Using modified Delphi method to propose and validate the components of a child injury surveillance system for Iran

Purpose:Child injuries are a public health concern globally.Injury surveillance systems(ISSs)have beneficial impact on child injury prevention.There is a need for evidence-based consensus on frameworks to establish child ISSs.This research aims to investigate the key components of a child ISS for Iran and to propose a framework for implementation.Methods:Data were gathered through interview with experts using unstructured questions from January 2017 to December 2018 to identify child ISS functional components.Qualitative data were analyzed using content analysis method.Then,modified Delphi method was used to validate the functional components.Based on the outcomes of the content analysis,a questionnaire with closed questions was developed and presented to a group of experts.Consensus was achieved in two rounds.Results:In round I,117 items reached consensus.In round II,5 items reached consensus and were incorporated into final framework.Consensus was reached for 122 items comprising the final framework and representing 7 key components:goals of the system,data sources,data set,coalition of stakeholders,data collection,data analysis and data distribution.Each component consisted of several subcomponents and respective elements.Conclusion:This agreed framework will assist in standardizing data collection,analysis and distribution,which help to detect child injury problems and provide evidence for preventive measures.

Ambulance Records as an Information Source to Document and Prevent Fall Injuries in Sweden

In Sweden, there has been only limited documentation for injuries requiring ambulance responses. The main objective of this study is, through the use of historic data, to assess the suitability of ambulance records to describe circumstances with fall injuries. Methods: The injury events data around patients were sourced from the ambulance data register. Descriptive statistics were used to describe injured patients based on age group, type of injury, place of injury, injury mechanism and consequence of an injury event. Two-group comparison was performed with Pearson’s chi-squared. Predictors of transport to hospital were identified using logistic regression analyses. Result: Ambulance provides unique data on all injury events, with direct implications for translational research, public policy and clinical practice (safety promotion). In 2002 ambulance attended 3964 injured people which represents 14% of ambulance attended workload in Värmland county, Sweden. The most common trauma location was the traffic area followed by residential area and nursing home. These three injury sites account for 2320 cases (61.6%). The most common cause of injury was falls (63.9%) followed by contact with another person (26.5%). Contact with another person is the most common site of injury in the traffic area (79.5%), and men aged 25-66 years are overrepresented. Conclusion: Logistic regression found that, age-group and place code were significant predictor for being attended by ambulance. Traffic, home and nursing homes were over-represented injury environments (61.6%) that require special attention. Most injury cases occur in the home and nursing homes among people over 67 years of age. Surprisingly, most of the injury events in the traffic environment are about hitting another person. Paramedics can provide rich and valuable data on injury events. Registration of such data is entirely possible and desirable, and can be used in preventive work.

上海市伤害综合监测体系建设现状与对策建议

2008年起,我国逐步建立伤害综合监测制度,从多个来源收集死亡、住院、门急诊以及未就诊伤害的信息,绘制“伤害金字塔”,描述伤害发生的全貌。《“健康中国2030”规划纲要》明确提出“建立伤害综合监测体系”。上海市伤害监测工作一直走在全国前列,已将伤害监测纳入疾病综合监测体系建设的重要内容并持续推进。本文系统回顾国内外伤害监测进展,全面梳理上海市伤害综合监测体系建设的历程、现况和不足,提出开展专题调查拓展监测深度、依托信息化建设推进数据共享机制、综合部门需求加强伤害数据可及性和政策转化等建议,为进一步完善伤害综合监测体系建设提供依据。

Epidemiology of shoulder dislocations presenting to United States emergency departments:An updated ten-year study

BACKGROUND Glenohumeral dislocation is a common injury that may predispose patients to chronic pain and instability.However,there is a paucity of current data available regarding the epidemiological trends of this injury.AIM To provide an updated,comparative assessment of the epidemiology of shoulder dislocations presenting to emergency departments in the United States.We also sought to analyze patient demographic risk factors and consumer products associated with dislocation events.METHODS Data were obtained from the national electronic injury surveillance system database for glenohumeral dislocations between 2012 and 2021.Incidence,age,sex,and injury characteristics were analyzed using weighted population statistics as well as incidence rates and 95%confidence intervals(CI).RESULTS In total,an estimated 773039 shoulder dislocations(CI:640598-905481)presented to emergency rooms across the United States during the study period.The annual incidence rate was 23.96 per 100000 persons and the average patient age at the time of injury was 37.1 years.Significantly more male patients sustained dislocations than female patients(537189,69.5%,vs 235834,30.5%,P<0.001).With regard to associated consumer products,sports and recreation equipment were involved in the highest proportion of incidents(44.31%),followed by home structures and construction materials(21.22%),and home furnishings,fixtures,and accessories(21.21%).Regarding product sub-groups,stairs,ramps,landings,floors was cited in the greatest number of cases(131745).CONCLUSION The national annual incidence rate of glenohumeral dislocations throughout the study period was approximately 23.92 per 100000 persons.Male adolescents sustained the highest proportion of dislocations,with a peak incidence in age group 15-20 years,predominantly secondary to participation in sporting and recreational activities.Conversely,women experienced a relatively consistent incidence of dislocation throughout their lifespan.After age 63,the incidence rate of dislocations in females was found to surpass that observed in males.

Lacrosse-related injuries in boys and girls treated in U.S.emergency departments,2000-2016

Background:Lacrosse is one of the fastest-growing sports in the United States.Its rules regarding permitted contact differ by sex and age.There are no known studies using a nationally representative data set to analyze lacrosse injury patterns over several years by sex and age in the youth population.Methods:A retrospective analysis was performed using data from the National Electronic Injury Surveillance System for youth aged 11-18 years who were treated for lacrosse-related injuries in U.S.emergency departments from 2000 to 2016.Based on our review of the case narratives,we created and coded a new injury-mechanism variable.We generated national estimates from 6406 cases.Results:An estimated 206,274 lacrosse-related injuries to youths aged 11-18 years were treated in U.S.emergency departments from 2000 to 2016.The rate of injuries per 10,000 significantly increased from 1.9 in 2000 to a peak of 5.3 in 2012(p<0.0001),followed by a significant decrease to 3.4 in 2016(p=0.020).Injury mechanism,body part injured,and diagnosis differed by sex.Boys were 1.62 times(95%confidence interval(95%CI):1.25-2.09)more likely than girls to be injured by player-to-player contact.Girls were 2.21 times(95%CI:1.96-2.49)more likely than boys to have non-contact injuries.Overall,as age increased,the percentage of injuries from lacrosse sticks decreased and player-toplayer contact increased.Conclusion:Despite additional protective regulations in the sport,lacrosse is an important source of injury where we continue to see differences by sex and age.This study supports the continuation,modification,and addition of rules aimed at reducing lacrosse injury risk.

Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran： 2011-2014 data

Purpose： The administrative data from trauma centers could serve as potential sources of invaluable information while studying epidemiologic features of car accidents. In this cross-sectional analysis of Shahid Rajaee hospital administrative data, we aimed to evaluate patients injured in car accidents in terms of age, gender, injury severity, injured body regions and hospitalization outcome in the recent four years （2011-2014）. Methods： The hospital registry was accessed at Shiraz Trauma Research Center （Shiraz, lran） and the admission＇s unit data were merged with the information gathered upon discharge. A total number of 27,222 car accident patients aged over 15 years with International Classification of Diseases 10th revision （ICD-10） external causes of injury codes （V40.9-V49.9） were analyzed. Injury severity score and injured body regions were determined based on converting ICD-10 injury codes to Abbreviated Injury Scale （AIS- 98） severity codes using a domestically developed electronic algorithm. A binary logistic regression model was applied to the data to examine the contribution of all independent variables to in-hospital mortality. Results： Men accounted for 68.9% of the injuries and the male to female ratio was 2.2：1. The age of the studied population was （34 ±15） years, with more than 77.2% of the population located in the 15-45 years old age group. Head and neck was the most commonly injured body region （39.0%） followed by extremities （27.2%）. Injury severity score （ISS） was calculated for 13,152 （48.3%） patients, of whom, 80.9% had severity scores less than 9. There were 332 patients （1.2%） admitted to the intensive care units and 422 in-hospital fatalities （1.5%） were recorded during the study period. Age above 65 years [OR = 7.4, 95%, CI （5.0-10.9）], ISS above 16 [OR - 9.1, 95% CI （5.5-14.9）], sustaining a thoracic inJury [OR - 7.4, 95%, CI （4.6 -11.9）] and head injury [OR - 4.9, 95%, CI （3.1-7.6）] were the most important independent predictors of death following car accidents. Conclusion： Hospital administrative databases of this hospital could be used as reliable sources of in- formation in providing epidemiologic reports of car accidents in terms of severity and outcomes. Improving the quality of recordings at hospital databases is an important initial step towards more comorehensive iniurv surveillance in Fats, Iran.