Characteristics and outcome of severe traumatic brain injuries based on occupational status.

PURPOSE: The association of TBI with socioeconomic characteristics of patients has not been studied extensively. The objective of this study was to analyse the differences in injury characteristics and outcome in TBI patients based on their occupational status. METHODS: Data on patients from 13 centres based in Austria, Croatia, Slovakia, Bosnia and Herzegovina, and Macedonia were included in the analysis. Demographic characteristics, injury characteristics, treatment and outcome at various post-injury stages were compared according to occupational status. Logistic regression was used to adjust for the effect of co-variates. ICU mortality, hospital mortality, 6 months mortality, and outcome at 6 months were used as dependent variables. RESULTS: Overall, 886 patients were analysed with a mean age of 45.5 years. High-level falls were most prevalent in the blue-collar group (19%), most low-level falls occurred in the retired group. Traffic accidents were most common in students. The injuries were most severe in the blue-collar group and students. Highest mortalities and unfavourable outcomes were in the retired, students and white-collar workers had the best outcomes. Compared to retired patients, all groups had higher odds of favourable outcome at 6 months after adjusting for co-variates-OR from 2.2 (95% CI 1.1-4.6) for entrepreneurs to 3.6 (95% CI 1.8-7.2) for the blue-collar group. CONCLUSION: Our paper provides clues pertaining specifically to variations in patterns and outcomes of TBI according to occupational status which can inform prevention and planning of services and can serve to plan priorities for further research.

Mortality due to traumatic spinal cord injuries in Europe: a cross-sectional and pooled analysis of population-wide data from 22 countries.

BACKGROUND: Traumatic spinal cord injuries (TSCI) pose a significant burden globally, while existing epidemiological data-especially on population mortality-are limited. The aim of this study was to calculate the age-standardized population mortality rates attributable to TSCI in 22 European countries, along with the pooled age-standardized mortality rate attributable to TSCI in Europe. METHODS: A descriptive cross-sectional epidemiological study was conducted. Crude and age-standardized mortality rates attributable to TSCI for the year 2012 for 22 European countries were compared using data from death certificates provided by Eurostat. Pooled age-standardized mortality rates were calculated using the random effects model, and overall number of cases were estimated by extrapolating our findings to the populations of EU and Europe (48 countries), in 2012. RESULTS: A total of 1840 TSCI-related deaths were identified, of which 1084 (59%) were males. The pooled age-standardized TSCI-related mortality rate of 6.7 per million (95% CI: 5.2 to 8.2) overall, 9.4 (95% CI: 7.3 to 11.5) for males, and 4.5 (95% CI: 3.4 to 5.6) for females. Extrapolating our results, 3152 (95% CI: 2441 to 3915) deaths would occur in 2012 in the EU-28 and 4570 (95% CI: 3538 to 5675) deaths in the whole Europe. TSCI-related deaths contributed by 2% (95% CI: 1.8% to 2.2%) to the overall injury related mortality. 61% of fatal TSCI were located in the cervical spine area. CONCLUSION: To our knowledge, this is the largest study that reports TSCI-related population-based mortalities to date which brings valuable information that can inform further research or prevention strategies. Our study presents a comprehensive and large-scale overview of TSCI-related population mortality in Europe. With an estimated toll of nearly five thousand lives that could be potentially saved by prevention, our findings confirm TSCI as an important cause of injury related deaths in Europe. Further action towards harmonization of case ascertainment and towards prevention strategies targeted mainly on the elderly is warranted.

Impact of family level factors on alcohol drinking in primary school children.

OBJECTIVE: The aim of our study was to identify and analyze selected factors influencing alcohol use among primary school children aged 8 to 15 years in the academic year 2009/10. METHODS: The sample consisted of children from 28 primary schools. Data of this cross-sectional study were collected using questionnaires. Chi-Square test was used to test differences in proportions of observed phenomena between boys and girls. Multiple logistic regression analysis was performed to identify the influence of selected factors on the variable "child's alcohol drinking per week". RESULTS: The sample consisted of 2,494 respondents (52% of boys, 48% of girls). In the study group 78% of all respondents (95% CI=76-80) drank alcohol infrequently (less than once a week) or did not drink alcohol at all, and 22% of respondents (95% Cl=20-24) drank alcohol at least once a week. More boys than girls considered alcoholic beverages such as beer, wine and spirit as quite easily available. We performed the model of multivariate logistic regression analysis using the independent variables: age of respondents, gender of respondents, mother's alcohol drinking, father's alcohol drinking, sibling's alcohol drinking, parental rules, parental control, and mental support from parents (if their children have problems) to identify their effect on the dependent variable - child's alcohol drinking per week. We found out that mother's alcohol drinking and a lack of mental support from parents did not have a statistically significant influence on child's alcohol drinking per week. CONCLUSION: The results of our study point to the fact that it is necessary to focus on the prevention of alcohol drinking in general and among school children in particular. We recommend greater control of the sale of alcoholic beverages, so as to prevent the purchase by people under 18 years of age.