Analysis of Inpatient Hospital Falls with Serious Injury

2020 ◽  
pp. 105477382097340
Author(s):  
Eileen Costantinou ◽  
Julie A. Spencer
Keyword(s):  
Injury Severity ◽  
Healthcare Organizations ◽  
Chi Square ◽  
Service Line ◽  
Major Injury ◽  
Key Variables ◽  
Serious Injury ◽  
Serious Injuries ◽  
Age Range ◽  
Hospital Study

Fall-related serious injuries pose risks to patients and healthcare organizations. This retrospective, single-hospital study used a 38 variable instrument to understand characteristics of those who sustained a fall with serious injury. Analyses included descriptive statistics, frequency, and Chi-square tests of associations between key variables and outcomes of moderate versus major injury. Age range 25–91 years, predominantly 60–69 years (23.3%), and mostly male (50.9%). Highest percentage occurred between 0:00 and 06:59 (39.6%), and on Oncology service (28.3%). Fallers were in the room, (81.1%), sustained major injury (73.6%), fractured a major bone (43.4%), had altered mobility prior to the fall (67.9%), and had received at least one narcotic dose within 24 hours before the fall (43.2%). The associations between injury severity and age, gender, altered mobility, fall risk assessment pre-fall, and unit service line are not statistically significant, however have small-to-moderate clinical significance. This study adds to the literature in identifying characteristics of patients who sustain a fall-related serious injury.

scholarly journals Exploring the Determinants of the Severity of Pedestrian Injuries by Pedestrian Age: A Case Study of Daegu Metropolitan City, South Korea

2020 ◽  
Vol 17 (7) ◽  
pp. 2358 ◽  
Author(s):  
Seung-Hoon Park ◽  
Min-Kyung Bae
Keyword(s):  
Land Use ◽  
Injury Severity ◽  
Binary Logistic Regression ◽  
Vehicle Crashes ◽  
Pedestrian Injury ◽  
Moving Vehicles ◽  
Pedestrian Injuries ◽  
Serious Injury ◽  
Pedestrian Crashes ◽  
Age Range

Pedestrian-vehicle crashes can result in serious injury to pedestrians, who are exposed to danger when in close proximity to moving vehicles. Furthermore, these injuries can be considerably serious and even lead to death in a manner that varies depending on the pedestrian’s age. This is because the pedestrian’s physical characteristics and behaviors, particularly in relation to roads with moving vehicles, differ depending on the pedestrian’s age. This study examines the determinants of pedestrian injury severity by pedestrian age using binary logistic regression. Factors in the built environment, such as road characteristics and land use of the places where pedestrian crashes occurred, were considered, as were the accident characteristics of the pedestrians and drivers. The analysis determined that the accident characteristics of drivers and pedestrians are more influential in pedestrian-vehicle crashes than the factors of the built environmental characteristics. However, there are substantial differences in injury severity relative to the pedestrian’s age. Young pedestrians (aged under 20 years old) are more likely to suffer serious injury in school zones; however, no association between silver zones and injury severity is found for elderly pedestrians. For people in the age range of 20–39 years old, the severity of pedestrian injuries is lower in areas with more crosswalks and speed cameras. People in the age range of 40–64 years old are more likely to be injured in areas with more neighborhood streets and industrial land use. Elderly pedestrians are likely to suffer fatal injuries in areas with more traffic signals. This study finds that there are differences in the factors of pedestrian injury severity according to the age of pedestrians. Therefore, it is suggested that concrete and efficient policies related to pedestrian age are required to improve pedestrian safety and reduce pedestrian-vehicle crashes.

scholarly journals 35. Emergency Medical Services Use of Trauma Triage Criteria to Stratify Patients by Injury Severity and Need for Emergent Intervention

1996 ◽  
Vol 11 (S2) ◽  
pp. S32-S32
Author(s):  
Robert E. O'Connor ◽  
Glen H. Tinkoff ◽  
Susan Mascioli ◽  
Ross E. Megargel
Keyword(s):  
Injury Severity ◽  
Vital Signs ◽  
Penetrating Trauma ◽  
Trauma Patients ◽  
Chi Square ◽  
Probability Of Survival ◽  
Trauma Service ◽  
Severity Scores ◽  
Serious Injury ◽  
Level I

Purpose: Prehospital triage criteria (PTC) have been used to classify patients according to risk of serious injury. This study was conducted determine whether PTC could be used to identify serious injury, the need for intensive care (ICU), or immediate operative intervention (IOI).Methods: Data for this observational study were gathered prospectively, at a level-I trauma center, from a patient cohort admitted to the trauma service from 01 February to 31 July 1995. Specific triage criteria, based on information given by EMS prior to arrival were used to categorize patients by severity. Patients classified as most serious (codes) had the following: shock, major anatomic injury or proximal penetrating trauma. Patients classified as more serious (alerts) had one of the following: abnormal vital signs, Glasgow Coma Scale <13, moderate anatomic injury, high-risk mechanism of injury, or co-morbid factors. Patients not meeting either set of criteria, but were admitted, served as controls (consults). Injury severity scores (ISS) and probability of survival (Probsurvival) were calculated for each patient. The percentage admitted to the ICU, operating room (OR), or requiring IOI, were tabulated. Statistical analysis was performed using ANOVA, Mest and chi-square.

scholarly journals Estimated number of seriously injured road users admitted to hospital in France between 2010 and 2017, based on medico-administrative data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anthony Zullo ◽  
Maxime Large ◽  
Emmanuelle Amoros ◽  
Jean-Louis Martin
Keyword(s):  
Cost Estimation ◽  
Injury Severity ◽  
Medical Information ◽  
Hospital Admissions ◽  
Estimation Method ◽  
Developed Countries ◽  
Road Accident ◽  
Data Bases ◽  
Serious Injury ◽  
Serious Injuries

Abstract Background In France, like in most developed countries, the number of road accident fatalities is estimated from police data. These estimates are considered to be good-quality, unlike estimates of road injuries admitted to hospital, and especially serious injuries. Methods The present study aimed to supply such data from French hospital medical information data-bases (PMSI). In the PMSI data-bases, road accident victims are identified by external causes of morbidity and mortality, which should be systematically recorded in case of injury, but are often missing. We therefore modeled presence/absence of external cause from the relevant subset of the medicine-surgery-obstetrics PMSI data-base using a logistic regression, and then weighting the results by inverse estimated probability. As ICD-10 coding does not include injury severity, we used the AAAM10 conversion instrument developed by the American Association for Automotive Medicine, originators of the Abbreviated Injury Scale, so as to conform to the European Commission’s definition of serious injury. Results The number of road-accident related hospital admissions is estimated to be about 100000 per year; serious injuries increased from about 18000 in 2010 to almost 20000 in 2017, with almost 17000 in 2012 and 2013, with a mean of one fatality per 5 serious injury admissions. Conclusions These serious injury estimates are close to those obtained by our team from other data and with a different estimation method. The present method has the advantage of using ICD codes for injured people admitted to hospital. This classification and data source (hospital discharge registry) are also used by most european countries reporting serious injury estimates to the Commission. It allows cost estimation of hospital care, and could be applied to other types of accidental injury.

scholarly journals Risk Factors for Fall-Related Serious Injury among Korean Adults: A Cross-Sectional Retrospective Analysis

2021 ◽  
Vol 18 (3) ◽  
pp. 1239
Author(s):  
Moon-Sook Kim ◽  
Hyun-Myung Jung ◽  
Hyo-Yeon Lee ◽  
Jinhyun Kim
Keyword(s):  
Risk Factors ◽  
Fall Prevention ◽  
Medical Records ◽  
Brain Injuries ◽  
Tertiary Hospital ◽  
Antiplatelet Drugs ◽  
Cross Sectional ◽  
Complete Survey ◽  
Serious Injury ◽  
Serious Injuries

The purpose of this study was to identify the risk factors of serious fall-related injuries by analyzing the differences between two fall groups: one with serious fall-related injuries and one without such injuries. Applying a retrospective, descriptive investigation study design, we analyzed the degree of fall-related injury and the risk factors related to serious falls by conducting a complete survey of the medical records of fall patients reported throughout one full year, 2017, at a tertiary hospital in Seoul, Korea. Among the patients with reported falls, 188 sustained no injury (63.1%), 72 sustained minor injury (24.2%), and 38 patients sustained serious injury (12.8%). The serious fall-related injuries included eight lacerations requiring suture (2.7%), 23 fractures (7.7%), five brain injuries (1.7%), and two deaths (0.7%). Analysis results indicated that taking anticoagulants/antiplatelet drugs (p = 0.016) and having a fall history (p = 0.038) were statistically significant in the differences between the group with serious injury related to falls and the group without serious injury. Logistic regression revealed that taking anticoagulant/antiplatelet drugs was the factor most significantly correlated with serious injuries related to falls (OR = 2.299, p = 0.022). Results show that it is necessary to develop a patient-tailored fall prevention activity program.

scholarly journals Symptoms of Poststroke Depression among Stroke Survivors: An Appraisal of Psychiatry Needs and Care during Physiotherapy Rehabilitation

Scientifica ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Sam Chidi Ibeneme ◽  
Canice Chukwudi Anyachukwu ◽  
Akachukwu Nwosu ◽  
Georgian Chiaka Ibeneme ◽  
Muideen Bakare ◽  
...  
Keyword(s):  
Stroke Survivors ◽  
Poststroke Depression ◽  
Chi Square ◽  
Outpatient Unit ◽  
Psychiatry Review ◽  
Mini Mental Status Examination ◽  
Chi Square Test ◽  
Nigeria Teaching Hospital ◽  
Multiple Case ◽  
Age Range

Purpose. To identify stroke survivors with symptoms of poststroke depression and the extent of psychiatry needs and care they have received while on physiotherapy rehabilitation.Participants. Fifty stroke survivors (22 females and 28 males) at the outpatient unit of Physiotherapy Department, University of Nigeria Teaching Hospital, Enugu, who gave their informed consent, were randomly selected. Their age range and mean age were 26–66 years and54.76±8.79years, respectively.Method. A multiple case study of 50 stroke survivors for symptoms of poststroke depression was done with Beck’s Depression Inventory, mini mental status examination tool, and Modified Motor Assessment Scale. The tests were performed independently by the participants except otherwise stated and scored on a scale of 0–6. Data were analyzed usingZ-test for proportional significance and chi-square test for determining relationship between variables, atp<0.05.Results. Twenty-one (42.0%) stroke survivors had symptoms of PSD, which was significantly dependent on duration of stroke (χ2= 21.680, df = 6, andp=0.001), yet none of the participants had a psychiatry review.Conclusions. Symptoms of PSD may be common in cold compared to new cases of stroke and may need psychiatry care while on physiotherapy rehabilitation.

A Tale of Two Cities: What’s Driving the Firearm Mortality Difference in Two Large Urban Centers?

2021 ◽  
pp. 000313482094525
Author(s):  
Jessica K. Friedman ◽  
Elizabeth Mytty ◽  
Scott Ninokawa ◽  
Tara Reza ◽  
Elinore Kaufman ◽  
...  
Keyword(s):  
Injury Severity ◽  
Univariate Analysis ◽  
Case Fatality ◽  
Bivariate Analysis ◽  
Continuous Variables ◽  
Urban Centers ◽  
Chi Square ◽  
Police Data ◽  
Lower Blood ◽  
Mortality Difference

Introduction Per police data, the case fatality rate (CFR) of firearm assault in New Orleans (NO) over the last several years ranged between 27% and 35%, compared with 18%-22% in Philadelphia. The reasons for this disparity are unknown, and potentially reflect important system differences with broader implications for the reduction of firearm mortality. Methods A retrospective analysis of police and city-specific trauma databases between 2012 and 2017 was performed. Victims of firearm assaults within city limits were included. Univariate analysis was performed using chi-square for categorical and t-test for continuous variables. Bivariate analysis was conducted using logistic regression. Results Per police data, the CFR of firearm assault was 31% in NO and 20% in Philadelphia. However, per trauma registry data, the CFR of firearm assault was 14% in NO and 25% in Philadelphia. Patients in Philadelphia were older, had higher injury severity score, and lower blood pressure. Patients in NO had higher rates of head injury. 51% of patients in Philadelphia arrived via police compared to <1% in NO. There was no mortality difference between police and emergency medical service (EMS) transport. Longer EMS prehospital times were associated with increased mortality in NO but not Philadelphia. A much larger percentage of patients died on-scene in NO than Philadelphia. Conclusions Our findings suggest that the major driver of increased mortality following firearm assault in NO compared with Philadelphia is death prior to the arrival of first responders. Interventions that shorten prehospital time will likely have the greatest impact on mortality in NO. This should include the consideration of police transport.

scholarly journals Maximum Voluntary Molar and Incisor Biting Force and Morphological Variables in Subjects With Different Vertical Skeletal Patterns

2021 ◽  
pp. 030157422110448
Author(s):  
Ankita Singh ◽  
Pradeep Tandon ◽  
Dipti Shastri
Keyword(s):  
Chi Square ◽  
Skeletal Class ◽  
Gender Influence ◽  
Custom Made ◽  
Chi Square Test ◽  
Facial Pattern ◽  
Morphological Variables ◽  
The Right ◽  
Age Range ◽  
Male Subjects

Objective: To estimate the maximum voluntary molar biting force (MBF) and incisor biting force (IBF) and their relationship to morphological variables in subjects with different vertical skeletal patterns. Materials and Methods: Maximum voluntary MBF, IBF, and morphological variables were recorded in 120 subjects (60 males and 60 females) with skeletal class I pattern in the age range of 14 to 24 years. All subjects were divided into 3 groups: Normodivergent, hypodivergent, and hyperdivergent, according to the maxillomandibular plane angle and Jarabak ratio. Bite force measurements were undertaken using a custom-made portable digital gnathodynamometer on the left and the right sides of the jaw in the molar and incisor regions during maximal clenching. Statistical analysis was performed using independent t-test, chi-square test, and ANOVA test using SPSS version 22.0.0.0 software. Results: MBF and IBF are influenced by gender with higher values obtained for male subjects in all groups in the following order: hypodivergent > normodivergent > hyperdivergent. No significant changes were seen with morphological variables in different groups. Conclusion: Molar and incisor biting forces are highest in hypodivergent subjects and least in hyperdivergent subjects as a reflection of jaw morphology and muscular efficiency. In all groups, males exhibit higher force values than females, underlining a strong gender influence on biting force and facial pattern.

scholarly journals Assessment of the Consistency of Tetabulin Injection to the Patients with an Open Fracture Referred to the Khatamolanbia Hospital, Zahedan in 2017 with the National Guidelines

2020 ◽  
Vol 10 (1) ◽  
pp. 148
Author(s):  
Mohammad Sedaghat ◽  
Alireza Dashipour ◽  
Mahtab Masood
Keyword(s):  
Open Fracture ◽  
Pearson Correlation ◽  
Open Fractures ◽  
Risk Of Infection ◽  
National Guidelines ◽  
Clostridium Tetani ◽  
Chi Square ◽  
Cross Sectional ◽  
Age Range ◽  
Positive Effect

Background and Goal: Open fractures are at risk of infection with Clostridium tetani and severe traumatic infections. Tetabulin injection is strongly recommended for the patients with an open fracture and severe wounds. The goal of this study is to assess the consistency of tetabulin injection to the patients with an open fracture referred to the Khatamolanbia hospital in Zahedan in 2017 with the national guidelines. Materials and Methods: This study is a cross-sectional descriptive study. 300 patients with an open fracture referred to the ER of the Khatamolanbia Hospital in Zahedan in 2017 were selected as the sample. Their fracture type and severity were assessed. The data were classified in the tables and statistically analyzed using Chi-square, pared t-test, Pearson correlation, and regression in SPSS 26. Findings: Among 300 patients, 275 patients (91.7%) were male and 25 patients (8.3%) were female. The most frequent age range was 20 to 30 years old (31.7%), and the least frequent ones were 5 to 10 years old (10%) and more than 50 years old (11.6%). The results showed that gender has no significant effect on the predictability of the need of tetabulin injection for the patients with open fractures (P=0.780). However, age has a significant positive effect on the predictability of the need of tetabulin injection for the patients with open fractures; as the age increases, the need for tetabulin injection also increases, and it must be injected in the 50 years and older patients (P=0.05). Conclusion: The results showed that age was effective on the decrease of the serum level of anti-tetanus antibody, however, gender had no significant effect on it. Therefore, it is concluded that tetabulin injection for open fractures is consistent with the national guideline.

scholarly journals Correspondence of the Boston Assessment of Traumatic Brain Injury-Lifetime and In-Theater Department of Defense Medical Records

2021 ◽  
Author(s):  
Sahra Kim ◽  
Alyssa Currao ◽  
Jennifer R. Fonda ◽  
Brigitta Beck ◽  
Alexandra Kenna ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Department Of Defense ◽  
Medical Records ◽  
Brain Injuries ◽  
Injury Severity ◽  
Assessment Tools ◽  
System Level ◽  
Chi Square ◽  
Convenience Sample

Abstract Background: Since 2006, efforts have been made to increase the identification of traumatic brain injuries (TBIs) in post-9/11 military personnel. The BAT-L is the first validated instrument to diagnose TBIs throughout the lifespan in post-9/11 Veterans. The objective is to investigate the correspondence of the Boston Assessment of TBI-Lifetime (BAT-L) diagnostic prevalence and injury severity of traumatic brain injury with in-theater medical records from Department of Defense (DoD). Methods: A convenience sample of 153 Veterans deployed in 2011 enrolled in the TRACTS longitudinal cohort study was examined. Retrospective review of DoD online medical records to determine diagnostic prevalence and injury severity for all head injury cases during deployment were compared with diagnostic prevalence and injury severity from the BAT-L clinical interview using Chi-square analyses.Results: There was moderate correspondence for TBI diagnosis between the BAT-L and DoD records (κ = 0.42). Sensitivity was 72.7% and specificity was 82.8%. Comparison of injury severity also had moderate correspondence (κ = 0.41). Missing TBI diagnostic data from DoD records was frequent; 43% percent of TBIs reported on the BAT-L did not have any documentation of mTBI assessment or diagnosis in DoD records while 83% did not have in-theater documentation.Conclusions: Diagnosis of TBI via the BAT-L retrospective interview was both sensitive and specific when compared to DoD medical records. However, diagnostic correspondence was only moderate. This lack of diagnostic agreement was related to multiple factors including lack of documentation of injury, differences in assessment tools and goals, and other combat-related motivational factors associated with failure to report injuries while deployed. Several policies were implemented to address underreporting and under-documentation of TBI, yet challenges remain. Findings suggest changes at both individual-level (e.g. service members) and system-level (e.g. DoD/military branches) are needed to adequately diagnose and document all TBI during deployment.

scholarly journals ULTRASOUND PREDICTABILITY OF LOWER UTERINE SEGMENT CESAREAN SECTION SCAR THICKNESS

2020 ◽  
pp. 9-11
Author(s):  
Madhu Kumari ◽  
Kumari Bibha ◽  
Abha Sinha ◽  
Debarshi Jana
Keyword(s):  
Cesarean Section ◽  
Gestational Age ◽  
Statistical Significance ◽  
P Value ◽  
Chi Square ◽  
Medical College ◽  
Chi Square Test ◽  
Uterine Scar ◽  
Age Range ◽  
The Given

Objective: The objective of this study is to find out association between scar thickness, assessed sonographically, and intraoperative findings (IOF). Study Design: Descriptive study. Place and Duration of Study: Department of Obstetrics and Gynecology, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar from June 2019 to May 2020. Methodology: A total of 70 pregnant patients were included in this study. Transabdominal ultrasound was done for scarred uteri. Sonographic findings were co-related with introperative findings. All the given data were entered on SPSS version 23. Age was expressed as mean ± SD. Parity, gestational age, and interval between cesarean sections were expressed as frequencies with percentages. Statistical analysis was done by using Chi-square test for categorical data for association between sonographic scar thickness and intraoperative findings. The statistical significance was set at p-value <0.05. Results: The age range of the patients was 20- 36 years with a mean of 27.91 ±3.690 years. Gestational age at the time of cesarean section was between 27-40 weeks of gestation with a mean of 37 ±2.126 weeks. The interval from previous cesarean was 10 months at the minimum, and 6 years at the maximum with a mean of 2.29 ±1.0 months. Mean scar thickness was 2.5 mm. Association between scar thickness (<1-3 mm) and intaoperative findings of dehiscence and rupture showed a p-value of <0.001. Conclusion: Sonographic assessment of a uterine scar has a practical application to determine the thickness of previous scar, and assess its integrity.

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