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Hauser E, Borgatto AF, Meneghini V, Barbosa AR. Factors Associated With Driving Status Among Brazilian Older Adults. J Appl Gerontol 2022; 41:2244-2252. [PMID: 35654484 DOI: 10.1177/07334648221106764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study analyzed the factors associated with driving status among older adults in Brazil. The sample consisted of 15,221 older adults (≥65 years) residing in Brazilian capitals in 2018. The following question established the participants' driving status: "Do you drive a car, motorcycle, and/or another vehicle?" Sociodemographic, health conditions, and health-related behaviors were derived through standard procedures. Poisson regression analysis was performed to estimate prevalence ratios and 95% confidence interval. The prevalence of drivers was 28.83%. We found that being physically active during leisure time and higher daily recreational screen time (>3 h/day) were associated with driving status. Self-perceived negative health and being physically active by commuting showed an inverse association with driving status. The high prevalence of older drivers and the characteristics associated with driving reinforces the importance of public policy strategies for these individuals.
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Affiliation(s)
- Eduardo Hauser
- School of Sports, 28117Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Adriano F Borgatto
- 28117School of Technology, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Vandrize Meneghini
- Center for Clinical and Epidemiological Research, Universidade de São Paulo, São Paulo, Brazil
| | - Aline R Barbosa
- School of Sports, 28117Universidade Federal de Santa Catarina, Florianópolis, Brazil
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Gökçe E, Stojan R, Mack M, Bock O, Voelcker-Rehage C. Lifestyle Matters: Effects of Habitual Physical Activity on Driving Skills in Older Age. Brain Sci 2022; 12:608. [PMID: 35624995 PMCID: PMC9139606 DOI: 10.3390/brainsci12050608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022] Open
Abstract
Research on multitasking driving has suggested age-related deterioration in driving performance. It has been shown that physical and cognitive functioning, which are related to driving performance and decline with aging, are positively associated with physical activity behavior. This study aimed to explore whether driving performance decline becomes severe with advancing age and whether physical activity behavior modifies age-related deterioration in driving performance. A total of one hundred forty-one healthy adults were categorized into three groups based on their age; old-old (74.21 ± 2.33 years), young-old (66.53 ± 1.50 years), and young adults (23.25 ± 2.82 years). Participants completed a realistic multitasking driving task. Physical activity and cardiorespiratory fitness levels were evaluated. Older groups drove more slowly and laterally than young adults, and old-old adults drove slower than young-old ones across the whole driving course. Physical activity level did not interact with the aging effect on driving performance, whereas cardiovascular fitness interacted. Higher-fitness young-old and young adults drove faster than higher-fitness old-old adults. Higher-fitness old adults drove more laterally than higher-fitness young adults. The present study demonstrated a gradual decline in driving performance in old adults, and cardiorespiratory fitness interacted with the aging effect on driving performance. Future research on the interaction of aging and physical activity behavior on driving performance in different age groups is of great value and may help deepen our knowledge.
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Affiliation(s)
- Evrim Gökçe
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149 Münster, Germany; (R.S.); (M.M.)
- Sports Health Rehabilitation Laboratory, Ankara City Hospital, Ankara 06800, Turkey
| | - Robert Stojan
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149 Münster, Germany; (R.S.); (M.M.)
| | - Melanie Mack
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149 Münster, Germany; (R.S.); (M.M.)
| | - Otmar Bock
- Institute of Exercise Training and Sport Informatics, German Sport University, Am Sportpark Muengersdorf 6, 50927 Cologne, Germany;
| | - Claudia Voelcker-Rehage
- Department of Neuromotor Behavior and Exercise, Institute of Sport and Exercise Sciences, University of Münster, Wilhelm-Schickard-Straße 8, 48149 Münster, Germany; (R.S.); (M.M.)
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Nakao S, Katayama Y, Kitamura T, Hirose T, Tachino J, Ishida K, Ojima M, Kiguchi T, Umemura Y, Noda T, Matsuyama T, Kiyohara K, Nakagawa Y. Assessing the impact of the national traffic safety campaign: a nationwide cohort study in Japan. BMJ Open 2022; 12:e054295. [PMID: 35105584 PMCID: PMC8808439 DOI: 10.1136/bmjopen-2021-054295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES This study aimed to examine the difference in mortality from serious road traffic injuries during the National Traffic Safety Campaign compared with other periods and identify the common mechanisms of injury by age group in Japan. DESIGN A retrospective review of Japan Trauma Data Bank (JTDB). SETTING A total of 280 participating major emergency institutions across Japan. PARTICIPANTS Patients with road traffic injuries registered in JTDB between 2004 and 2018 were recruited in the study. We included patients injured by traffic crashes during the National Traffic Safety Campaigns and controls using a double control method. The National Traffic Safety Campaign comprises 10 consecutive days in spring and fall (20 days in each year), and controls was the same calendar days 2 weeks before and after the days in the National Traffic Safety Campaigns (40 days in each year) to control for weekday, seasonal and yearly trends. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was in-hospital mortality. The secondary outcome was the incidences of severe traffic injury. RESULTS Among 126 857 patients recorded as road traffic injuries in JTDB, we identified 6181 patients (21 cases per day) with injuries occurring during the National Traffic Safety Campaigns and 12 382 controls (21 cases per day). The overall in-hospital mortality was 11.4%. We did not observe a significant difference in in-hospital mortality between the groups (11.8% vs 11.1%) with an adjusted OR of 1.05 (95% CI 0.95 to 1.16). The most common mechanism of injury in each age group was bicycle crash among children, motorcycle crash among adults and pedestrian among the elderly. CONCLUSIONS We found no change in the incidence of severe traffic injury or in-hospital mortality during the National Traffic Safety Campaign in Japan. Serious road trauma was high for bicycles among children, motorcycles among adults and pedestrian among the elderly.
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Affiliation(s)
- Shunichiro Nakao
- Department of Traumatology and Acute Critical Medicine, Osaka University Faculty of Medicine Graduate School of Medicine, Suita, Osaka, Japan
| | - Yusuke Katayama
- Department of Traumatology and Acute Critical Medicine, Osaka University Faculty of Medicine Graduate School of Medicine, Suita, Osaka, Japan
| | - Tetsuhisa Kitamura
- Department of Social and Environmental Medicine, Osaka University Faculty of Medicine Graduate School of Medicine, Suita, Osaka, Japan
| | - Tomoya Hirose
- Department of Traumatology and Acute Critical Medicine, Osaka University Faculty of Medicine Graduate School of Medicine, Suita, Osaka, Japan
| | - Jotaro Tachino
- Department of Traumatology and Acute Critical Medicine, Osaka University Faculty of Medicine Graduate School of Medicine, Suita, Osaka, Japan
| | - Kenichiro Ishida
- Department of Acute Medicine and Critical Care Medical Center, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Masahiro Ojima
- Department of Acute Medicine and Critical Care Medical Center, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Takeyuki Kiguchi
- Department of Emergency and Critical Care, Osaka General Medical Center, Osaka, Japan
| | - Yutaka Umemura
- Department of Emergency and Critical Care, Osaka General Medical Center, Osaka, Japan
| | - Tomohiro Noda
- Department of Traumatology and Critical Care Medicine, Osaka City University Graduate School of Medicine School of Medicine, Osaka, Japan
| | - Tasuku Matsuyama
- Department of Emergency Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kosuke Kiyohara
- Department of Food Science, Otsuma Women's University, Chiyoda-ku, Tokyo, Japan
| | - Yuko Nakagawa
- Department of Traumatology and Acute Critical Medicine, Osaka University Faculty of Medicine Graduate School of Medicine, Suita, Osaka, Japan
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Okui T, Park J. Analysis of the regional distribution of road traffic mortality and associated factors in Japan. Inj Epidemiol 2021; 8:60. [PMID: 34711289 PMCID: PMC8555252 DOI: 10.1186/s40621-021-00356-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regional differences in road traffic (RT) mortality among municipalities have not been revealed in Japan. Further, the association between RT mortality and regional socioeconomic characteristics has not been investigated. We analyzed geographic differences in RT mortality and its associated factors using the Vital Statistics in Japan. METHODS We used data on RT mortality by sex and municipality in Japan from 2013 to 2017. We calculated the standardized mortality ratio (SMR) of RT for each municipality by sex using an Empirical Bayes method. The SMRs were mapped onto a map of Japan to show the geographic differences. In addition, an ecological study investigated the municipal characteristics associated with the SMR using demographic socioeconomic, medical, weather, and vehicular characteristics as explanatory variables. The ecological study used a spatial statistical model. RESULTS The mapping revealed that the number of municipalities with a high SMR of RT (SMR > 2) was larger in men than in women. In addition, SMRs of capital areas (Kanagawa and Tokyo prefectures) tended to be low in men and women. The regression analysis revealed that population density was negatively associated with the SMR in men and women, and the degree of the association was the largest among explanatory variables. In contrast, there was a positive association between the proportion of non-Japanese persons and SMR. The proportions of lower educational level (elementary school or junior high school graduates), agriculture, forestry, and fisheries workers, service workers, and blue-collar workers were positively associated with the SMR in men. The proportion of unemployed persons was negatively associated with the SMR in men. CONCLUSIONS Socioeconomic characteristics are associated with geographic differences in RT mortality particularly in men. The results suggested preventive measures targeted at men of low socioeconomic status and non-Japanese persons are needed to decrease RT mortality further.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1, Higashi-ku, Fukuoka City, Fukuoka Prefecture, 812-8582, Japan.
| | - Jinsang Park
- Department of Pharmaceutical Sciences, International University of Health and Welfare, Fukuoka, Japan
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Shoar S, Hosseini FS, Naderan M, Khavandi S, Tabibzadeh E, Khavandi S, Shoar N. Cardiac injury following blunt chest trauma: diagnosis, management, and uncertainty. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2021; 11:80-89. [PMID: 34094699 PMCID: PMC8166660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 01/26/2021] [Indexed: 06/12/2023]
Abstract
Due to the evolving nature of injuries caused by high-speed motor vehicle accidents, the incidence rate of blunt chest trauma is continuously increasing. Blunt cardiac injury (BCI) is a potentially lethal entity as a result of trauma to the chest. Due to its indistinct clinical presentation and heterogeneous definition, BCI might be missed during the initial survey of trauma patients in the acute care setting. Additionally, unnecessary operation in hemodynamically stable patients in whom the extent of cardiac injury has not been thoroughly evaluated might result in adverse clinical outcome. Due to ongoing advances in the diagnostic modalities and minimally invasive procedures in the acute care and trauma setting, patients with blunt trauma to the chest, who are also suspected of having a BCI, can be monitored with more confidence and managed accordingly as the clinical scenario evolves. While low-yield diagnostics such as chest X ray, electrocardiogram, and a bedside ultrasonography are still routinely performed in patients with suspected BCI, high-yield modalities such as computed tomography, highly sensitive cardiac biomarkers, and transesophageal echocardiography are all a next step in the management approach. In either case, the clinical judgment of the medical team plays a pivotal role in transition to the next step with adequate resuscitation remaining an inevitable part.
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Affiliation(s)
- Saeed Shoar
- Department of Clinical Research, ScientificWriting CorpHouston, TX, USA
| | | | - Mohammad Naderan
- Faculty of Medicine, Tehran University of Medical SciencesTehran, Iran
| | - Siamak Khavandi
- Department of Ophthalmology, Tabriz University of Medical SciencesTabriz, Iran
| | - Elsa Tabibzadeh
- Department of Anaesthesiology and Critical Care, Tabriz University of Medical SciencesTabriz, Iran
| | - Soheila Khavandi
- Department of Cardiology, Tabriz University of Medical SciencesTabriz, Iran
| | - Nasrin Shoar
- Faculty of Medicine, Kashan University of Medical SciencesKashan, Iran
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Kim JS, Bae JB, Han K, Hong JW, Han JH, Kim TH, Kwak KP, Kim K, Kim BJ, Kim SG, Kim JL, Kim TH, Moon SW, Park JY, Park JH, Byun S, Suh SW, Seo JY, So Y, Ryu SH, Youn JC, Lee KH, Lee DY, Lee DW, Lee SB, Lee JJ, Lee JR, Jeong H, Jeong HG, Jhoo JH, Han JW, Kim KW. Driving-Related Adverse Events in the Elderly Men: A Population-Based Prospective Cohort Study. Psychiatry Investig 2020; 17:744-750. [PMID: 32683838 PMCID: PMC7449837 DOI: 10.30773/pi.2019.0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 03/18/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study estimated the incidence of driving-related adverse events and examined the association of cognitive function with the risk of future driving-related adverse events in the elderly Korean male population. METHODS We analyzed 1,172 male drivers aged 60 years or older in the Korean Longitudinal Study on Cognitive Aging and Dementia (KLOSCAD). Using the data from Korean National Police Agency, we classified the participants into three groups: safe driving (drove for 2 years after baseline without a traffic accident or repeated violations), driving cessation (stopped driving), and risky driving (one or more traffic accidents or repeated violations). We estimated the incidences of driving cessation and risky driving, and examined the effect of cognitive function on their risks. RESULTS The incidence of driving cessation and risky driving in the Korean male drivers aged 60 years or older was 19.3 and 69.9 per 1,000 person-years respectively and increased in the late 80s. Drivers with better baseline Word List Memory Test scores showed less risky driving (OR=0.94, p=0.039). CONCLUSION Driving-related adverse events increased in late 80s, and better memory function was protective against these events.
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Affiliation(s)
- Jae Sung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jong Bin Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kyuhee Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jong Woo Hong
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Hyun Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, Republic of Korea
| | - Kayoung Kim
- Department of Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University College of Medicine, Jinju, Republic of Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Tae Hyun Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Republic of Korea
| | - Jae Young Park
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Republic of Korea
| | - Seonjeong Byun
- Department of Neuropsychiatry, National Medical Center, Seoul, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung Wan Suh
- Department of Psychiatry, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
| | - Ji Young Seo
- Department of Psychiatry, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Yoonseop So
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, Republic of Korea
| | - Kyoung Hwan Lee
- Department of Psychiatry, Bongseng Memorial Hospital, Busan, Republic of Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong-Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, Republic of Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, Republic of Korea
| | - Ju Ri Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyeon Jeong
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyun-Ghang Jeong
- Department of Psychiatry, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jin Hyeong Jhoo
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, Republic of Korea
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Factors influencing vehicle passenger fatality have changed over 10 years: a nationwide hospital-based study. Sci Rep 2020; 10:3316. [PMID: 32094429 PMCID: PMC7040014 DOI: 10.1038/s41598-020-60222-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 02/10/2020] [Indexed: 11/22/2022] Open
Abstract
Traffic injury trends have changed with safety developments. To establish effective preventive measures against traffic fatalities, the factors influencing fatalities must be understood. The present study evaluated data from a national medical database to determine the changes in these factors over time, as this has not been previously investigated. This observational study retrospectively analysed data from the Japanese Trauma Data Bank. Vehicle passengers involved in collisions from 2004–2008 and 2016–2017 were included. Data were compared between the two study periods, and between fatal and non-fatal patients within each period. Multivariate logistic regression analyses were performed to determine the factors influencing fatalities. In 2016–2017, patients were older and had lower fatality rates. In 2004–2008, fatalities were more likely to involve older male front-seat passengers with low d-BP, BT, and GCS values, and high AIS of the neck and abdomen. However, in 2016–2017, fatalities were more likely to involve older males with low GCS, high AIS of the abdomen, and positive focused assessment with sonography for trauma results. Our study identified independent factors influencing vehicle passenger fatalities, which will likely continue to evolve with the aging of the population and changing manners of injury.
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Hauser E, Barbosa AR, Pfützenreuter AH. Prevalence of older drivers in Brazil: results from Vigitel 2018. GERIATRICS, GERONTOLOGY AND AGING 2020. [DOI: 10.5327/z2447-2123202000089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE: To estimate the prevalence of Brazilian older adults who drive a car/ride a motorcycle, according to sociodemographic characteristics. METHODS: This cross-sectional study uses data from the 2018 Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel). The prevalence of drivers was determined by an affirmative answer to the following question: “Do you drive a car, motorcycle and/or other vehicle?”. RESULTS: Among the 15,333 individuals aged 65 and over living in Brazilian capitals and the Federal District, the overall prevalence of drivers was 28.73% (95%CI 27.22 – 30.29) and was higher among men (53.37%; 95%CI 50.45 – 56.28), those with higher education (65.44%; 95%CI 61.98 – 68.75), and individuals aged 65 to 69 years (35.7%; 95%CI 33.06 – 38.61). Among the regions of Brazil, prevalence varied from 35% (Midwest and South) to approximately 22% (North and Northeast). Florianopolis (42.2%; 95%CI 38.05 – 46.47) and Palmas (40.32%; 95%CI 32.74 – 48.38) were the cities with the highest prevalence of older drivers. CONCLUSIONS: Characteristics such as sex, age group, region, and state capital of residence affect the prevalence of older drivers. Our results contribute to knowledge about how older adults choose to move around in large Brazilian cities, enabling proposal of strategies to improve the quality of this population’s displacement.
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Factors associated with posttraumatic meningitis among traumatic head injury patients: a nationwide study in Japan. Eur J Trauma Emerg Surg 2019; 47:251-259. [PMID: 31478074 PMCID: PMC7851005 DOI: 10.1007/s00068-019-01224-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 08/28/2019] [Indexed: 11/23/2022]
Abstract
Purpose Posttraumatic meningitis is one of the severe complications that can result in increased mortality and longer hospital stay among trauma patients. Factors such as cerebrospinal fluid (CSF) fistula and basilar skull fracture are associated with posttraumatic meningitis. However, it remains unclear whether procedures such as burr hole surgery in the emergency department and decompressive craniectomy are associated with posttraumatic meningitis. The aim of this study was to assess factors associated with posttraumatic meningitis with a nationwide hospital-based trauma registry in Japan. Methods This was a retrospective observational study with a 12-year study period from January 2004 to December 2015. We included trauma patients registered in the Japanese Trauma Data Bank, whose head Abbreviated Injury Scale score was ≥ 3 in this study. The main endpoint was the occurrence of meningitis during hospitalization. Multivariable logistic regression analysis was used to assess independent parameters associated with posttraumatic meningitis such as CSF fistula, burr hole surgery in the emergency department, and decompressive craniectomy. Results Among 60,390 head injury patients with head AIS score 3 or more, 284 (0.5%) patients had posttraumatic meningitis. Factors associated with posttraumatic meningitis were burr hole surgery in the emergency department (adjusted odds ratio [AOR] 2.158 [95% confidence interval (CI) 1.401–3.325]), decompressive craniectomy (AOR 2.123 [95% CI 1.506–2.993]), external ventricular drainage (AOR 1.843 [95% CI, 1.157–2.935]), CSF leakage (AOR 3.328 [95% CI 2.205–5.022]), and basilar skull fracture (AOR 1.651 [95% CI 1.178–2.314]). Conclusions In this population of trauma patients, burr hole surgery in the emergency department and decompressive craniectomy was associated with posttraumatic meningitis.
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