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- Bergström, Monica Frick, et al.
(author)
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Extent and consequences of misclassified injury diagnoses in a national hospital discharge registry
- 2011
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In: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 17:2, s. 108-113
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Journal article (peer-reviewed)abstract
- Background Classification of injuries and estimation of injury severity on the basis of ICD-10 injury coding are powerful epidemiological tools. Little is known about the characteristics and consequences of primary coding errors and their consequences for such applications. Materials and methods From the Swedish national hospital discharge register, 15 899 incident injury cases primarily admitted to the two hospitals in Uppsala County between 2000 and 2004 were identified. Of these, 967 randomly selected patient records were reviewed. Errors in injury diagnosis were corrected, and the consequences of these changes were analysed. Results Out of 1370 injury codes, 10% were corrected, but 95% of the injury codes were correct to the third position. In 21% (95% CI 19% to 24%) of 967 hospital admissions, at least one ICD-10 code for injury was changed or added, but only 13% (127) had some change made to their injury mortality diagnosis matrix classification. Among the cases with coding errors, the mean ICD-based injury severity score changed slightly (difference 0.016; 95% CI 0.007 to 0.032). The area under the receiver operating characteristics curve was 0.892 for predicting hospital mortality and remained essentially unchanged after the correction of codes (95% CI for difference -0.022 to 0.013). Conclusion Errors in ICD-10-coded injuries in hospital discharge data were common, but the consequences for injury categorisation were moderate and the consequences for injury severity estimates were in most cases minor. The error rate for detailed levels of cause-of-injury codes was high and may be detrimental for identifying specific targets for prevention.
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- Gedeborg, Rolf, et al.
(author)
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Population density and mortality among individuals in motor vehicle crashes
- 2010
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In: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 16:5, s. 302-308
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Journal article (peer-reviewed)abstract
- ObjectiveTo assess whether higher mortality rates among individuals in motor vehicle crashes in areas with low population density depend on injury type and severity or are related to the performance of emergency medical services (EMS).Methods Prehospital and hospital deaths were studied in a population-based cohort of 41 243 motor vehicle crashes that occurred in Sweden between 1998 and 2004. The final multivariable analysis was restricted to 6884 individuals in motor vehicle crashes, to minimise the effects of confounding factors.Results Crude mortality rates following motor vehicle crashes were inversely related to regional population density. In regions with low population density, the unadjusted rate ratio for prehospital death was 2.2 (95% CI 1.9 to 2.5) and for hospital death 1.5 (95% CI 1.1 to 1.9), compared with a high-density population. However, after controlling for regional differences in age, gender and the type/severity of injuries among 6884 individuals in motor vehicle crashes, low population density was no longer associated with increased mortality. At 25 years of age, predicted prehospital mortality was 9% lower (95% CI 5% to 12%) in regions with low population density compared with high population density. This difference decreased with increasing age, but was still 3% lower (95% CI 0.5% to 5%) at 65 years of age.ConclusionsThe inverse relationship between population density and mortality among individuals in motor vehicle crashes is related to pre-crash factors that influence the type and severity of injuries and not to differences in EMS.
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- Gustavsson, Johanna, 1972-, et al.
(author)
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Preventing fall injuries among elderly by shock absorbing flooring
- 2012
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In: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785.
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Conference paper (peer-reviewed)abstract
- Background. Within nursing homes, the fall-related fracture incidence rate is between 5 and 10 %. For those living in nursing homes there are limited options for active fall injury prevention, due to physical impairments and diseases. Instead, passive fall injury prevention is a more realistic alternative. Shock absorbing flooring has been suggested as a potential passive safety measure for this group of individuals.Aims/Objectives/Purpose. To evaluate the fall injury reducing effect of shock absorbing flooring in a nursing home setting in Sunne, Sweden.Methods. The study is case controlled, with the shock absorbing flooring installed on one ward with a maximum of 12 residents and the other 5 wards are controls. The total number of residents including control wards is approximately 60. Baseline measurements are made with estimates of the risk of falling as well as the risk of fall-related injury.Results/Outcome. After one year, there has been 22 falls on the shock absorbing flooring, with no resulting injury compared to 130 falls and 4 fractures on the control wards. An unexpected finding is that the acoustic environment has improved considerably, creating a calmer environment for the elderly.Significance/Contribution to the field. To our knowledge, this is the first time a shock absorbing flooring has been tested and evaluated as a means of injury preventionin a nursing home. Although this is a pilot study, it contributes towards improved passive safety for this frail group of elderly.
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- Hashemi, Esmatossadat, et al.
(author)
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Safe community evaluation in terms of child safety
- 2012
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In: Injury Prevention. - : BMJ. - 1353-8047 .- 1475-5785. ; 18:Suppl 1, s. A42-
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Journal article (peer-reviewed)abstract
- Background Evaluation of child safety in designated SC is still a neglected indicator.Aims The purpose was to introduce a comprehensive model to conduct SC evaluation in terms of child safety.Methods Applications of designated SC with emphasis on child safety were reviewed. Besides, Pubmed and Embase were searched to find scientific articles of child safety evaluation.Results Key ways of child safety evaluation can be summed up as follows: In order to evaluate the impact of SC on child safety, quasi experimental study with emphasis on safe home, school, street, sport place and other environments is conducted to compare SC and control community at designation and re-designation time. When it comes to do outcome evaluation, in another quasi experimental study, incidence, severity and burden of child injuries are assessed in SC and control community by four household surveys where there is no data registry. Besides WHO and CDC questionnaires, delphi technique is an useful alternative to prepare questionnaires.Contribution to the Field Importance of child safety among growing number of SC has given rise to the necessity of a practical method for child safety evaluation in SCs.
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