The burden of injury in Brazil, 2003

CONTEXT AND OBJECTIVE: Since 1980, injuries have been the second biggest cause of death among the Brazilian population. This study aimed to analyze national data on fatal injuries and nonfatal injury hospitalization in Brazil, for 2003. DESIGN AND SETTING: This was a population-based descriptive study, Brazil, 2003. METHODS: Data from 126,520 fatal injuries and 733,712 nonfatal injuries seen at public hospitals were analyzed. The data were stratified by sex, age, intent and injury mechanism. Raw and age- and sex-specific rates were calculated per 100,000 individuals. RESULTS: The raw injury mortality rate was 71.5/100,000 (122.6/100,000 for male and 22.0/100,000 for female). For fatal injuries, the proportions of unintentional and intentional injuries were equal (44.3% and 46.9%, respectively). Homicides were the leading cause, 40.3% overall (28.8/100,000), followed by transport-related deaths, 26.2% overall (17.0/100,000). For nonfatal injuries, the rate was 414.8/100,000 and unintentional injuries were predominant (88.9%). Overall, the leading cause was unintentional falls, accounting for 42.6% of victims treated in public hospitals (176.8/100,000). Transport-related injuries were second: 15.0% overall; 62.0/100,000. Fractures comprised 46.7% of principal diagnoses at hospitals. The injury types in the fatal and nonfatal datasets varied according to sex and age. The highest rates were found among young males and elderly people. CONCLUSIONS: Injury prevention activities need to be developed. To prevent deaths, homicide has to be addressed. Among hospitalized cases, falls are the most important problem. Traffic-related injuries play an important role in morbidity and mortality.

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Injuries Reported by Selected Health Facilities During the Arbaeenia Mass Gathering at Babel Governorate, Iraq, 2014: Retrospective Records Analysis (Preprint)

10.2196/preprints.10877 ◽

2018 ◽

Author(s):

Abdulaal Chitheer ◽

Faris Lami ◽

Ahmed Radhi ◽

Ali Arbaji

Keyword(s):

Medical Care ◽

Traffic Accidents ◽

Public Hospitals ◽

Mass Gathering ◽

Injury Surveillance System ◽

Mass Gatherings ◽

Minor Injuries ◽

Nonfatal Injuries ◽

Injured Patients ◽

Fatal Injuries

BACKGROUND Arbaeenia is the largest religious mass gathering in Iraq. The conditions associated with mass gatherings result in high rates of injury. There have been no prior studies on injuries during the Arbaeenia mass gathering. OBJECTIVE This study describes the injuries observed during the Arbaeenia mass gathering in Babel Governorate in Iraq between November 24 and December 14, 2014. METHODS The study was conducted in Babel Governorate at the emergency departments of six public hospitals and two major temporary medical units that were located along the three roads connecting the Middle and Southern Iraqi governorates. We used the Iraq Injury Surveillance System modified form to collect information on injured patients treated in the selected facilities. Data on fatal injuries was obtained from the coroner’s office. The following data were collected from the patients: demographics, outcome of injury, place and time of occurrence, mode of evacuation and medical care before arriving at the hospital, duration of travel from place of occurrence to hospital, disposition of non-fatal injury, cause and mode of injury, and whether the injury occurred in connection with the Arbaeenia mass gathering. RESULTS Information was collected on 1564 injury cases, of which 73 were fatal. About half of the reported nonfatal injuries, 687/1404 (48.9%), and a quarter of fatalities, 18/73 (25%) were related to the Arbaeenia mass gathering (<i>P</i><.001). Most of the reported injuries were unintentional, 1341/1404 (95.51%), occurred on the street, 864/1323 (65.6%), occurred during the daytime 1103/1174 (93.95 %). Most of those injured were evacuated by means other than ambulance 1107/1206 (91.79%) and did not receive pre-hospital medical care 788/1163 (67.7%). Minor injuries 400/1546 (25.9%) and traffic accidents 394/1546 (25.5%) were the most common types of injuries, followed by falls 270/1546 (17.5%). Among fatal injuries, traffic accidents 38/73 (52%) and violence 18/73 (25%) were the leading causes of death. Mass gathering injuries were more likely to occur among individuals aged 21-40 years (odds ratio [OR] 3.5; 95% CI 2.7-4.5) and >41 years (OR 7.6; 95% CI 5.4-10.6) versus those <21 years; more likely to be unintentional than assault (OR 5.3; 95% CI 1.8-15.5); more likely to happen on the street versus at home (OR 37.7; 95% CI 22.4-63.6); less likely to happen at night than during the day (OR 0.2; 95% CI 0.1-0.4); and less likely to result in hospital admission (OR 0.5; 95% CI 0.3-0.7). CONCLUSIONS The study shows that most injuries were minor, unintentional, and nonfatal, and most people with injuries had limited access to ambulance transportation and did not require hospitalization.

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Visual impairment increases the risk of dementia, especially in young males in a 12-year longitudinal follow-up study of a national cohort

Scientific Reports ◽

10.1038/s41598-021-91026-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ga-In Lee ◽

Sang Ah Chi ◽

Kyunga Kim ◽

Sang Won Seo ◽

Hee Jin Kim ◽

...

Keyword(s):

Visual Impairment ◽

Household Income ◽

Cox Regression ◽

Population Based ◽

Study Cohort ◽

National Data ◽

Young Males ◽

Hazard Ratios ◽

National Cohort

AbstractWe investigated the effect of visual impairment (VI) on dementia development in a national cohort. In this 12-year nationwide population-based retrospective cohort study, national data were collected from National Health Insurance Cooperation of South Korea from 2002 to 2017, comprising 799,074 subjects selected from the dementia-free cohort representative of the Korean population. Crude hazard ratios (HRs) as well as age- and sex-adjusted HRs and confidence intervals (CIs) for the development of dementia were estimated using multivariable Cox regression models. VI significantly increased the risk of dementia with a HR of 2.726 (95% CI 2.251–3.300, p < 0.0001) after adjusting for age, sex, and interaction between age, sex, and VI. HR of interaction between VI and age for dementia was 0.539 (95% CI 0.436–0.667, p < 0.0001). In the sensitivity analysis after adjustment for age, sex, household income level, BMI and other comorbidities, VI showed higher risk for all the type of dementia (p < 0.0001). In subgroup analysis of VI, young males showed the highest risk for development of dementia with a HR of 2.687 (95% CI 2.219–3.254, p < 0.0001). VI significantly increased the risk of dementia in the study cohort, and young males with VI appeared to be the most susceptible to the development of dementia.

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Injuries Reported by Selected Health Facilities During the Arbaeenia Mass Gathering at Babel Governorate, Iraq, 2014: Retrospective Records Analysis

JMIR Public Health and Surveillance ◽

10.2196/10877 ◽

2020 ◽

Vol 6 (2) ◽

pp. e10877

Author(s):

Abdulaal Chitheer ◽

Faris Lami ◽

Ahmed Radhi ◽

Ali Arbaji

Keyword(s):

Medical Care ◽

Traffic Accidents ◽

Public Hospitals ◽

Mass Gathering ◽

Injury Surveillance System ◽

Mass Gatherings ◽

Minor Injuries ◽

Nonfatal Injuries ◽

Injured Patients ◽

Fatal Injuries

Background Arbaeenia is the largest religious mass gathering in Iraq. The conditions associated with mass gatherings result in high rates of injury. There have been no prior studies on injuries during the Arbaeenia mass gathering. Objective This study describes the injuries observed during the Arbaeenia mass gathering in Babel Governorate in Iraq between November 24 and December 14, 2014. Methods The study was conducted in Babel Governorate at the emergency departments of six public hospitals and two major temporary medical units that were located along the three roads connecting the Middle and Southern Iraqi governorates. We used the Iraq Injury Surveillance System modified form to collect information on injured patients treated in the selected facilities. Data on fatal injuries was obtained from the coroner’s office. The following data were collected from the patients: demographics, outcome of injury, place and time of occurrence, mode of evacuation and medical care before arriving at the hospital, duration of travel from place of occurrence to hospital, disposition of non-fatal injury, cause and mode of injury, and whether the injury occurred in connection with the Arbaeenia mass gathering. Results Information was collected on 1564 injury cases, of which 73 were fatal. About half of the reported nonfatal injuries, 687/1404 (48.9%), and a quarter of fatalities, 18/73 (25%) were related to the Arbaeenia mass gathering (P<.001). Most of the reported injuries were unintentional, 1341/1404 (95.51%), occurred on the street, 864/1323 (65.6%), occurred during the daytime 1103/1174 (93.95 %). Most of those injured were evacuated by means other than ambulance 1107/1206 (91.79%) and did not receive pre-hospital medical care 788/1163 (67.7%). Minor injuries 400/1546 (25.9%) and traffic accidents 394/1546 (25.5%) were the most common types of injuries, followed by falls 270/1546 (17.5%). Among fatal injuries, traffic accidents 38/73 (52%) and violence 18/73 (25%) were the leading causes of death. Mass gathering injuries were more likely to occur among individuals aged 21-40 years (odds ratio [OR] 3.5; 95% CI 2.7-4.5) and >41 years (OR 7.6; 95% CI 5.4-10.6) versus those <21 years; more likely to be unintentional than assault (OR 5.3; 95% CI 1.8-15.5); more likely to happen on the street versus at home (OR 37.7; 95% CI 22.4-63.6); less likely to happen at night than during the day (OR 0.2; 95% CI 0.1-0.4); and less likely to result in hospital admission (OR 0.5; 95% CI 0.3-0.7). Conclusions The study shows that most injuries were minor, unintentional, and nonfatal, and most people with injuries had limited access to ambulance transportation and did not require hospitalization.

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Injury mortality report for São Paulo State, 2003

Sao Paulo Medical Journal ◽

10.1590/s1516-31802007000300003 ◽

2007 ◽

Vol 125 (3) ◽

pp. 139-143 ◽

Cited By ~ 12

Author(s):

Vilma Pinheiro Gawryszeski

Keyword(s):

Motor Vehicle ◽

Health Department ◽

Population Based ◽

Sao Paulo ◽

The State ◽

Public Health Issue ◽

São Paulo ◽

Vehicle Traffic ◽

Intentional Injuries ◽

Injury Mortality

CONTEXT AND OBJECTIVE: Injuries are an important public health issue in the State of São Paulo. Each year around 32,000 people are killed and 180,000 are hospitalized due to injury. The aim of this work was to analyze fatal injury data to provide an overview on mortality due to injuries in the State of São Paulo in 2003, the most recent year for which data are available. DESIGN AND SETTING: Population-based descriptive study carried out in the State Health Department of São Paulo. METHODS: Data from 31,032 deaths due to injury were analyzed. The dataset was from the Mortality Information System (SIM/DATASUS). The data were stratified by sex, age, intent and mechanism of injury. Unadjusted and age and sex-specific rates were calculated per 100,000 population. RESULTS:The unadjusted injury mortality rate was 80.2/100,000 (140.2/100,000 for males and 22.4/100,000 for females). The highest rates were found for males and among young and old people. A greater proportion of intentional injuries than of unintentional deaths resulted in death (49.73% and 39.7%, respectively). Homicides were the leading cause, 44.6% overall (35.8/100,000), followed by motor vehicle traffic, 22.3% overall (17.9/100,000). Firearms played an important role among homicide deaths. Intention and mechanism of injuries varied according to sex and age group. CONCLUSION: These data indicate a need to develop injury prevention strategies, considering the magnitude of the problem and the groups at high risk. Homicides among young people have to be addressed. Motor vehicle traffic injuries play an important role for all ages.

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Effect of Pokémon GO on incidence of fatal traffic injuries: a population-based quasi-experimental study using the national traffic collisions database in Japan

Injury Prevention ◽

10.1136/injuryprev-2017-042503 ◽

2017 ◽

Vol 24 (6) ◽

pp. 448-450 ◽

Cited By ~ 8

Author(s):

Sachiko Ono ◽

Yosuke Ono ◽

Nobuaki Michihata ◽

Yusuke Sasabuchi ◽

Hideo Yasunaga

Keyword(s):

Experimental Study ◽

Traffic Accident ◽

Regression Discontinuity ◽

Population Based ◽

National Data ◽

Difference In Differences ◽

Quasi Experimental ◽

Accident Research ◽

Pokémon Go ◽

Augmented Reality Game

Pokémon GO (Niantic Labs, released on 22 July 2016 in Japan) is an augmented reality game that gained huge popularity worldwide. Despite concern about Pokémon GO–related traffic collisions, the effect of playing Pokémon GO on the incidence of traffic injuries remains unknown. We performed a population-based quasi-experimental study using national data from the Institute for Traffic Accident Research and Data Analysis, Japan. The outcome was incidence of traffic injuries. Of 127 082 000 people in Japan, 886 fatal traffic injuries were observed between 1 June and 31 August in 2016. Regression discontinuity analysis showed a non-significant change in incidence of fatal traffic injuries after the Pokémon GO release (0.017 deaths per million, 95%CI −0.036 to 0.071). This finding was similar to that obtained from a difference-in-differences analysis. Effect of Pokémon GO on fatal traffic injuries may be negligible.

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Use of ticagrelor and the risks of pneumonia and pneumonia-specific death in patients with non-acute coronary syndrome conditions: a population-based cohort study

Scientific Reports ◽

10.1038/s41598-021-00105-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Qi Feng ◽

Man Fung Tsoi ◽

Yue Fei ◽

Ching Lung Cheung ◽

Bernard M. Y. Cheung

Keyword(s):

Acute Coronary Syndrome ◽

Cohort Study ◽

Hong Kong ◽

Lower Risk ◽

Population Based ◽

Public Hospitals ◽

Sensitivity Analyses ◽

Coronary Syndrome ◽

Matching Adjustment ◽

Analysis Models

AbstractPrevious studies have shown that ticagrelor reduced risk of pneumonia in patients with acute coronary syndrome (ACS) compared to clopidogrel, however, its effect in patients with non-ACS cardiovascular diseases remains uncertain. The aim was to investigate the effect of ticagrelor on pneumonia and pneumonia-specific death compared to clopidogrel in non-ACS patients in Hong Kong. This was a population-based cohort study. We included consecutive patients using ticagrelor or clopidogrel admitted for non-ACS conditions in Hong Kong public hospitals from March 2012 to September 2019. Patients using both drugs were excluded. The outcomes of interest were incident pneumonia, all-cause death, and pneumonia-specific death. Multivariable survival analysis models were used to estimate the effects [hazard ratio (HR) and 95% confidence interval (CI)]. Propensity score matching, adjustment and weighting were performed as sensitivity analyses. In total, 90,154 patients were included (mean age 70.66 years, males 61.7%). The majority of them (97.2%) used clopidogrel. Ticagrelor was associated with a lower risk of incident pneumonia [0.59 (0.46–0.75)], all-cause death [0.83 (0.73–0.93)] and pneumonia-specific death [0.49 (0.36–0.67)]. Sensitivity analyses yielded similar results. Ticagrelor was associated with lower risk of all-cause death, pneumonia-specific death, and incident pneumonia in patients with non-ACS cardiovascular conditions, consistent with previous evidence in patients with ACS. This additional effect of anti-pneumonia should be considered when choosing a proper P2Y12 inhibitor for patients with high risk of pneumonia.

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Paediatric/young versus adult patients with long QT syndrome

Open Heart ◽

10.1136/openhrt-2021-001671 ◽

2021 ◽

Vol 8 (2) ◽

pp. e001671

Author(s):

Sharen Lee ◽

Jiandong Zhou ◽

Kamalan Jeevaratnam ◽

Wing Tak Wong ◽

Ian Chi Kei Wong ◽

...

Keyword(s):

Long Qt Syndrome ◽

Primary Outcome ◽

Population Based ◽

Public Hospitals ◽

Qtc Interval ◽

Onset Age ◽

Long Qt ◽

History Of ◽

Qt Syndrome ◽

Random Survival Forest

IntroductionLong QT syndrome (LQTS) is a less prevalent cardiac ion channelopathy than Brugada syndrome in Asia. The present study compared the outcomes between paediatric/young and adult LQTS patients.MethodsThis was a population-based retrospective cohort study of consecutive patients diagnosed with LQTS attending public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).ResultsA total of 142 LQTS (mean onset age=27±23 years old) were included. Arrhythmias other than VT/VF (HR 4.67, 95% CI (1.53 to 14.3), p=0.007), initial VT/VF (HR=3.25 (95% CI 1.29 to 8.16), p=0.012) and Schwartz score (HR=1.90 (95% CI 1.11 to 3.26), p=0.020) were predictive of the primary outcome for the overall cohort, while arrhythmias other than VT/VF (HR=5.41 (95% CI 1.36 to 21.4), p=0.016) and Schwartz score (HR=4.67 (95% CI 1.48 to 14.7), p=0.009) were predictive for the adult subgroup (>25 years old; n=58). A random survival forest model identified initial VT/VF, Schwartz score, initial QTc interval, family history of LQTS, initially asymptomatic and arrhythmias other than VT/VF as the most important variables for risk prediction.ConclusionClinical and ECG presentation varies between the paediatric/young and adult LQTS population. Machine learning models achieved more accurate VT/VF prediction.

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Abstract P287: Sex Differences in Stroke Incidence: The REGARDS Study

Circulation ◽

10.1161/circ.125.suppl_10.ap287 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Virginia J Howard ◽

Suzanne E Judd ◽

Abraham J Letter ◽

Dawn O Kleindorfer ◽

Leslie A McClure ◽

...

Keyword(s):

Sex Differences ◽

Stroke Risk ◽

Proportional Hazards ◽

Population Based ◽

Incidence Rates ◽

National Data ◽

Stroke Incidence ◽

The Difference ◽

Regards Study

Background: There are strikingly few national data available to describe sex differences in age-specific stroke incidence. Methods: REGARDS is a national, population-based, longitudinal study of black and white participants aged > 45 years old, with oversampling of blacks and residents of the stroke belt. Between 2003 and 2007, 30,239 participants were enrolled and examined; follow-up is every 6 months by telephone for self- or proxy-reported stroke, with retrieval and adjudication of medical records by physicians. This analysis included 27,756 participants with follow up data who had no physician-diagnosed stroke at baseline. Stroke incidence rates were calculated as the number of stroke events divided by the person-years at risk with 95% confidence limits. Proportional hazards models were used to assess the race-specific association of sex with stroke risk by age strata (<65, 65–74, and 75+) after adjustment for socioeconomic factors, and Framingham stroke risk factors. Results: There were 613 incident strokes events over 135,551 person-years of follow-up. Stroke incidence rates increased with age (from 237/100,000 to 1003/100,000), and were higher in men than women in both blacks and whites (left panel of figure). After multivariable adjustment, men had higher risk than women at younger ages (<75) but for the 65–75 age group, the difference is larger for blacks than whites (right panel of figure). Discussion: These national data confirm the patterns in male/female stroke risk observed in the Greater Cincinnati/Northern Kentucky Stroke Study, with smaller sex differences at older ages, and for men, larger excess risk in whites than blacks.

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Deep Recurrent Neural Networks for Edge Monitoring of Personal Risk and Warning Situations

Scientific Programming ◽

10.1155/2019/9135196 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 3

Author(s):

Emanuele Torti ◽

Mirto Musci ◽

Federico Guareschi ◽

Francesco Leporati ◽

Marco Piastra

Keyword(s):

Power Consumption ◽

Hospital Admissions ◽

State Of The Art ◽

Computational Power ◽

Wearable System ◽

Personal Risk ◽

Learning Techniques ◽

Unintentional Falls ◽

Nonfatal Injuries

Accidental falls are the main cause of fatal and nonfatal injuries, which typically lead to hospital admissions among elderly people. A wearable system capable of detecting unintentional falls and sending remote notifications will clearly improve the quality of the life of such subjects and also helps to reduce public health costs. In this paper, we describe an edge computing wearable system based on deep learning techniques. In particular, we give special attention to the description of the classification and communication modules, which have been developed by keeping in mind the limits in terms of computational power, memory occupancy, and power consumption of the designed wearable device. The system thus developed is capable of classifying 3D-accelerometer signals in real-time and to issue remote alerts while keeping power consumption low and improving on the present state-of-the-art solutions in the literature.

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