Morbimortalidade por causas externas no brasil entre 2015 e 2019: um estudo ecológico / Morbimortality from external causes in brazil between 2015 and 2019: an ecological study / Morbimortalidad por causas externas en brasil entre 2015 y 2019: un estudio ecológico

Introdução: Agravos à saúde ocasionados por causas externas incluem, tanto agravos oriundos de determinantes acidentais, quanto intencionais. Sendo multifatorial, encontra-se como uma das principais causas de morbimortalidade no mundo, com destaque na população jovem,economicamente ativa e do sexo masculino. Objetivo:Realizar um levantamento em bases de dados secundários nacionais e compilar estratégias de avaliação e planejamento dos indicadores de morbidade e mortalidade por Unidade da Federação do Brasil por causas externas, segundo faixa etária, de 2015 a 2019. Metodologia:Trata-se de um estudo do tipo transversal, ecológico, retrospectivo com abordagem quantitativa, realizado em base de dados secundários. Resultados:Os dados revelaram consideráveis valores de taxas e morbimortalidade por causa externas gerais no Brasil. Dando destaque às agressões; acidentes de transporte e lesões autoprovocadas voluntariamente, em espacial entre a população jovem. Conclusões: Frente aos possíveis impactos do agravo em estudo, nos âmbitos da saúde e economia, entende-se que devem ser investigados aspectos específicos acerca das localidades e das diversas variáveis envolvidas que elucidem necessidades singulares importantes para o planejamento em âmbitos loco regionais já que cadaagravo pode ter comportamento diferente nos distintos territórios (AU).

Introduction: Health problems caused by external causes include both health problems arising from accidental and intentional determinants. Being multifactorial, it is one of the main causes of morbidity and mortality in the world, especially in the young, economically active and male population. Objective:To carry out a survey in national secondary databases and compile assessment and planning strategies for morbidity and mortality indicators by Unit of the Federation of Brazil due to external causes, by age group, from 2015 to 2019. Methodology: This is a cross-sectional, ecological, retrospective study with an approach quantitative analysis, carried out on secondary data bases. Results: The data revealed considerable values of rates and morbidity and mortality due to general external causes in Brazil. Emphasizing aggressions; transport accidents and voluntarily self-inflicted injuries, in space among the young population. Conclusions:In view of the possible impacts of the disease under study, in the areas of health and economics, it is understood that specific aspects should be investigated about the localities and the various variables involved that elucidate unique needs that are important for planning in loco regional environments since each grievance may behave differently in different territories (AU).

Introducción: Los problemas de salud causados por causas externas incluyen tanto los problemas de salud derivados de determinantes accidentales como intencionales. Al ser multifactorial, es una de las principales causas de morbilidad y mortalidad en el mundo, especialmente en la población joven, económicamente activa y masculina. Objetivo: Realizar una encuesta en bases de datos secundarias nacionales y recopilar estrategias de evaluación y planificación de indicadores de morbilidad y mortalidad por Unidad de la Federación de Brasil por causas externas, por grupo de edad, de 2015 a 2019.Metodología: Se trata de un estudio transversal,ecológico, retrospectivo con un enfoque del análisis cuantitativo, realizado sobre bases de datos secundarias. Resultados: Los datos revelaron valores considerables de tasas y morbilidad y mortalidad por causas externas generales en Brasil. Haciendo hincapié en las agresiones; accidentes de transporte y lesiones autoinfligidas voluntariamente, en el espacio entre la población joven. Conclusiones: Ante los posibles impactos de la enfermedad en estudio, en las áreas de salud y economía, se entiende que se deben investigar aspectos específicos sobre las localidades y las diversas variables involucradas que dilucidan necesidades singulares que son importantes para la planificación in loco. contextos regionales, ya que cada agravio puede comportarse de manera diferente en diferentes territorios (AU).

Epidemiological survey on the inpatients with injury first discharged from Department of Orthopedic Trauma, Nanfang Hospital from 2013 to 2017 / 中华创伤骨科杂志

Objective To analyze the injury causes and types in the inpatients first discharged from the Department of Orthopedic Trauma,Nanfang Hospital after treatment of injury from 2013 to 2017.Methods An epidemiological survey was conducted on the inpatients first discharged from the Department of Orthopedic Trauma,Nanfang Hospital after injury treatment from January 2013 to December 2017.Their data were extracted by information system IBM SPSS 23.0 for analyses of their gender,regional origin,distribution of injury causes and types.Results From 2013 to 2017,a total of 6,736 inpatients were first discharged after treatment of injury.The total ratio of male to female was 2.71∶ 1.Although the male to female ratios were significantly different between different years (x2 =10.755,P =0.029),the proportions of males were all over 70％.Although the distribution of regional origins of the patients was significantly different between different years (x2 =86.193,P ＜ 0.001),the patients mostly came from the regions outside the administrative district where Nanfang Hospital was located,especially those from the provinces other than Guangdong.The major external cause of injury was falling,followed by exposure to inanimate mechanical violence.There were differences in external cause of injury between different age groups.Wrist and hand injury,knee and lower leg injury,shoulder and upper arm injury were the top three sorts of injury for hospitalization.Wrist and hand injury was mainly found in the age group from 20 to 29 years old,knee and lower leg injury mostly in the age group from 30 to 39 years old,and shoulder and upper arm injury mainly in the age group younger than 10 years old,hip and thigh injury mostly in the age group older than 70 years old.Conclusions Falling was the major external cause of injury;injury predominated in males;the majority of the patients came from the regions outside the administrative district where Nanfang Hospital was located;wrist and hand injury were more common in young people while hip and thigh injury more common in the elderly.

Violências contra adolescentes nas capitais brasileiras, segundo inquérito em serviços de urgência / Violence against adolescents in Brazilian capitals based on a survey conducted at emergency services

Resumo No estudo descrevem-se as características das violências praticadas contra os adolescentes atendidos em serviços de urgência e emergência participantes do inquérito Vigilância de Violências e Acidentes (VIVA), em 2014, e analisar possíveis associações entre as variáveis. Foram analisados dados de 815 adolescentes na amostra e utilizada a análise de correspondência, que consiste em análise exploratória, visando identificar variáveis associadas de forma simultânea à violência contra eles. A agressão praticada contra os adolescentes teve como vítimas mais frequentes o sexo masculino, o meio de agressão utilizado foi a arma de fogo e objeto pérfuro cortante. Na faixa etária de 15 a 19 anos, predominaram as ocorrências praticadas nas vias públicas, por agressores desconhecidos e predominaram lesões como fraturas e cortes. Entre as vítimas entre 10 e 14 anos, o local de ocorrência foi a escola e o agressor foi o amigo, por meio de ameaças. Entre as vítimas do sexo feminino, as ocorrências foram mais frequentes na residência. Conclui-se que a violência envolvendo adolescentes perpassa as mais importantes instituições socializadoras: a família, a escola, apontando a necessidade de mobilizar toda a sociedade na perspectiva do seu enfrentamento.

Abstract This study explored the characteristics of violence against adolescents who received treatment at urgent and emergency care centers participating in the 2014 Violence and Accident Surveillance System (Sistema de Vigilância de Violências e Acidentes, VIVA) survey and determined the association between demographic variables and the characteristics of violent events. The sample was composed of 815 adolescents who responded to the 2014 VIVA survey. Correspondence analysis was used to determine possible associations between the variables. Victims were predominantly males and the most common form of aggression was the use of firearms and sharp objects. Among males aged between 15 and 19 years, violent acts were predominantly committed in public thoroughfares and by strangers, and the most common injuries consisted of fractures and cuts, while among younger adolescents aged between 10 and 14 years the most common form of aggression was threats made by friends at school. The most common place of occurrence among females was the home. It is concluded that violence against adolescents permeates the chief agencies of socialization - the family and school - demonstrating the need to mobilize the whole society in tackling this problem.

Perfil dos acidentes na infância e adolescência atendidos em um hospital público / Profile of accidents in children and adolescents receiving care at a public hospital

Resumo Objetivo Analisar as ocorrências de acidentes atendidos no pronto-socorro pediátrico de um hospital público. Métodos Trata-se de uma pesquisa transversal, descritiva e correlacional sobre a ocorrência de acidentes em crianças e adolescentes, identificados no momento do atendimento em um pronto-socorro pediátrico no Município de São José dos Campos. A amostra inicial foi de 2.440 registros de atendimentos, mas foi reduzida para 2.421, porque em 16 casos houve a suspeita de violência e em três não foi possível localizar os dados. O preenchimento do instrumento de coleta de dados foi realizado por meio de dados registrados na ficha de atendimento da unidade. O período de coleta foi de 01 de setembro a 31 de dezembro de 2013. Os critérios de inclusão foram: ser criança ou adolescente de 0 a 13 anos de idade; ser atendidos por acidentes, no pronto-atendimento do referido hospital no período do estudo. O critério de exclusão foi ter sido atendido no referido pronto-atendimento devido a outras causas no período do estudo. Resultados Os acidentes corresponderam a 12,1% do atendimento; predominância do sexo masculino (62,5%); faixa etária mais acometida foi a de 10 a 13 (33,6%). O tipo de acidente mais frequente foi queda (48,7%). A parte do corpo acometida, em crianças de até um ano, foi o segmento cefálico/pescoço (75,0%), nos adolescentes, foram membros superiores (MMSS) e inferiores (MMII) com aproximadamente 30,0%. Os principais procedimentos intra-hospitalares foram: Raio-X (67,6%), avaliação de especialista (52,7%); imobilização ortopédica (25,9%). Alta foi o desfecho mais ocorrido (84,0%), seguido por observação (10,5%), internação (4,2%) e um óbito. Conclusão acidentes tiveram alta incidência, acarretando impacto para a população e setor saúde, incluindo elevação do número de atendimentos e, por consequência, do custo, além de incalculáveis reflexos emocionais.

Abstract Objective To analyze the occurrence of accidents in a pediatric emergency room at a public hospital. Methods This was a cross-sectional, descriptive, and correlational study on the occurrence of accidents among children and adolescents identified during care delivery in a pediatric emergency room in the municipality of São José dos Campos. The initial sample included 2440 recorded cases, but the sample sized was reduced to 2,421 because 16 cases were suspected of a violent cause and 3 cases were missing data. The data collection instrument was completed by data registration in the unit using a care form. Data were collected from September 01 to December 31, 2013. Inclusion criteria were children and adolescents aged 0 to 13 years with an accident-related admission to the emergency room at the hospital where the study was carried out. We excluded those who were assisted in the emergency room for any other reason during the study period. Results Accidents corresponded to 12.1% of instances of care delivered. A majority occurred in boys (62.5%); participants' ages ranged from 0 to 13 years (33.6%). Falls were the most frequent type of accident (48.7%). The body part most affected in children up to 1 year of age was cephalic/neck (75.0%); among adolescents, the most affected body parts were the upper limbs and lower limbs (approximately 30% occurrence). Main in-hospital procedures were radiography (67.6%), evaluation by a specialist (52.7%), and orthopedic splinting (25.9%). Discharge was the most common endpoint (84.0%), followed by observation (10.5%), hospitalization (4.2%), and death (one patient). Conclusion Accidents had a higher incidence and had an impact on the population and health sector of the municipality, including an increase in the number of instances of care and, consequently, in cost, in addition to the incalculable emotional impact.

Investigation of amputees with prosthetic limbs at our hospital / Journal of Rural Medicine

<p><b>Objectives:</b> This study was performed to elucidate the characteristics of amputees in our hospital. We also evaluated whether the causes and characteristics of the amputations influenced the patients’ prosthetic walking ability.</p><p><b>Materials and Methods:</b> We retrospectively examined 47 amputees in our hospital from December 1996 to April 2016 with respect to the causes and levels of amputation. Of 28 lower limb amputees from April 2008 to April 2016, 22 received prostheses and were divided into 2 groups according to the cause of the amputation, as follows: the internal cause group (e.g., vascular deficiency and infection) and the external cause group (e.g., trauma, burn injury, and crush syndrome). The characteristics and process of achieving prosthetic ambulation were compared between these groups.</p><p><b>Results:</b> Trauma was the most common cause of both upper (70.0%) and lower limb amputations (40.5%). Unilateral amputation was performed in 93.2% of patients (upper limb amputation, 100.0%; lower limb amputation, 91.9%). Patients were older in the internal than in the external cause group (<i>P</i> = 0.026). The serum albumin (<i>P</i> = 0.003) and total cholesterol concentrations (<i>P</i> = 0.046) on admission were significantly lower in the internal than in the external cause group. All patients in the internal cause group had comorbidities. The proportions of patients with diabetes mellitus (<i>P</i> = 0.011) and cerebrovascular disease (<i>P</i>=0.036) were significantly higher in the internal than in the external cause group. No significant difference in walking ability was found between the internal and external cause groups at the time of discharge.</p><p><b>Conclusion:</b> Most amputees in our hospital underwent unilateral lower limb amputation due to trauma. Although the patients with internal causes of amputation were older, more frequently had malnutrition, and had more comorbidities than those with external causes, they achieved prosthetic walking with statistically insignificant difference at the end of hospitalization, excluding six patients who had no prosthetic prescription.</p>

Elevation of Serum Aminotransferase Levels and Future Risk of Death from External Causes: A Prospective Cohort Study in Korea

PURPOSE: The association between liver enzymes and death from external causes has not been examined. We investigated the association between serum aminotransferase levels and external-cause mortality in a large prospective cohort study. MATERIALS AND METHODS: A total of 142322 subjects of 35-59 years of age who completed baseline examinations in 1990 and 1992 were enrolled. Mortalities were identified using death certificates. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were categorized into quintiles. Sub-distribution hazards ratios and 95% confidence intervals (CIs) were estimated using a competing risks regression model in which deaths from other causes were treated as competing risks. RESULTS: Of 8808 deaths, 1111 (12.6%) were due to external causes. Injury accounted for 256 deaths, and suicide accounted for 255. After adjusting for covariates, elevated ALT and AST were significantly associated with an increased risk of all external-cause mortalities, as well as suicide and injury. Sub-distribution hazards ratios (95% CIs) of the highest versus the lowest quintiles of serum ALT and AST were, respectively, 1.57 (1.26-1.95) and 1.45 (1.20-1.76) for all external causes, 2.73 (1.68-4.46) and 1.75 (1.15-2.66) for suicide, and 1.79 (1.10-2.90) and 1.85 (1.21-2.82) for injury. The risk of external-cause mortality was also significantly higher in the fourth quintile of ALT (21.6-27.5 IU/L) than in its first quintile. CONCLUSION: Elevated aminotransferase levels, even within the normal range, were significantly associated with increased risk of all external-cause mortalities, including suicide, and injury.

Study on the External Causes of Mortality In Korea / 한국역학회지

PURPOSE: This study was conducted to analysis the trends and states of external auses of mortality in Korea from 1985 to 1998. METHODS: This study was based on data published in 1985-1998 from the annual report of cause of death statistics of National Statistical Office. RESULTS: In the proportion of total death cases during 1985-1998, External causes of mortality was ranged from 11 percent to 15 percent. Death rate(per 100,000) of external causes of mortality(ECM) decreased recently from 85.7 in 1991 to 68.9 in 1998. Death rate of ECM in male was 2.6 times higher than that of female. Among total cases of ECM, the first leading cause of death was transport accidents. intentional self-harm was the second leading cause of death(26.8 percent in 1998). In trends of death rate(per 100,000) for ECM during 1885-1998, there were decreased for following causes of death; transport accidents, falls, accidental drowning and submersion, exposure to smoke, fire and flames, accidential poisoning by and exposure to noxious substances, Death rates of ententional self-harm and assault were increased during the periods. The age specific death rate increased with age for all ECM except for assault. The risk of death caused by ECM was higher in aged 65 and over than in ages 0-19 years among all ECM. The risk of death for male aged 65 and over were 6.9 times in transport accidents, 26 times in fall, 37 times in accidential poisoning by and exposure to noxious substances, and 18 times in intentional self-harm compared with 0-19 years. The risk of death for female aged 65 and over were 27 times in fall, 22 times in accidential poisoning by and exposure to noxious substances compared with 0-19 years. In seasonal variation of ECM cases for 1998. There was highest proportion in August(10.4 percent). The highest proportion by death seasion were winter(32.7 percent) in exposure to smoke, fire and flames, summer(27,7 percent) in fall, summer(52.4 percent) in accidental drowning and submersion, summer in 32.0 percent) in accidential poisoning by and exposure to noxious substances, spring(28.2 percent) in intentional self-harm, assault. and autumn(28.2 percent) in transport accidents. CONCLUSION: Above results suggest that a preventive education program for safety accidents should be developed by considering gender and age of the objecties and seasons of the year.