Blunt Adrenal Injury: Results of a State Trauma Registry Review

2019 ◽  
Vol 85 (4) ◽  
pp. 390-396 ◽  
Author(s):  
Jody C. Digiacomo ◽  
Noam Gerber ◽  
L. D. George Angus ◽  
Swapna Munnangi ◽  
Sara Cardozo-Stolberg
Keyword(s):  
New York ◽  
Adrenal Gland ◽  
Blunt Trauma ◽  
Injury Severity ◽  
Trauma Registry ◽  
New York State ◽  
Incidence Rates ◽  
Inhospital Mortality ◽  
Increased Risk ◽  
Severity Scores

In the past, injuries to the adrenal glands due to blunt trauma were considered rare, and were reported to be associated with high Injury Severity Scores (ISSs) and high mortality. Recent reports have reported a much high incidence associated with lower ISS and lower mortality. The purpose of this study was to assess the incidence of adrenal gland injuries due to blunt trauma in a large state trauma registry and determine whether these injuries are associated with a higher ISS and increased risk for mortality. A retrospective review was performed on the New York State Trauma Registry comparing blunt injured adults with adrenal injuries to those who did not. Concurrent organ injuries, ISS, and inhospital mortality were compared. Three hundred thirty-nine patients with adrenal gland injuries were identified. Concurrent liver and kidney injuries were more prevalent in the adrenal injured group, and concurrent injuries to the small and large intestine and spleen were more prevalent in the nonadrenal injured group. There was no difference in ISS or mortality between the adrenal injured and nonadrenal injured populations. The results of this study are consistent with recent smaller studies which identified incidence rates which were higher than previously reported and that ISS and mortality risk were unchanged by the presence of blunt adrenal gland injuries. Adrenal gland injuries due to blunt trauma are not uncommon, with an incidence rate of 0.61 per cent. Adrenal gland injuries are not associated with higher ISS or an increased risk of mortality.

scholarly journals LUNG CANCER INCIDENCE IN VARIOUS CITIES OF THE WORLD (REVIEW)

2020 ◽  
Vol 66 (3) ◽  
pp. 239-246
Author(s):  
Liliya Zhuykova ◽  
Yevgeniy Choynzonov ◽  
Olga Ananina ◽  
Nina Lyakhova ◽  
Lidiya Pikalova
Keyword(s):  
Lung Cancer ◽  
New York ◽  
New York City ◽  
Cancer Incidence ◽  
Rural Areas ◽  
Urban Areas ◽  
New York State ◽  
Incidence Rates ◽  
Lung Cancer Incidence ◽  
Cancer Incidence Rates

Apart from smoking, an urban factor is an established risk factor for lung cancer. Lung cancer is associated with environmental factors, occupational exposure, bad habits and lifestyle factors. Approximately 17% of the annual deaths from lung cancer among adults are attributable to exposure to carcinogens located in the surface layer of the urban atmosphere, with industrial pollution and occupational hazards. According to recent data, 97% of cities in low- and middle-income countries with a population of more than 100 thousand people do not meet WHO recommendations for air quality; in high-income countries, this figure has been reduced to 49%. In the United States, the studies demonstrated that the prevalence of combined lung cancer was higher in urban areas (10.2%) than in rural areas (4.8%). There was a difference in the lung cancer incidence rates between the populations of the New York City and the New York State. In males, the lung cancer incidence rates were 1.4 times higher in the New York City than in the New York State (68.9 ± 1.2 0/0000 versus 48.5 ± 0.2 0/0000). In females, the lung cancer incidence rates were 1.2 times higher in the New York City than in the New York State (43.0 ± 0.3 and 34.9 ± 0.1 0/0000, respectively). In China, in urban areas, the lung cancer incidence mortality rates were 36.6 0/0000 and 28.9 0/0000, respectively. In rural areas, the corresponding values were 33.4 and 26.6 0/0000, respectively. Although the lung cancer incidence and mortality rates are higher in urban areas than in rural areas, these differences are gradually decreasing: the incidence rate between urban and rural areas has decreased from 2.1 to 1.1. The issue of the impact of environment on the incidence of lung cancer is challenging. The outdoor environment affects people’s health with varying degrees of intensity both in time and in space.

Blood Transfusion is an Independent Predictor of Mortality after Blunt Trauma

2007 ◽  
Vol 73 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Anthony Charles ◽  
Almaasa Shaikh ◽  
Madonna Walters ◽  
Susan Huehl ◽  
Richard Pomerantz
Keyword(s):  
Logistic Regression ◽  
Blood Transfusion ◽  
Blunt Trauma ◽  
Injury Severity ◽  
Trauma Registry ◽  
Blunt Injury ◽  
Trauma Patients ◽  
Trauma Population ◽  
Transfusion Requirements ◽  
Level 2

Allogeneic blood transfusion is associated with increased morbidity and mortality. The authors evaluated the affect of blood transfusion, independent of injury severity on mortality. The authors conducted a retrospective review of all patients, age ≥18 years with blunt injury admitted to their Level 2 trauma center from 1994 to 2004 by query of the NTRACS trauma registry. Initial systolic blood pressure and heart rate determined the shock index. Logistic regression was used to model the affect of blood transfusion on mortality. Transfusion requirements were categorized as follows: A, 0 U; B, 1 to 2 U; C, 3 to 5 U; D, ≥6 U blood. In this sample of 8215 blunt trauma patients, 324 patients received blood transfusion. Mortality rates between the transfused and nontransfused groups were 15.12 per cent and 1.84 per cent ( P < 0.000) respectively. In the logistic regression model, transfusion category B did not have a significant affect on the odds of death ( P = 0.176); the affect of transfusing 3 to 5 U and ≥6 U had a mortality odds ratio of 3.22 ( P = 0.002) and 4.87 ( P = 0.000) respectively. Transfusing ≥2U blood was strongly associated with mortality in this blunt trauma population. There must be a continuous attempt to limit blood transfusion when feasible and physiologically appropriate.

An Epidemiologic Survey of Injury in Golfers

1998 ◽  
Vol 7 (2) ◽  
pp. 112-121 ◽  
Author(s):  
John J. Nicholas ◽  
Margaret Reidy ◽  
Denise M. Oleske
Keyword(s):  
New York ◽  
Carpal Tunnel ◽  
New York State ◽  
Golf Ball ◽  
Significant Morbidity ◽  
York State ◽  
Epidemiologic Survey ◽  
Increased Risk ◽  
High Incidence ◽  
Back Problems

In order to supplement the literature that describes individual injuries of the shoulder, carpal tunnel, and back in golfers, we administered a survey to demonstrate the incidence of golfers' injuries and describe the most frequent types. A questionnaire was administered to 1,790 members of the New York State Golf Association (amateur) under age 21. Three hundred sixty-eight players responded. Half of those responding had been struck by a golf ball at least on one occasion (47.6%), and 23% of the injuries were to the head or neck. Male golfers were 2.66 times more likely to be struck by a golf ball than females. Women and golfers with a higher handicap were at an increased risk for upper extremity problems, whereas younger and overweight golfers were more likely to have golf-related back problems. We concluded that golf is associated with a significant morbidity. Repetitious trunk and upper limb motions probably contribute to musculoskeletal disorders. However, an unexpectedly high incidence of trauma from projectile golf balls leads to the conclusion that no amount of stretching or muscular exercise is as important as increased alertness by golfers to decrease this hazard.

The impact of age and gender on the incidence of glial tumors in New York state from 1976–1995

2000 ◽  
Vol 93 (6) ◽  
pp. 932-939 ◽  
Author(s):  
Brian P. McKinley ◽  
Arthur M. Michalek ◽  
Robert A. Fenstermaker ◽  
Robert J. Plunkett
Keyword(s):  
New York ◽  
New York State ◽  
Incidence Rates ◽  
Female Population ◽  
Glial Tumors ◽  
Content Type ◽  
York State ◽  
Adjusted Incidence ◽  
Age And Sex ◽  
Fine Print

Object. In this study the authors describe secular trends in the incidence of three glial tumors—glioblastoma multiforme (GBM), astrocytoma not otherwise specified (ANOS), and anaplastic astrocytoma (AA)—in New York state from 1976 through 1995. They also describe the effect of age and sex on the relative risk (RR) for these tumors, specifically GBM.Methods. Crude, age-, and sex-specific incidence rates were calculated for each tumor type from 1976 to 1995 by using data from the New York State Cancer Registry. Age-adjusted incidence rates were calculated by the direct standardization procedure, in which the 1970 United States Census Population Standard Million is used. The RR of GBM for the female population was calculated and plotted. Statistical comparisons were made using Pearson's correlation coefficient and regression analysis with the coefficient of variation.Conclusions. The age-adjusted incidence of these three glial tumors increased during the study period. Increases in age-specific incidence of GBM were primarily limited to patients 60 years of age or older. The reasons for these increases cannot be fully explained with the data. Those in the female population had a lower risk of developing these tumors than those in the male. For GBM, the protective effect of sex was first evident at the approximate age of menarche, was greatest at the approximate age of menopause, and decreased in postmenopausal age strata. The overall protective effect of female sex and the described trend in RR for GBM in the female population suggests that sex hormones and/or genetic differences between males and females may play a role in the pathogenesis of this tumor.

Abstract WP185: The Risk of Pregnancy-associated Stroke Does not Increase With Age: an Analysis of Claims Data From New York State

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Hajere J Gatollari ◽  
Eliza C Miller ◽  
Gloria Too ◽  
Amelia K Boehme ◽  
Anna Colello ◽  
...  
Keyword(s):  
New York ◽  
Pregnant Women ◽  
Older Women ◽  
Post Partum ◽  
New York State ◽  
Vital Statistics ◽  
York State Department ◽  
Limited Information ◽  
York State ◽  
Increased Risk

Introduction: Stroke is a rare but feared complication of pregnancy and the postpartum period. Prior studies have found that older age is associated with increased risk of pregnancy-associated stroke (PAS). It is unclear to what extent pregnancy contributes to this increased risk of PAS. There is limited information on age-specific incidence ratios to assess whether the risk of PAS is comparable to stroke in similarly aged non-pregnant women. Hypothesis: Increased incidence of PAS in older women is attributable to the increasing risk of stroke with age. Methods: We used the 2008-2012 New York State Department of Health (NYS DOH) Statewide Planning and Research Cooperative System (SPARCS) inpatient database to identify women aged 12-50 with ischemic (ICD-9 433, 434, 436), ICH (ICD-9 431), SAH (ICD-9 430), and non-specified PAS, including post-partum stroke (ICD-9 671.7, 674). Population data were obtained from NYS DOH Vital Statistics. Age-specific incidence ratios were calculated for strokes in pregnant or postpartum women compared to non-pregnant women. We used standard age groups considered by obstetricians to be at low, moderate, or high risk for pregnancy complications, including stroke. Results: Of 7099 stroke hospitalizations occurring in women, 386 were in pregnant women. The table shows the incidence of stroke in women stratified by pregnancy status and age group, and age-specific incidence risk ratios associated with pregnancy. Conclusions: Compared to non-pregnant women of the same age, pregnant women appeared to be at similarly increased risk of stroke at all ages, except for those over age 40. These results suggest that pregnancy itself does not further increase the risk of stroke in older women, though they could also reflect a tendency for healthier women to have pregnancies at later ages. More research is needed to investigate the characteristics that may put younger women at increased risk of stroke, compared to their non-pregnant contemporaries.

scholarly journals Acute traumatic injuries of the adrenal gland: results of analysis of the Pennsylvania trauma outcomes study registry

2020 ◽  
Vol 5 (1) ◽  
pp. e000487
Author(s):  
Jody C DiGiacomo ◽  
Noam Gerber ◽  
L D George Angus ◽  
Swapna Munnangi ◽  
Sara Cardozo-Stolberg
Keyword(s):  
Adrenal Gland ◽  
Injury Severity ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Severe Injury ◽  
Level Of Evidence ◽  
Trauma Outcomes ◽  
Traumatic Injuries ◽  
Abdominal Organs ◽  
Outcomes Study

BackgroundBlunt injuries to the adrenal glands are considered rare, associated with severe injury, and highly mortal, based on autopsy series and earlier retrospective reviews. Recent studies have reported higher incidence rates associated with lower injury severity and mortality rates.MethodsA 3-year review of the Pennsylvania Trauma Outcomes Study Registry of adults with intra-abdominal injuries after blunt trauma was performed and associated organ injuries, injury parameters and in-hospital mortality were compared between those with and those without adrenal gland injury.Results5679 patient records were identified, 439 with adrenal gland injuries and 5240 without. The liver and the kidney were the intra-abdominal organs most frequently associated with injuries to an adrenal gland, and the spleen was the intra-abdominal organ most frequently injured in those without an adrenal gland injury. There was no difference in mortality rates.DiscussionInjuries to the adrenal gland occur with an incidence of 0.43% after blunt force trauma. The presence of a blunt adrenal gland injury is not a marker of severe injury or associated with an increased mortality rate.Level of evidenceII, Retrospective Study.

Changing to AIS 2005 and agreement of injury severity scores in a trauma registry with scores based on manual chart review

Injury ◽  
2011 ◽  
Vol 42 (9) ◽  
pp. 934-939 ◽  
Author(s):  
Kenneth E. Stewart ◽  
Linda D. Cowan ◽  
David M. Thompson
Keyword(s):  
Chart Review ◽  
Injury Severity ◽  
Trauma Registry ◽  
Severity Scores
Sign in / Sign up

Export Citation Format

Share Document