Injury-International Journal of the Care of the Injured最新文献

{"title":"Infectious complications after traumatic spine injury requiring surgery in a French level-1 trauma center: An observational study","authors":"Georgios Wallden ,&nbsp;Thomas Botrel ,&nbsp;Florian Blanchard ,&nbsp;Laura Marie-Hardy ,&nbsp;Mathieu Raux ,&nbsp;Arthur James","doi":"10.1016/j.injury.2025.112305","DOIUrl":"10.1016/j.injury.2025.112305","url":null,"abstract":"<div><h3>Background</h3><div>Traumatic spine injury (TSI) is a prevalent condition that often requires surgical intervention. Two serious infectious complications after surgery are surgical site infections (SSI) and lower respiratory tract infections (LRTI). Yet, studies on SSI and LRTI on trauma patients, particularly with a specific focus on microbiology are lacking. The primary aim of this study is to investigate the prevalence rate of early SSI, occurring within one month of surgery or three months when instrumented, and LRTI in level-1 trauma center patients requiring surgery after TSI.</div></div><div><h3>Methods</h3><div>This monocenter retrospective observational study was conducted at an academic level-1 trauma center, including patients with TSI requiring surgery. Data on patients’ baseline characteristics, trauma related information, initial and intra-operative management, infectious complications data and hospitalization outcomes were collected. The two primary outcomes were the prevalence of early SSI and LRTI. Secondary outcomes included the identification of factors associated with developing these infections, analysis of identified organisms, and assessment of clinical outcomes.</div></div><div><h3>Results</h3><div>A total of 2606 patients were screened between May 2018 and October 2022, 194 were included. Most of them were polytrauma patients defined by Injury Severity Score ≥ 16 (71 %). Early SSI occurred in 20 patients (10 %) and LRTI occurred in 58 patients (30 %). The number of vertebral levels instrumented (odds ratio [OR] 1.24, 95 % confidence interval [95 % CI] 1.01–1.52) was associated with SSI. The causative organisms were predominantly Gram-positive cocci (19/36 identified organisms). Factors associated with LRTI were an injury severity score ≥ 25 (OR 7.41; 95 % CI, 3.28–17.99), spinal injury at levels C3-C7 (OR 2.24; 95 % CI 1.01–5.14) and antibiotics during initial management (OR 7.09; 95 % CI, 2.71–20.49). The causative organisms were predominantly Gram-negative bacilli (58/80 identified organisms). Patients with LRTI experienced longer hospital stays, extended durations of mechanical ventilation, and higher mortality rates at 30 days and one year than those without.</div></div><div><h3>Conclusion</h3><div>Early SSI and LRTI are underestimated complications in severe trauma patients with TSI requiring surgery. Identifying risk factors and causative organisms is an important step for advancing research on targeted prevention and treatment of SSI and LRTI after trauma.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112305"},"PeriodicalIF":2.2,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of recent advances in tissue engineering scaffolds for meniscus repair","authors":"Yi-Lin Chen ,&nbsp;Ji-Ri-Mu-Tu Xiao ,&nbsp;Xuan-Xuan Zhu ,&nbsp;Zhi-Ming Ni ,&nbsp;Song Huang ,&nbsp;Zong-Rui Zhang ,&nbsp;Qiang Zhang ,&nbsp;Heng Yin ,&nbsp;Yafeng Zhang ,&nbsp;Liangyu Cai","doi":"10.1016/j.injury.2025.112283","DOIUrl":"10.1016/j.injury.2025.112283","url":null,"abstract":"<div><div>The meniscus, a critical load-bearing structure between the femur and the tibia, plays a key role in the functioning of the knee joint by distributing mechanical stress and minimizing friction. A brief overview of the anatomical characteristics and biomechanical functions of the meniscus is provided in this review, followed by a discussion of recent developments in tissue engineering scaffolds for meniscus repair over the past five years. The classification of scaffolds is based on the materials with an analysis of their respective advantages and limitations. The challenges associated with meniscal tissue engineering are summarized and potential research directions are proposed to guide the development of more effective regenerative strategies.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112283"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143759751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing the epidemiology of traumatic ear injuries: A 20 year analysis of emergency department visits in the U.S","authors":"Sam Boroumand ,&nbsp;Beatrice Katsnelson ,&nbsp;SeungJu Jackie Oh ,&nbsp;Katelyn Lewis ,&nbsp;Lioba Huelsboemer ,&nbsp;Viola A. Stögner ,&nbsp;Martin Kauke-Navarro ,&nbsp;Siba Haykal ,&nbsp;Bohdan Pomahac","doi":"10.1016/j.injury.2025.112287","DOIUrl":"10.1016/j.injury.2025.112287","url":null,"abstract":"<div><h3>Background</h3><div>The ear is one of the most technically difficult areas to reconstruct following traumatic injury. Utilizing the largest national multicenter patient sample to date, this study seeks to provide a critical overview of the epidemiology of traumatic ear injuries.</div></div><div><h3>Methods</h3><div>The NEISS database was searched from 2003–2022 to identify patients with related traumatic ear injuries. Three age groups were examined: geriatric (65+), adult (18–64), and pediatric (2–17). Variables including race, sex, incident location, commercial products involved, and emergency department disposition were evaluated between the groups utilizing two-proportion z-tests with Bonferroni correction.</div></div><div><h3>Results</h3><div>25,285 patients who sustained ear injuries were identified from the NEISS database. The top five types of ear injuries were laceration, contusion, puncture, hematoma, and burn. Geriatric patients experienced a significantly higher frequency of ear lacerations (82.5 % vs 68.6 %, <em>p</em> &lt; 0.001) relative to non-geriatric adults, while children had a significantly greater frequency of hematomas (3.7 % vs 2.8 %, <em>p</em> = 0.001), and contusions (18.0 % vs 16.0 %, <em>p</em> = 0.006). The top five products involved for ear injuries were tables, first aid equipment, bed/bedframe, jewelry, and chairs. Geriatric adults had a significantly higher frequency of ear injuries from bed frames relative to non-geriatric adults (20.0 % vs 3.2 %, <em>p</em> &lt; 0.001) and were over five times more likely to be admitted to the hospital..</div></div><div><h3>Conclusions</h3><div>This study offers novel insights into the epidemiology of traumatic ear injuries in the U.S especially across different age demographics. The greater prevalence of ear injuries from tables, first aid equipment, and with sporting activities among children highlights needs for childproofing homes and providing greater patient education and regulation on ear safety. The increased fragility of tissue and greater prevalence of fall injuries among geriatric patients demonstrates need for ongoing physical therapy and fall risk measures to be implemented. Collectively, the results help inform public health strategies to prevent such injuries as well as provide invaluable clinical context for reconstructive surgeons.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112287"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in bicycle related injuries in children 0–9 years of age in an urban Danish population 1980-2023.","authors":"Sunna Eldon Thorsdottir ,&nbsp;Jens Martin Lauritsen ,&nbsp;Christian Faergemann","doi":"10.1016/j.injury.2025.112290","DOIUrl":"10.1016/j.injury.2025.112290","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of the study is to describe the development of bicycle related injuries over the last four decades among young children and to describe their role as a passenger or cyclist.</div></div><div><h3>Methods</h3><div>Retrospective study of 7368 children aged 0-9 years that sustained a bicycle related injury in the period 1980-2023. Incidence rates (IR) where analyzed in three age groups; 0-2 years, 3-5 years and 6-9 years. Data was analyzed in regards to age, gender, severity of injury, usage of bicycle helmet and whether the child was a cyclist or a passenger on a bike.</div></div><div><h3>Results</h3><div>Bicycle related injury accounted for 74.5% of all traffic related injuries for children 0-9 years treated at XXX 1980-2023. There was a decrease in IRs for all age groups and both genders in the study period with an overall IR decrease by 69.0%. The IR for major and minor injury decreased for all age groups and both genders with an overall decrease of 75.6% and 84.8%, respectively. In the study period, 85.0% of children were injured as cyclists and 15.0% as passengers.</div></div><div><h3>Conclusions</h3><div>The study showed a significant decrease in overall IR when stratifying by age, gender, injury severity and the role of the child as cyclist or passenger. The study provides useful information for future studies and campaigns regarding children's bicycle safety.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112290"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Board sport injuries among pediatric patients: A ten year epidemiologic analysis","authors":"Alexander Gerick ,&nbsp;David Kell ,&nbsp;Brendan A. Williams","doi":"10.1016/j.injury.2025.112280","DOIUrl":"10.1016/j.injury.2025.112280","url":null,"abstract":"<div><h3>Background</h3><div>Snowboarding, skateboarding, and water surfing have emerged as popular pediatric sports. While prior work has examined differences among some types of board sports in certain populations, no prior study has directly compared pediatric injury patterns in board sports with similar techniques but on different terrains. The aim of this study was to compare the frequency and severity of orthopedic and craniofacial trauma sustained by pediatric skateboarders, snowboarders, and surfers. These injury types were selected as they encompass the majority of board sport-related trauma, providing a broad overview of injury patterns across different terrains.</div></div><div><h3>Hypothesis</h3><div>We hypothesized that pediatric skateboarders and snowboarders sustained more fractures and strains/sprains to the upper extremity, while pediatric surfers sustained more injuries to the head and neck.</div></div><div><h3>Methods</h3><div>The National Electronic Injury Surveillance System (NEISS) was queried for orthopedic and craniofacial trauma related to unpowered skateboarding, snowboarding, and surfing between 2014 and 2023. Annualized trends in injury type, injury location, and injury prevalence were examined over the study period and across sport type. Univariate analyses were utilized to compare injury characteristics and patient demographics across board sport cohorts.</div></div><div><h3>Results</h3><div>NEISS case criteria identified an estimated 546,231 board sport injuries over the study period. Early-adolescent males were the most commonly injured cohort (76.0 %; CI: 73.8–78.2 %). Fractures to the upper extremity were the most common orthopedic injury among skateboarders (31.6 %; CI: 24.8–38.4 %) and snowboarders (45.7 %; CI: 38.9–52.5 %), while lacerations to the head and neck were the most common injury among surfers (24.5 %; CI: 22.0–26.95 %). Pediatric snowboarders sustained more upper extremity fractures and concussions, but sustained less trauma to the lower extremity.</div></div><div><h3>Conclusions</h3><div>Findings from this study indicate that pediatric board sport athletes sustain injuries that are analogous but unique. Upper extremity fractures are common in skateboarding and snowboarding. While surfing has a higher incidence of laceration injuries, snowboarding has a higher incidence of concussions but lower incidence of lower extremity injuries. It is important for healthcare personnel to be aware of these injury patterns, especially in settings where immediate healthcare is limited.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112280"},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and validation of a novel clinical bedside tool (Time-Up and Flex) in rehabilitation for geriatric hip fracture patients post hip fracture surgery","authors":"Johnson Pok-Him Tam ,&nbsp;Timmy Chi Wing Chan ,&nbsp;Colin Shing-Yat Yung ,&nbsp;Tak-Wing Lau ,&nbsp;Frankie Leung ,&nbsp;Christian Fang","doi":"10.1016/j.injury.2025.112282","DOIUrl":"10.1016/j.injury.2025.112282","url":null,"abstract":"<div><h3>Objective</h3><div>Fragility fractures in the elderly population is increasing due to the global aging population. Rehabilitation following hip fracture surgery plays a crucial role in restoring functional independence and quality of life. There are currently limited bedside rehabilitation tool for geriatric hip fracture patients. A novel tool (Time-Up and Flex [TUF]) was designed with the aim to allow patients perform bedside rehab exercises, provide objective feedback and enhance recovery.</div></div><div><h3>Design</h3><div>A single centre, double-blinded, prospective validation study. A 3D printed TUF tool measures time taken to actively flex the operated hip to 30° on post-operative days [POD] 1, 7 and 14. The time is compared against subjective (Numerical Patient Reported Pain Scale [NPRS]) and objective outcomes (Tinetti Scale [TS], Functional Ambulation Category [FAC]). Assessors of the TUF score are blinded to the assessors of patient report outcome measures.</div></div><div><h3>Results</h3><div>Mean time for TUF were 12.7 s (seconds), 9.5 s and 6.7 s, NPRS were 7.3, 4.8, 3.2, TS were 9.8, 14.1, 18.6, FAC were 1.2, 2.0, 3.1 on POD1, 7 and 14 respectively. Coefficient of correlation for TUF time against NPRS was 0.729 (<em>p</em> &lt; 0.05), TUF time against TS was -0.721 (<em>p</em> &lt; 0.05), TUF time against FAC -0.688 (<em>p</em> &lt; 0.05). A decrease in TUF time correlated to a statistically significant decrease in NPRS, increase in TS and FAC. The calculated Cohen's D and Cronbach Alpha for TUF tool supported its ability to produce consistent and valid results.</div></div><div><h3>Conclusion</h3><div>TUF tool is valid and correlates with patient's subjective and objective outcomes. It has a good predictor value for the patient's pain, mobility and future falls risk. TUF tool has potential to be incorporated into geriatric hip fracture rehabilitation pathway in the future.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112282"},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten-year patterns of emergent concussion injuries among various martial arts disciplines","authors":"Daniel Kiehl ,&nbsp;Jake Purcell ,&nbsp;Lydia Pezzullo ,&nbsp;Ryan M. Nixon ,&nbsp;Matthew Martenson ,&nbsp;Kevin R. Vincent ,&nbsp;Heather K. Vincent","doi":"10.1016/j.injury.2025.112289","DOIUrl":"10.1016/j.injury.2025.112289","url":null,"abstract":"<div><h3>Background</h3><div>Martial arts participation appears to be increasing in the US, and along with benefits to health and wellbeing, the sport carries musculoskeletal and neurological injury risks which differ among disciplines. Evidence is limited regarding the burden of concussion injuries in many martial arts disciplines, particularly among female athletes and outside of competitions. The purposes were: 1) to characterize injury patterns over 2013–2022 for concussion injuries treated in emergency departments (ED) related to martial arts; and 2) to compare the number of concussions by mechanism, circumstance, sex and martial art discipline.</div></div><div><h3>Methods</h3><div>This was a retrospective, epidemiological study of National Electronic Injury Surveillance System (NEISS) data from patients who sought ED care for martial arts-related concussions (<em>N</em> = 581; 29.1 % female). Annual concussion case numbers compared over time and by sex using linear regression. Concussion case numbers were compared by major discipline (Karate, Jiu-Jitsu, Taekwondo, Mixed martial arts [MMA], kickboxing, Judo, and other forms) and sex. Mechanisms (fall, kicked, tackled/thrown, punched-hit-struck, weapon, unspecified) and circumstances (practice, competition) were compared by discipline and sex.</div></div><div><h3>Results</h3><div>Regressions indicated that year or sex were significant contributors to annual concussion case numbers (both <em>p</em>&gt;.05). The number of concussions was highest for Karate for males (<em>p</em> &lt; .05). A greater proportion of cases occurred in males than females in MMA, Taekwondo, Jiu-Jitsu, and other forms (<em>p</em> = .031). Falls and being punched-hit-struck were the most commonly-documented mechanisms of concussion (23 % and 20 %, respectively). For females, more concussions were incurred during competition for Judo and Taekwondo than in other disciplines (<em>p</em> = .002). For males, more concussions occurred in class/practice with Judo and Karate than in other disciplines (<em>p</em> = .018). 96.4 % of cases were treated and released, and 3.1 % were hospitalized.</div></div><div><h3>Conclusion</h3><div>Since 2020, the concussion burden in martial arts has grown, particularly among males, which may be related to overall greater participation in the sport, especially karate and other forms. Prospective injury surveillance, better uptake of safety gear and implementation of skills risk into routine sport participation that minimize head injury, and careful documentation of injury circumstance could help advance martial arts safety.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112289"},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Toddler fractures immobilisation and complications: A retrospective review","authors":"John Coveney ,&nbsp;Michael Barrett","doi":"10.1016/j.injury.2025.112295","DOIUrl":"10.1016/j.injury.2025.112295","url":null,"abstract":"","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112295"},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors associated with surgical site infection after internal fixation of ballistic diaphyseal fractures","authors":"Martin J. Weaver ,&nbsp;Usher Khan ,&nbsp;Simar Puri ,&nbsp;Salsabil Lamiha ,&nbsp;Kyle Swanson ,&nbsp;Ibrahim Rababa ,&nbsp;Adrian Olson ,&nbsp;Benjamin Best","doi":"10.1016/j.injury.2025.112302","DOIUrl":"10.1016/j.injury.2025.112302","url":null,"abstract":"<div><h3>Objectives</h3><div>Management of civilian gunshot wound (GSW) fractures is controversial, with limited data on infection risk and controversy regarding treatment. While lower-energy GSWs are considered lower risk than other open fractures, complication rates remain high. This study aimed to identify risk factors for infection in operatively treated ballistic fractures.</div></div><div><h3>Methods</h3><div>After institutional review board approval, we identified 2136 GSW-related fractures from 01/01/2012 to 12/31/2021 at our level one trauma center. After excluding articular, hand, foot, injuries through viscera and pre-existing infections, 110 patients with 125 long bone fractures were retrospectively reviewed. The primary outcome was infection requiring reoperation. Statistical analysis included Mann-Whitney U, T-tests, Pearson's Chi-square, ROC analysis, and Youden's index.</div></div><div><h3>Results</h3><div>Sixteen patients (14.5 %) developed infections requiring reoperation. The cohort had a mean age of 30 years, 90 % male, BMI 27.7 ± 7.2 kg/m², Charlson comorbidity index &lt;1, and 37 % smokers. Increased infection risk was associated with admission glucose (<em>p</em> &lt; 0.001) and length of stay (<em>p</em> &lt; 0.001). Admission glucose &gt;156 mg/dL increased odds of infection sixfold (OR 6.1, 95 % CI 2.0–19.0), while a hospital stay &gt;10 days increased odds of infection twentyfold (OR 21.1, 95 % CI 5.3–82.7). Transfusion (<em>p</em> = 0.004), abdominal (<em>p</em> = 0.007), and chest trauma (<em>p</em> = 0.010) also correlated with infection risk. No significant associations were found with nicotine use, Charlson comorbidity index, or BMI.</div></div><div><h3>Conclusions</h3><div>Operatively treated long bone injuries had a 14.5 % infection rate. Elevated admission glucose and prolonged hospital stay significantly increased infection risk, particularly in polytrauma patients. Identifying high-risk patients, promoting early mobilization, and ensuring glycemic control may help reduce infections. Further research is needed to develop targeted prevention strategies.</div></div><div><h3>Level of evidence</h3><div>3 (Retrospective Comparative Study)</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 6","pages":"Article 112302"},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends and determinants of falls: A generalized estimating equations modelling approach using serial data from the geelong osteoporosis study","authors":"Tewodros Yosef ,&nbsp;Julie A Pasco ,&nbsp;Monica C Tembo ,&nbsp;Lana J Williams ,&nbsp;Kara L Holloway-Kew","doi":"10.1016/j.injury.2025.112298","DOIUrl":"10.1016/j.injury.2025.112298","url":null,"abstract":"<div><h3>Background</h3><div>With Australia's aging population, the incidence of falls is expected to rise. The proportion of adults aged ≥65 years is projected to increase from 15 % in 2017 to 22 % by 2057, highlighting the growing need for effective fall prevention measures. Therefore, this study aimed to assess fall trends and determinants using repeated follow-up data from a population-based study.</div></div><div><h3>Methods</h3><div>This study utilized data from the Geelong Osteoporosis Study (GOS) to analyse fall trends in men and women. Men's data were collected at baseline (2001–2006; <em>n</em> = 1533), 5 years (2006–2011; <em>n</em> = 968), and 15 years (2016–2021; <em>n</em> = 627), while women's data were from 6 years (2001–2003; <em>n</em> = 1014), 10 years (2004–2008; <em>n</em> = 1098), and 15 years (2011–2014; <em>n</em> = 844). Falls data, self-reported for the past 12 months, were age-standardised to the Australian population. Data included self-reported prior fractures, medications, comorbidities, alcohol use, and smoking, along with measured anthropometrics, muscle strength, biochemical tests, and imaging. A multivariable Generalised Estimating Equation model identified fall determinants, reporting adjusted odds ratios (AORs) and 95 % confidence intervals.</div></div><div><h3>Results</h3><div>In men, the age-adjusted prevalence of falls declined over time, while in women, it initially dropped by 4.2 % before a slight 0.6 % increase. After adjusting for confounders, each additional year of age raised the fall risk by 1 % (AOR = 1.01, 95 % CI: 1.00–1.02). Women had a 52 % higher likelihood of falling than men (AOR = 1.52, 95 % CI: 1.22–1.88). Diabetes increased the risk by 69 % (AOR = 1.69, 95 % CI: 1.23–2.31), while a 1 N/kg increase in hip flexion strength lowered the risk by 3 % (AOR = 0.97, 95 % CI: 0.95–0.99).</div></div><div><h3>Conclusion</h3><div>Men experienced a steady decrease in fall prevalence over time, whereas women displayed a more intricate trend, with falls initially declining before subsequently rising, following a polynomial pattern. The key predictors of falls included age, sex, diabetes and hip flexion strength. Policies should prioritize tailored fall prevention, strength training, and diabetes care integration.</div></div>","PeriodicalId":54978,"journal":{"name":"Injury-International Journal of the Care of the Injured","volume":"56 4","pages":"Article 112298"},"PeriodicalIF":2.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143696820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}