1
|
Yang Y, Chen W, He H, Zhang X, Huang J, Zhu G, Lu X, Xiao Z. Analysis of the clinical features of 980 accidental pediatric injuries in the PICU. Front Pediatr 2025; 13:1562237. [PMID: 40376623 PMCID: PMC12078296 DOI: 10.3389/fped.2025.1562237] [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: 01/17/2025] [Accepted: 04/01/2025] [Indexed: 05/18/2025] Open
Abstract
Objective This study aimed to investigate the causes and clinical characteristics of 980 cases of accidental pediatric injuries admitted to the pediatric intensive care unit (PICU) to provide clinical evidence to support the prevention and reduction of severe accidental pediatric injuries. Methods A total of 980 patients with accidental pediatric injuries admitted to the pediatric intensive care unit (PICU) of Hunan Children's Hospital from 2017 to 2023 were included in this study. Results Between 2017 and 2023, 980 patients with accidental pediatric injuries were admitted to the PICU, comprising 588 boys and 392 girls (boy-to-girl ratio: 1.5:1). During the study period, a total of 16,151 children were admitted to the PICU, of whom 980 were admitted due to accidental injuries and 15,171 due to non-accidental injuries. There were no statistically significant differences in sex distribution between the accidental and non-accidental injury groups. Accidental pediatric injuries were most common among infants, toddlers, and preschool children, with the number of PICU admissions decreasing with increasing age. Across all years, infants and preschool children were the most affected. Traffic accidents and falls showed an increasing trend over time, whereas poisoning and drowning showed a decreasing trend. Differences in the composition of causes by year were statistically significant. The overall mortality rate among children with accidental injuries was 4.39%. The mortality rates by cause were as follows: traffic accidents (4.2%), falls (3.2%), foreign objects (7.1%), carbon monoxide poisoning (0.0%), food poisoning (9.7%), drug poisoning (1.0%), other types of poisoning (4.2%), burns and corrosive injuries (0.0%), drowning (13.0%), suffocation syndrome (23.1%), and other causes (4.3%). Prognostic differences between causes were statistically significant. Conclusion Accidental pediatric injuries predominantly occur in boys, with infants and preschool children being the most affected. These injuries are more common in summer, with drug poisoning, traffic accidents, and falls being the main causes. Among the common causes, traffic accidents and falls showed an increasing trend, whereas poisoning and drowning showed a decreasing trend. Suffocation syndrome, drowning, and food poisoning were associated with high mortality rates.
Collapse
Affiliation(s)
- Yufan Yang
- Department of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, China
- Department of Intensive Care Unit, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, China
| | - Wang Chen
- Department of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, China
| | - Hengyun He
- Department of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, China
| | - Xinping Zhang
- Department of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, China
- Department of Intensive Care Unit, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, China
| | - Jiaotian Huang
- Department of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, China
- Department of Intensive Care Unit, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, China
| | - Guanghui Zhu
- Department of Orthopedics, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, China
| | - Xiulan Lu
- Department of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, China
- Department of Intensive Care Unit, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, China
| | - Zhenghui Xiao
- Department of Intensive Care Unit, The School of Pediatrics, Hengyang Medical School, University of South China (Hunan Children’s Hospital), Changsha, Hunan, China
- Department of Intensive Care Unit, The Affiliated Children’s Hospital of Xiangya School of Medicine, Central South University (Hunan Children’s Hospital), Changsha, Hunan, China
| |
Collapse
|
2
|
Silva JMND, Idalino RDCDL. Effects of age, period, and birth cohort on fall-related mortality in older adults in Brazil from 1980 to 2019. CAD SAUDE PUBLICA 2025; 41:e00136524. [PMID: 40172342 PMCID: PMC11960758 DOI: 10.1590/0102-311xen136524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 10/11/2024] [Accepted: 10/31/2024] [Indexed: 04/04/2025] Open
Abstract
Falls in older adults are a major public health problem. This study aimed to estimate the effects of age, period, and birth cohort on fall-related mortality in older adults in Brazil and its geographic regions, by sex, from 1980 to 2019. We conducted an ecological time-series study using data on fall-related deaths in older adults extracted from Brazilian Mortality Information System. Poisson models were adjusted for sex and geographic region to estimate age-period-cohort effects. From 1980 to 2019, Brazil recorded 170,607 fall-related deaths in older adults, with 50.1% occurring in women. More than half of these deaths occurred in the age group of 80 years or older (55%) and in the Southeast Region (52%). We observed an increase in fall-related mortality rates across all age groups and regions, regardless of sex. There was an increased risk of death in all periods after the reference period (2000 to 2004) in all geographic regions and for both sexes. We also observed a gradual increase in mortality risk for men born before 1914 and after 1935 compared to the reference cohort (1930 to 1934). In contrast, we found a protective effect across all birth cohorts for women. There was a consistent increase in fall-related mortality risk among older people in Brazil, posing a public health challenge. The findings highlight the urgent need for implementing public health policies that promotes older adults' health and prevents fall risks to improve this population's quality of life.
Collapse
Affiliation(s)
- José Mário Nunes da Silva
- Departamento de Estatística, Universidade Federal do Piauí, Teresina, Brasil
- Laboratório de Inferência Causal em Epidemiologia, Universidade de São Paulo, São Paulo, Brasil
| | - Rita de Cássia de Lima Idalino
- Departamento de Estatística, Universidade Federal do Piauí, Teresina, Brasil
- Laboratório de Colaboração Estatística, Universidade Federal do Piauí, Teresina, Brasil
| |
Collapse
|
3
|
Sui L, Lv Y, Feng KX, Jing FJ. Burden of falls in China, 1992-2021 and projections to 2030: a systematic analysis for the global burden of disease study 2021. Front Public Health 2025; 13:1538406. [PMID: 40190758 PMCID: PMC11968356 DOI: 10.3389/fpubh.2025.1538406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Accepted: 02/28/2025] [Indexed: 04/09/2025] Open
Abstract
Background The escalating burden of falls in China necessitates a detailed examination to elucidate its dynamics and trends. Using data from the Global Burden of Disease Study (GBD) 2021, this research assessed the burden of falls in China. Methods Data from GBD 2021 were analyzed using Joinpoint regression to identify long-term trends. The impact of mortality and disability-adjusted life years (DALYs) rate for falls was investigated through the age-period-cohort model. Additionally, a decomposition analysis was performed to ascertain the distinct impacts of population growth, aging, and epidemiological changes on the burden of falls from 1992 to 2021. Furthermore, this study employed both the BAPC and Nordpred models to project future burdens of falls. Results From 1992 to 2021 in China, the age-standardized rates of falls showed divergent trends. Prevalence and incidence rates increased, while mortality rates generally decreased. Males consistently exhibited higher rates than females. The rates of prevalence, incidence, and mortality exhibit a sharp increase beyond the age of 75 in 2021. Decomposition analysis identified aging as the primary driver of increased prevalence and mortality, particularly in females. Joinpoint regression analysis revealed fluctuating trends in prevalence and incidence with periods of increase and decline, and a general decrease in mortality except during brief intervals. DALYs and years of life lost (YLLs) rates generally decreased, with intervals of stabilization and minor increases, while years lived with disability (YLDs) showed significant fluctuations. By 2030, the projected DALYs rate for falls is expected to rise to approximately 547.4 per 100,000. Fractures of the lower extremity predominated as the leading cause of disability post-fall, with hip fractures increasingly contributing to disability among the older adult. Additionally, from 1992 to 2021, the population attributable fraction (PAF) of low bone mineral density for DALYs due to falls increased to 23.2%, with the PAF reaching 33.3% among women in 2021. Conclusion Falls continue to significantly burden public health in China. Our findings highlight the urgent need to develop targeted prevention and intervention strategies that cater to the country's unique demographic characteristics, aiming to mitigate the growing public health impact of falls.
Collapse
Affiliation(s)
| | | | | | - Fu Jie Jing
- School of Acupuncture-Tuina, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| |
Collapse
|
4
|
Lin WQ, Liao YX, Wang JY, Luo LY, Yuan LX, Sun SY, Xu Y, Sun MY, Wang C, Zhou Q, Liu XY, Liu H. Associations between type 2 diabetes mellitus and risk of falls among community-dwelling elderly people in Guangzhou, China: a prospective cohort study. BMC Geriatr 2024; 24:717. [PMID: 39210251 PMCID: PMC11363668 DOI: 10.1186/s12877-024-05314-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Several studies have demonstrated that older adults with type 2 diabetes mellitus (T2DM) have a higher risk of falls compared to those without T2DM, which may lead to disability and a lower quality of life. While, limited prospective studies have quantified the associations in southern China. We conducted a longitudinal cohort study to quantify the associations between T2DM and falls and investigate the risk factors of falls among community-dwelling elderly people in Guangzhou, China. METHODS The population-based study included 8800 residents aged 65 and over in 11 counties of Guangzhou at baseline in 2020 and then prospectively followed up through 2022. Of 6169 participants had complete follow-up and were included in the present study. A fall event was identified by self-reported. The Cox regression was applied to quantify the associations between T2DM and falls, and hazard ratios (HRs) were calculated to the factors associated with falls among participants. RESULTS The median follow-up time for participants was 2.42 years. During the follow-up period, the incidence of falls among all participants was 21.96%. After adjusting for covariates in Cox regression models, T2DM remained a significant risk factor for falls, with HR of 1.781 (95% CI: 1.600-1.983) in the unadjusted covariates model and 1.757 (1.577-1.957) in the adjusted covariates model. Female (1.286, 1.136-1.457), older age (≥ 80: 1.448, 1.214-1.729), single marital status (1.239, 1.039-1.477), lower education level (primary school and below: 1.619, 1.004-1.361), hypertension (1.149, 1.026-1.286) and stroke (1.619, 1.176-2.228) were associated with a higher risk of falls, whereas everyday physical exercise (0.793, 0.686-0.918) was associated with a lower risk of falls. CONCLUSION Falls are common, with risks between T2DM and falls quantified and several factors investigated in the longitudinal cohort study among community-dwelling elderly people in Guangzhou, China. Targeted action on the risk factors may reduce the burden of falls in elderly people with T2DM in the future.
Collapse
Affiliation(s)
- Wei-Quan Lin
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Ying-Xin Liao
- School of Public Health, Guangzhou Medical University, Guangzhou, 511436, China
| | - Jing-Ya Wang
- Institute of Applied Health Research, University of Birmingham, Birmingham, B152TT, UK
| | - Li-Ying Luo
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Le-Xin Yuan
- Brain Hospital of Guangzhou Medical University, Guangzhou Huiai Hospital, Guangzhou, 510370, China
| | - Si-Yu Sun
- School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Yue Xu
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Min-Ying Sun
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Chang Wang
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Qin Zhou
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Xiang-Yi Liu
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China
| | - Hui Liu
- Department of Basic Public Health, Center for Disease Control and Prevention of Guangzhou, Guangzhou, 510440, China.
| |
Collapse
|
5
|
Meng Y, Wang C, Liu Y. Trend analysis and prediction of injury incidence in China from 1990 to 2019 based on Bayesian age-period-cohort model. Inj Prev 2024:ip-2024-045303. [PMID: 39025670 DOI: 10.1136/ip-2024-045303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/07/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Injury is a major challenge to global public health. Analysing the trend of injury incidence in China from 1990 to 2019 and predicting future trends in incidence can provide a theoretical basis for injury prevention and control in China. METHODS We collected age-standardised incidence rates of injuries in China from 1990 to 2019 from the Global Burden of Disease 2019 study. We analysed trends using joinpoint regression and age-period-cohort models. A prediction study was conducted using the Bayesian age-period-cohort model. RESULTS From 1990 to 2019, there was an increasing trend in transport injuries, a decreasing trend in unintentional injuries and a decreasing trend in self-harm and interpersonal violence. The high-risk age for transport injuries, unintentional injuries and self-harm and interpersonal violence were 20-69 years (relative risk (RR)>1), ≤14 and ≥80 years (RR>1) and 20-24 years (RR=2.311, 95% CI 2.296 to 2.326), respectively. Projections indicate that by 2030, the incidence of transport and unintentional injuries will increase, whereas the incidence of self-harm and interpersonal violence will decrease. CONCLUSION The age group with the highest risk of transport injuries, unintentional injuries and self-harm and interpersonal violence were the 20-69 years, ≤ 14 and ≥80 years and 20-24 years age groups, respectively. Transport injuries and unintentional injuries will increase in 2020-2030, while self-harm and interpersonal violence will decrease. These can serve as a basis for developing measures to prevent and manage the impact of injuries.
Collapse
Affiliation(s)
- Yuanjie Meng
- Department of Public Health, Qinghai University Medical College, Xining, Qinghai, China
| | - Chaocai Wang
- Qinghai Provincial Center for Disease Control and Prevention, Xining, China
| | - Yan Liu
- Department of Public Health, Qinghai University Medical College, Xining, Qinghai, China
| |
Collapse
|
6
|
van der Naald N, Verbeek F, Baden DN, Verbeek AJM, Ham WHW, Verbeek J, Brummelkamp E, Groenewoud H, Stolwijk-van Niekerk C, Verbeek A. Trends and projections in fall death in the Netherlands from 1990 to 2045. Emerg Med J 2024; 41:404-408. [PMID: 38670793 DOI: 10.1136/emermed-2023-213073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Increasing life expectancy in high-income countries has been linked to a rise in fall mortality. In the Netherlands, mortality rates from falls have increased gradually from the 1950s, with some indication of stabilisation in the 1990s. For population health and clinical practice, it is important to foresee the future fall mortality trajectories. METHODS A graphical approach was used to explore trends in mortality by age, calendar period and cohorts born in the periods of 1915-1945. Population data and the numbers of people with accidental fall fatality as underlying cause of death from 1990 to 2021 were derived from Statistics Netherlands. Age-standardised mortality rates of unintentional falls per 100 000 population were calculated by year and sex. A log-linear model was used to examine the separate effects of age, period and cohort on the trend in mortality and to produce estimates of future numbers of fall deaths until 2045. RESULTS While the total population increased by 17% between 1990 and 2021, absolute numbers of fall-related deaths rose by 230% (from 1584 to 5234), which was 251% (an increase of 576 deaths in 1990 to 2021 deaths in 2020) for men and 219% (from 1008 to 3213) for women. Age-standardised figures were higher for women than men and increased more over time. In 2020, 79% of those with death due to falls were over the age of 80, and 35% were 90 years or older. From 2020 to 2045, the observed and projected numbers of fall deaths were 2021 and 7073 for men (250% increase) and 3213 and 12 575 for women (291% increase). CONCLUSION Mortality due to falls has increased in the past decades and will continue to rise sharply, mainly caused by growing numbers of older adults, especially those in their 80s and 90s. Contributing risk factors are well known, implementation of preventive measures is a much needed next step. An effective approach to managing elderly people after falls is warranted to reduce crowding in the emergency care and reduce unnecessary long hospital stays.
Collapse
Affiliation(s)
| | - Frank Verbeek
- School of Health Studies, HAN University of Applied Sciences-Campus Nijmegen, Nijmegen, The Netherlands
| | - David Nico Baden
- Department of Emergency Medicine, Diakonessenhuis Hospital, Utrecht, The Netherlands
| | - Anna J M Verbeek
- Department of Emergency Medicine, Noordwest Ziekenhuisgroep, Alkmaar, The Netherlands
| | - Wietske H W Ham
- Department of Emergency Medicine, UMC Utrecht, Utrecht, The Netherlands
- Institute of Nursing Studies, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Jan Verbeek
- Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, The Netherlands
| | - Erik Brummelkamp
- Department for Health Evidence, Radboudumc, Nijmegen, The Netherlands
| | - Hans Groenewoud
- Department for Health Evidence, Radboudumc, Nijmegen, The Netherlands
| | | | - André Verbeek
- Department for Health Evidence, Radboudumc, Nijmegen, The Netherlands
| |
Collapse
|
7
|
Du W, Wang R, Fan X, Wu X, Yang J, Zhou J, Yu H. Trends in injury-related mortality among residents of Jiangsu Province from 2012 to 2021: an age-period-cohort analysis. Front Public Health 2024; 12:1373238. [PMID: 38919918 PMCID: PMC11196603 DOI: 10.3389/fpubh.2024.1373238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
Objective We investigated the temporal trends and examined age-, period-, and cohort-specific effects of injury-related deaths among residents in Jiangsu to provide evidence for future injury prevention. Methods This study included 406,936 injury deaths from the Jiangsu provincial population death registration system. The average annual percent change (AAPC) in age-standardized mortality rates (ASMRs) was analyzed using joinpoint regression. Age-period-cohort models were generated to explore the effects of age, period, and birth cohort effects on mortality risk. Results ASMRs for all injuries (AAPC = -2.3%), road traffic accidents (AAPC = -5.3%), suicide (AAPC = -3.8%), and drowning (AAPC = -3.9%) showed a downward trend during 2012-2021(all p < 0.05), while unintentional falls showed an upward trend (AAPC = 5.1%, p < 0.05). From 2012 to 2021, the age-standardized mortality rates (ASMRs) for four primary types of injuries consistently exhibited higher among males compared to females, with rural regions displaying higher ASMRs than urban areas. Trends in ASMRs for road traffic accidents, drowning, and unintentional falls by sex and urban/rural areas were consistent with overall trends. Significant age, cohort, and period effects were identified in the trends of injury-related deaths for both sexes in Jiangsu. The age effect showed that the highest age effect for injury-related deaths was for the ages of 85 years and above, except for suicide, which was for the ages 80-84 years. Between 2012 and 2021, the period effect on road traffic accidents declined, while that on accidental falls increased. Initially, the period effect on suicide decreased but then rose, peaking in 2012 with a Relative Risk (RR) of 1.11 (95% CI: 1.04-1.19). Similarly, the period effect on drowning initially declined before rising, with the highest effect observed in 2013, at an RR of 1.12 (95% CI: 1.07-1.19). The highest cohort effects for road traffic accidents were observed in the 1957-1961 group, for accidental falls in the 1952-1956 group, and for both drowning and suicide in the 1927-1931 group. Conclusion The mortality rate of unintentional falls has been increasing. Older adults are at high risk for the four leading injuries. The improvements in mortality rates can be attributed to advancements in education, urbanization, and the promulgation and implementation of laws and policies.
Collapse
Affiliation(s)
- Wencong Du
- Department of Noncommunicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Rong Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China
| | - Xikang Fan
- Department of Noncommunicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xun Wu
- Department of Noncommunicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jie Yang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jinyi Zhou
- Department of Noncommunicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hao Yu
- Department of Noncommunicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| |
Collapse
|
8
|
Lin FF, Yang WY, Zhou JX, Cao LY, Huang LL. Retrospective Investigation and Research on Fall Events Among Hospitalized Patients in the Rehabilitation Department. Risk Manag Healthc Policy 2024; 17:1069-1078. [PMID: 38699655 PMCID: PMC11063461 DOI: 10.2147/rmhp.s445808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/01/2024] [Indexed: 05/05/2024] Open
Abstract
Objective We investigated the clinical characteristics, fall outcomes, and related factors of falls in patients who were hospitalized in the rehabilitation department, and explored strategies to reduce the incidence of falls and prevent falls in patients. Methods Data from 60 patients who fell in the rehabilitation department between 2016 and 2021 were analyzed for clinical characteristics, associated factors, incidence of falls, injuries, and patient demographics. Under the random stratified sampling method, 60 patients who did not fall during the same period were selected as the control group, and relevant data was collected. Measurement data were compared using an independent sample t-test. Enumeration data were compared using chi-squared (χ2) test was employed to compare these data between the two groups. Non-parametric data were analyzed using the Mann-Whitney U-test. Factors potentially influencing falls were scrutinized through both univariate and binary logistic regression analyses. Results The median annual incidence of falls among patients who were hospitalized in the rehabilitation department was 0.04%, while the overall fall injury rate was 60%. Falls were most prevalent within 30 days of hospitalization (71.67%). The most common fall-related condition was craniocerebral disease (83.33%). The incidents of falls location of fall were mainly reported in nearby areas of rehabilitation ward (70%). Most accidents occurred between 7:00 a.m.-12:00 p.m. and 3:01 p.m.-6:00 p.m. (63.33%), and dyskinesia was the most common cause of falls (71.67%). There were 39 patients (65.00%) with Barthel Index (BI) scores ranging between 40-60. Conclusion Patients in the rehabilitation department had a greater incidence of falls and fall injuries. Within 30 days of admission, patients with moderately dependent craniocerebral disorders and dyskinesia frequently experienced falls during typical daytime shifts in areas characterized by endemic conditions.
Collapse
Affiliation(s)
- Fang-Fang Lin
- Department of Rehabilitation, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China
| | - Wei-Yuan Yang
- Department of Rehabilitation, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China
| | - Jun-Xiang Zhou
- Department of Rehabilitation, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China
| | - Luo-Yuan Cao
- Department of Central Laboratory, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China
| | - Ling-Ling Huang
- Department of Rehabilitation, Ningde Municipal Hospital Affiliated to Ningde Normal University, Ningde, 352000, People’s Republic of China
| |
Collapse
|
9
|
Liu T, Li F, Li Y, Li J, Chen L, Yang Z, Cao C. Epidemiological characteristics and factors influencing hospitalization burden among trauma patients: a retrospective analysis. Eur J Trauma Emerg Surg 2024; 50:425-437. [PMID: 37653128 DOI: 10.1007/s00068-023-02353-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE This investigation aimed to understand the epidemiological characteristics and hospitalization burden and its possible influencing factors of patients with different injury mechanisms. METHODS All trauma patients admitted via the emergency department at a trauma center from November 1, 2020, to April 30, 2022, were identified. The hospitalization burden, including the number of hospitalizations, deaths and in-hospital mortality, length of stay (LOS), and medical costs, was calculated. Univariate and multivariate logistic regression models were used to analyze the factors influencing the hospitalization burden of trauma. The receiver-operating characteristic (ROC) curves were drawn to evaluate the predictive value of the multivariate model. RESULTS 16 485 trauma patients with 16 552 hospitalizations were included, with an in-hospital mortality rate of 1.269‰, median LOS of 7 days, and median hospitalization costs of 54 725.28 CNY. The median age was 52 years. 62.54% were hospitalized due to falls. The upper and lower extremities were the most common injury regions. There are differences between the demographic, injury, and hospitalization characteristics and factors influencing hospitalization burden across injury mechanisms, but there were also common influencing factors. Injury region, surgery, transfusion, and ICU treatment are influential factors for prolonged LOS. Age, injury region, surgery, and transfusion were influential factors for high hospitalization costs. CONCLUSIONS This study provided primary evidence on the hospitalization burden of trauma. Considering demographics, injury and hospitalization characteristics as additional discriminators could further intervene in LOS and medical costs. Targeted efforts to use more early prevention measures could potentially lower future hospitalization burden.
Collapse
Affiliation(s)
- Tao Liu
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Fangguo Li
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Yue Li
- College of Management and Economics, Tianjin University, Tianjin, China
| | - Ji Li
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China
| | - Liming Chen
- Department of Anorectal Surgery, Tianjin Hospital, Tianjin University, Tianjin, China
| | - Zhao Yang
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin University, Tianjin, China.
| | - Chunxia Cao
- Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China.
| |
Collapse
|
10
|
Mashimo S, Gilmour S. Temporal, seasonal, and spatial patterns in fall-related mortality in Japan: Analysis of national vital statistics from 1975 to 2019. Injury 2023; 54:111138. [PMID: 37867027 DOI: 10.1016/j.injury.2023.111138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/14/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Falls are a significant public health issue in aging societies. This study aimed to examine the temporal, seasonal, and spatial patterns in fall-related mortality in Japan, and to investigate the potential factors associated with fall-related mortality. METHODS The number of unintentional fall-related deaths from 1979 to 2019 were obtained from Japanese vital statistics and crude and direct age-standardized mortality rates (DSR) were calculated. We also calculated the standardized mortality ratio (SMR) to determine seasonal and prefectural differences. In addition, spatial regression was conducted to examine the potential factors associated with fall-related mortality. RESULTS The DSR among those over 65 years old showed a decreasing trend from 1979, but remained unchanged from 1990 to 2019. Based on the spatial regression model, the factors significantly associated with SMRs were the proportion of the aged population (Coefficient: 0.049), the number of hospitals (0.118), the number of clinics (1.169), the number of hospital beds (-0.060), and the number of physiotherapists (-0.069) for men; and the proportion of aged single households (-0.060), the number of hospitals (0.132), the number of clinics (1.498), the number of hospital beds (-0.051), and the number of physicians (-0.308) for women. CONCLUSIONS Fall-related mortality among Japanese elderly people has remained unchanged in recent years. In addition, seasonal and spatial patterns were also observed, and it was found that demographic data and healthcare resources in the prefectures affected fall-related mortality rates. Appropriate prevention measures of fall-related deaths should be considered according to the region-specific characteristics and issues.
Collapse
Affiliation(s)
- Shota Mashimo
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan; Department of Rehabilitation, St. Luke's International Hospital, Tokyo, Japan.
| | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| |
Collapse
|
11
|
Liu Y, Kabba JA, Xu S, Gu H, Su X, Liu Y, Yu H. Regional and temporal trends of falls and injurious falls among Chinese older adults: results from China Health and Retirement Longitudinal Study, 2011-2018. Inj Prev 2023; 29:389-398. [PMID: 37208004 DOI: 10.1136/ip-2022-044833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/07/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVE This study aimed to investigate temporal trends and regional differences of both falls and injurious falls among Chinese older adults and identify the associated risk factors. METHODS We conducted a retrospective analysis using the 2011, 2013, 2015 and 2018 waves of China Health and Retirement Longitudinal Study. Our sample included 35 613 people aged 60 years or above. We analysed two binary outcome variables that were collected at each wave, including whether a respondent had any falls in the last 2 or 3 years, and if so, whether a respondent experienced any injurious falls that warranted seeking medical treatment. The explanatory variables included individual-level sociodemographic characteristics, physical function and health status. We conducted both descriptive and multivariate logistic analyses. RESULTS We found no significant trend for falls after adjusting for individual-level factors, while significant regional variations in falls existed with higher fall prevalence in the central and western areas, compared with the eastern area. We detected a significant descending trend of injurious falls between 2011 and 2018 and identified the northeastern region with the lowest rates of injurious falls during the study period. Our study also revealed significant risk factors for falls and injurious falls, such as chronic conditions and function limitations. CONCLUSIONS Our results indicated no temporal trend of falls, a declined trend of injurious falls, and significant regional variations in the prevalence of falls and injurious falls in 2011-2018. These findings have important implications for prioritising areas and subpopulations to prevent falls and injuries among China's elderly population.
Collapse
Affiliation(s)
- Yang Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University School of Pharmacy, Xi'an, Shaanxi, China
- Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Sen Xu
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Pharmacy Administration and Clinical Pharmacy, Xi'an Jiaotong University School of Pharmacy, Xi'an, Shaanxi, China
- Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hanxin Gu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiaoming Su
- Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Xicheng, Beijing, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hao Yu
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
12
|
Liang H, Yue Z, Liu Y, Yan Z, Wang B, Xiang N, Liu E. Association between mild cognitive impairment and falls among Chinese older adults: the mediating roles of balance capacity and depressive symptoms. Inj Prev 2023; 29:173-179. [PMID: 36600524 DOI: 10.1136/ip-2022-044743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/06/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND This study aimed to examine the association between mild cognitive impairment (MCI) and the follow-up risk of falls among Chinese older adults, exploring the mediating roles of balance capacity and depressive symptoms in the association between MCI and falls. METHODS A total of 5482 adults aged 60 years and above from waves 2015 and 2018 of the China Health and Retirement Longitudinal Study were included for analysis. Cognition was assessed by a global cognition score, which included three tests: episodic memory, figure drawing and Telephone Interview of Cognitive Status. Depressive symptoms were assessed with the Centre for Epidemiological Studies Depression Scale. Logistic regression models were used to estimate the association between MCI and falls. Mediation analysis was employed to explore the potential mediating roles of balance capacity and depressive symptoms in the association between MCI and falls. RESULTS MCI was significantly associated with the risk of falls (OR 1.259, 95% CI 1.080 to 1.467). Balance capacity and depressive symptoms played parallel mediating roles in the association between MCI and falls, and the mediating effects were 0.004 (95% CI 0.003 to 0.024) and 0.010 (95% CI 0.004 to 0.016), respectively. CONCLUSIONS It is necessary to screen for and recognise MCI in order to prevent falls among older adults. More efforts should be made to improve balance capacity and relieve depressive symptoms to reduce the risk of falls among older adults with MCI.
Collapse
Affiliation(s)
- Hang Liang
- Zhongnan University of Economics and Law, Wuhan, Hubei, China
| | - Zhang Yue
- Zhongnan University of Economics and Law, Wuhan, Hubei, China
| | - Yimin Liu
- Zhongnan University of Economics and Law, Wuhan, Hubei, China
| | - Ziju Yan
- Zhongnan University of Economics and Law, Wuhan, Hubei, China
| | - Boyu Wang
- Zhongnan University of Economics and Law, Wuhan, Hubei, China
| | - Nan Xiang
- Zhongnan University of Economics and Law, Wuhan, Hubei, China
| | - Erpeng Liu
- Zhongnan University of Economics and Law, Wuhan, Hubei, China
| |
Collapse
|
13
|
Luo Y, Ran H, Deng Y, Li H, Zhang M, Zhao L. Paid caregivers' experiences of falls prevention and care in China's senior care facilities: A phenomenological study. Front Public Health 2023; 11:973827. [PMID: 36875422 PMCID: PMC9978790 DOI: 10.3389/fpubh.2023.973827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Background In China, as population aging accelerates, senior care facilities have gradually become a mainstream option. According to the World Health Organization (WHO), the annual rate of falls has increased from 30 to 50% in senior care facilities. A study found that older adults who live in senior care facilities are three times more likely to fall than those who live in the community. The quality of care is highly related to the occurrence of falls. Therefore, exploring paid caregivers' experiences is very important to prevent falls in senior care facilities. Objective The aim of this study was to explore paid caregivers' experiences of fall prevention and care in China's senior care facilities. Furthermore, we discussed the situation and provided suggestions. Design This is a phenomenological study using face-to-face, in-depth, semi-structured interviews. Setting The study was conducted at four senior care facilities in Changsha, Hunan, China. Participants Fourteen paid caregivers in four senior care facilities, including nursing assistants and senior nurses, participated in this study. Methods A purposive sample method was used to select 14 nursing assistants and senior nurses from four different senior care facilities in Changsha from March to April 2022. Every participant individually completed a face-to-face, in-depth, semi-structured interview. Based on the phenomenological research methodology, the thematic analysis method and the Colaizzi analysis method were used for data analysis and theme extraction. Results Based on interview data, a total of seven themes were distilled: (1) paid caregivers' professional requirements; (2) paid caregivers' attitude toward falls; (3) paid caregivers' fall training and education; (4) paid caregivers' knowledge about falls; (5) paid caregivers' fall risk assessment; (6) paid caregivers' fall prevention; and (7) paid caregivers' fall treatment. Conclusion In China's senior care facilities, paid caregivers to need to be responsible and pay appropriate attention to older adults. First, senior nurses and nursing assistants need to enhance communication and cooperation. Second, they must learn about deficiencies in fall risk assessment and try their best to improve their capability. Third, they must adopt appropriate education methods to improve fall prevention capability. Finally, the protection of privacy should be taken seriously.
Collapse
Affiliation(s)
- Yuan Luo
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Haiye Ran
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Yuqian Deng
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Huan Li
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
| | - Mengxi Zhang
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
| | - Liping Zhao
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
| |
Collapse
|