The prognosis of falls in elderly people living at home.
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BACKGROUND: there are few longitudinal studies of the prognosis of falling at home. OBJECTIVE: to determine outcomes in older people who fall once and more than once. DESIGN: longitudinal prospective cohort study. SETTING: primary care in the UK. SUBJECTS: 1815 subjects over 75 who had a standardized and validated health check. METHOD: annual interviews over 4 years. Practice records were used to establish death and admission to institutions. RESULTS: risk of death was increased at 1 year [odds ratio (OR) 2.6, 95% confidence interval (CI) 1.4-4.7] and 3 years (OR 1.9, 95% CI 1.2-3.0) for recurrent fallers but not single fallers (OR 0.9, 95% CI 0.5-1.6 at 1 year; OR 0.97, 95% CI 0.7-1.4 at 3 years). Risk of admission to long-term care over 1 year was markedly increased both for single fallers (OR 3.8, 95% CI 1.8-8.3) and recurrent fallers (OR 4.5, 95% CI 1.7-12). Functional decline was not related to faller status, the latter being very variable from one year to the next. CONCLUSIONS: the stronger relationship between falling and admission to long-term care rather than mortality supports the hypothesis that the perceived risks for those who fall only once are exaggerated. (+info)
House fire injury prevention update. Part I. A review of risk factors for fatal and non-fatal house fire injury.
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OBJECTIVE: To summarize house fire injury risk factor data, using relative risk estimation as a uniform method of comparison. METHODS: Residential fire risk factor studies were identified as follows: MEDLINE (1983 to March 1997) was searched using the keywords fire*/burn*, with etiology/cause*, prevention, epidemiology, and smoke detector* or alarm*. ERIC (1966 to March 1997) and PSYCLIT (1974 to June 1997) were searched by the above keywords, as well as safety, skills, education, and training. Other sources included: references of retrieved publications, review articles, and injury prevention books; Injury Prevention journal hand search; government documents; and internet sources. When not provided by the authors, relative risk (RR), odds ratio, and standardized mortality ratios were calculated, to enhance comparison between studies. RESULTS: Fifteen relevant articles were retrieved, including two case-control studies. Non-modifiable risk factors included young age (RR 1.8-7.5), old age (RR 2.6-3.6), male gender (RR 1.4-2.9), non-white race (RR 1.3-15.0), low income (RR 3.4), disability (RR 2.5-6.5), and late night/early morning occurrence (RR 4.1). Modifiable risk factors included place of residence (RR 2.1-4.2), type of residence (RR 1.7-10.5), smoking (RR 1.5 to 7.7), and alcohol use (RR 0.7-7.5). Mobile homes and homes with fewer safety features, such as a smoke detector or a telephone, presented a higher risk of fatal injury. CONCLUSIONS: Risk factor data should be used to assist in the development, targeting, and evaluation of preventive strategies. Development of a series of quantitative systematic reviews could synthesize existing data in areas such as house fire injury prevention. (+info)
Estimating the proportion of homes with functioning smoke alarms: a comparison of telephone survey and household survey results.
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OBJECTIVES: This study determined the proportion of homes with functioning smoke alarms in a low-income area experiencing a high rate of residential fire-related injuries. METHODS: An on-site survey of households was conducted to confirm the results of a telephone survey. RESULTS: In the telephone survey, 71% of households reported having functioning smoke alarms. In the household survey, 66% of households reported having functioning alarms; however, when the alarms were tested, the percentage dropped to 49%. CONCLUSIONS: Telephone surveys may overestimate the presence of functioning smoke alarms in some populations. Thus, the use of telephone surveys to establish baseline measures could significantly affect the evaluation of smoke-alarm giveaway programs. (+info)
Eye injuries in children: the current picture.
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AIMS: To investigate the current causes and outcomes of paediatric ocular trauma. METHODS: A prospective observational study of all children admitted to hospital with ocular trauma in Scotland over a 1 year period. RESULTS: The commonest mechanism of injury was blunt trauma, accounting for 65% of the total. 60% of the patients were admitted with a hyphaema. Injuries necessitating admission occurred most frequently at home (51%). Sporting activities were the commonest cause of injury in the 5-14 age group. There were no injuries caused by road traffic accidents or fireworks. Patients were admitted to hospital for a mean of 4.2 days (range 1-25 days). One (1%) child had an acuity in the "visually impaired" range (6/18-6/60) and one (1%) was "blind" (6/60) in the affected eye. No child was bilaterally blinded by injury and none required blind or partial sight registration. CONCLUSION: This study has shown that the incidence of eye injuries affecting children has fallen. The outcome of ocular trauma has improved significantly, and for the first time paediatric injuries appear to have a better prognosis than injuries affecting adults. (+info)
Traditional bone setter's gangrene.
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Traditional bone setter's gangrene (TBSG) is the term we use to describe the sequelae sometimes seen after treatment with native fracture splints. Twenty five consecutive complications were recorded in 25 patients aged between 5-50 years with a median age of 10 years. The major complication of the native fracture splint treatment was distal limb gangrene necessitating proximal amputations in 15 cases. (+info)
Personal and family predictors of children's medically attended injuries that occurred in the home.
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OBJECTIVE: This study examined the independent contributions of demographic, behavioral, and environmental antecedents of pediatric medically attended injuries that occurred in the home. SETTING: Two household and thirty six American children aged 4-12 in 1988 were drawn from the National Longitudinal Survey of Youth. METHOD: Multiple logistic regression was used to examine whether having a medically attended injury that occurred in the home in 1990 was related to environmental, behavioral, and demographic indicators measured in 1988. To account for individual differences in access to care, results were stratified within samples of children that had, and had not, demonstrated a prior ability to access the medical care system for injury treatment. RESULTS: Among children who did not access the medical care system for injury treatment in 1988, measures of home environmental risk factors did not distinguish those injured at home from those not injured at home in 1990. However, among children who did access the medical care system for injury treatment in 1988, indicators of "dark" (relative risk 4.68, p = 0.019) and "cluttered" (relative risk 4.31, p = 0.038) home environments became significantly and independently associated with home injuries in 1990. CONCLUSION: If not accounted for in data collection or analyses, individual differences in non-financial barriers to medical care may read to an underestimation of the influences of important home environmental risk factors for medically attended injuries. (+info)
Beliefs about the risks of guns in the home: analysis of a national survey.
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OBJECTIVES: While epidemiological evidence suggests homes with guns are more likely to be the site of a suicide or homicide than homes without guns, the public's perception of these risks remains unknown. This study assesses the prevalence of the belief that homes with guns are safer than homes without guns, and factors associated with this belief. METHODS: Telephone interviews were conducted with a random sample of 4138 registered voters in urban areas in the US. Multinomial logistic regression was used to assess correlates of beliefs about the safety of keeping a gun in the home. RESULTS: Twenty nine per cent of respondents believed keeping a gun in the home makes the home more safe, 40% said less safe, 23% said it depends, and 9% were unsure. The belief that a home is more safe with a gun was associated with being male, young, completing 12 years or fewer of education, having no children living at home, Republican party affiliation, and low levels of trust in the police for protection. Prior exposure to violence and fear of victimization were not associated with the outcome. CONCLUSIONS: Findings may increase understanding about the public's perception of the risk in keeping guns in the home and assist educational efforts to decrease the risk of these injuries. (+info)
Profile of the pediatric burn patient at the Schneider Children's Medical Center of Israel.
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BACKGROUND: Burn trauma occurs mostly in young children. Burn injury in the pediatric age group has multiple-aspect sequelae. OBJECTIVES: To characterize the profile of the injured pediatric burn patient, thus targeting the most vulnerable pediatric group. METHODS: Between 1 January and 31 December 1996, a total of 9,235 pediatric patients were admitted for various traumatic injuries (burns, lacerations, fractures, etc.) to the Emergency Medicine Department of Schneider Children's Medical Center. We conducted a retrospective study of the patients' charts, including demographic data, which were stored in a computerized database, for statistical evaluation. The characteristics of pediatric burn patients were examined and compared with other pediatric trauma patients. RESULTS: Of the total patient population, 282 (3.1%) suffered from burns (37% females, 63% males). The most frequent burn injury was scald burn (58%). The pediatric group that was most exposed to burns was 13-18 month old males. CONCLUSIONS: Having identified the high risk group among the pediatric burn patients, we suggest that prevention programs be directed towards this group in order to reduce further risk of burn injury. (+info)