Injury
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The costs associated with patients discharged with isolated clinician-elicited persistent midline tenderness and negative computed tomography (CT) findings have not been reported. Our aim was to determine the association of acute and post-acute patient and injury characteristics with health resource costs in such patients following road trauma. ⋯ In a homogeneous group of road trauma patients with non fracture-related persistent midline cervical tenderness, health resource costs varied considerably. As long term morbidity is common in this population, a history of resolved neurologic deficit may require greater intervention to mitigate costs. Additionally, adequate communication between acute and community care providers is essential in order to expedite the recovery process through early return to normal daily activities.
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In Canada, stratification by geographic area or socio-economic status remains relatively rare in national and provincial reporting and surveillance for injury prevention and trauma care. As injuries are known to affect some populations more than others, a more nuanced understanding of injury risk may in turn inform more effective prevention policy. In this study we assessed rates of hospitalization and death from motor vehicle collisions (MVC) in British Columbia (BC) by socio-economic status (SES) and by rural and urban status between 2001 and 2007. ⋯ Over a six-year period rural populations in BC experienced a three-fold increase in relative risk of death and an average of 50% increase in relative risk of hospitalization due to injury. When assessed against SES, relative risk of MVC mortality increased from 2.36 (2.05-2.72) to 4.07 (3.35-4.95) in reference to the least deprived areas, with an estimated 40% of all MVC-related mortality attributable to the relative differences across SES classes. Results from this study challenge current provincial and national reporting practises and emphasize the utility of employing the PAF for assessing variations in injury morbidity and mortality.
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Accurately determining the entry location of penetrating eye and face wounds and relating that to mortality and long-term morbidity is of vital importance in the design of future personal protective equipment. ⋯ Although the lower third of the face remains poorly protected, the incidence of lower facial wounds could be further reduced by the use of ballistic visors by servicemen in exposed positions in vehicles (which represented 16% of facial injuries). Such a visor could potentially have prevented 17 deaths. A rigid attachment to the front of a ballistic helmet would allow either a visor, a high visibility LED lamp or a night vision goggle to clip in and we believe this capability should be investigated through future human factor trials.
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Paediatric injury is a major global public health challenge. Epidemiological research is required for effective primary injury prevention and to develop trauma systems for optimal management of childhood injuries. This study aimed to describe the characteristics and geographical distribution of paediatric trauma deaths and to assess the relationship between rural locations and mortality rates. ⋯ Mortality rates after childhood injury are high in rural areas. Substantiated measures of rurality are required for optimal allocation of primary and secondary preventive measures.
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Due to the infrequent occurrence of large animal-related injury (LARI) in many areas, their significance as a public health problem could be overlooked. The purpose of this study was to examine the demographics and injury disparities associated with LARI. ⋯ Disparities based on age and gender are associated with hospital admission for LARI in the United States. These admissions have a significant impact on the healthcare system with nationwide cost estimates of nearly $60 million. These findings represent potential areas for targeted prevention efforts.