. 1,036 patients over age 9 were included, of which n=161 were PICU admissions. Females represented higher proportions of all suicide-related hospital admissions (67.9%). Looking at race/ethnicity, PICU admissions were largely Caucasian (83.2%); Blacks and Hispanics had lower odds of PICU admissions (OR: 0.49; 0.17, respectively). PICU-admitted patients were older (16.0 vs. 15.5; p=0.0001), with lower basal metabolic index (23.0 vs. 22.0; p=0.0013), and presented in summer months (OR: 1.51, p = 0.044). Time-series decomposition showed seasonal peaks in June and August. Local regions outside city limits identified higher numbers of PICU admissions. PICUs serve discrete geographical regions and are a source of information, when paired with clinical-geospatial/seasonal analyses, highlighting clinical and societal risk factors associated with PICU admissions.


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