Dataset Information

Weather Conditions and Outdoor Fall Injuries in Northwestern Russia.

ABSTRACT: This study aimed to investigate associations between the weather conditions and the frequency of medically-treated, non-fatal accidental outdoor fall injuries (AOFIs) in a provincial region of Northwestern Russia. Data on all non-fatal AOFIs that occurred from January 2015 through June 2018 (N = 1125) were extracted from the population-based Shenkursk Injury Registry (SHIR). Associations between the weather conditions and AOFIs were investigated separately for the cold (15 October-14 April) and the warm (15 April-14 October) seasons. Negative binomial regression was used to investigate daily numbers of AOFIs in the cold season, while zero-inflated Poisson regression was used for the warm season. The mean daily number of AOFIs was 1.7 times higher in the cold season compared to the warm season (1.10 vs. 0.65, respectively). The most typical accident mechanism in the cold season was slipping (83%), whereas stepping wrong or stumbling over something was most common (49%) in the warm season. The highest mean daily incidence of AOFIs in the cold season (20.2 per 100,000 population) was observed on days when the ground surface was covered by compact or wet snow, air temperature ranged from -7.0 °C to -0.7 °C, and the amount of precipitation was above 0.4 mm. In the warm season, the highest mean daily incidence (7.0 per 100,000 population) was observed when the air temperature and atmospheric pressure were between 9.0 °C and 15.1 °C and 1003.6 to 1010.9 hPa, respectively. Along with local weather forecasts, broadcasting warnings about the increased risks of outdoor falls may serve as an effective AOFI prevention tool.

SUBMITTER: Unguryanu TN

PROVIDER: S-EPMC7504524 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Weather Conditions and Outdoor Fall Injuries in Northwestern Russia.

Unguryanu Tatiana N TN Grjibovski Andrej M AM Trovik Tordis A TA Ytterstad Børge B Kudryavtsev Alexander V AV

International journal of environmental research and public health 20200821 17

This study aimed to investigate associations between the weather conditions and the frequency of medically-treated, non-fatal accidental outdoor fall injuries (AOFIs) in a provincial region of Northwestern Russia. Data on all non-fatal AOFIs that occurred from January 2015 through June 2018 (<i>N</i> = 1125) were extracted from the population-based Shenkursk Injury Registry (SHIR). Associations between the weather conditions and AOFIs were investigated separately for the cold (15 October-14 Apri ...[more]

PMID: 32825697

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Project description:ImportanceTo date, measurement and treatment of older adult fall injury has been siloed within specific care settings, such as a hospital or within a nursing home or community. Little is known about changes in fall risk across care settings. Understanding the occurrence of falls across settings has implications for measuring and incentivizing high-value care across care settings.ObjectiveTo estimate the risk of older adult fall injury within and across discrete periods during a 12-month care episode anchored by an acute hospitalization.Design, setting, and participantsThis cohort study is a longitudinal analysis of 12-month periods that include an anchor hospital stay using national data from 2006 to 2014. Participants included older (aged ≥65 years) Medicare fee-for-service beneficiaries from the Health and Retirement Study. Weekly fall injury rates were computed for 4 periods compared with the anchor hospitalization: at baseline (1-6 months before hospitalization), just before (<1 month before hospitalization), just after (<1 month after hospitalization), and at follow-up (1-6 months after hospitalization). Piecewise logistic regression models estimated weekly marginal risk of fall injury within each period, adjusting for sociodemographic and health characteristics. Fall injury risks for high-risk beneficiaries with a fall injury during the anchor hospitalization were also estimated. Data analysis was performed from November 2019 to April 2020.Main outcomes and measuresFall injuries.ResultsIn total, 10 106 anchor hospitalizations for 4101 beneficiaries (mean [SD] age, 77.1 [7.6] years; 5912 hospitalizations among women [58.5%]) were identified. The overall fall injury risk was 0.77%. In adjusted models, marginal increases in weekly fall injury risk just before hospitalization (0.27 percentage points [95% CI, 0.22 to 0.33 percentage points], or 30.0%; P < .001) were 4 times greater than decreases just after hospitalization (-0.18 percentage points [95% CI, -0.23 to -0.13 percentage points], or -9.2%; P < .001)]. A greater risk differential before and after hospitalization was observed for patients with an inpatient fall injury (1.89 percentage points [95% CI, 1.37 to 2.40], or 309.8%; P < .001; vs -0.39 percentage points [95% CI, -0.73 to -0.04], or -11.6%; P = .03).Conclusions and relevanceAn episode-based assessment of fall injury illustrates substantial variability in period-specific risks over an extended period including an anchor hospitalization. Risk transitions between periods include sizable increases just before hospitalization that do not fully subside after hospital discharge. Financial incentives to coordinate hospital and posthospital care for patients at risk for fall injury are needed. These could include bundled payments for fall injury episodes that incentivize coordination across settings.

Project description:BackgroundFalls are common in older adults and can lead to severe injuries. The Strategies to Reduce Injuries and Develop Confidence in Elders (STRIDE) trial cluster-randomized 86 primary care practices across 10 health systems to a multifactorial intervention to prevent fall injuries, delivered by registered nurses trained as falls care managers, or enhanced usual care. STRIDE enrolled 5451 community-dwelling older adults age ≥70 at increased fall injury risk.MethodsWe assessed fall-related outcomes via telephone interviews of participants (or proxies) every 4 months. At baseline, 12 and 24 months, we assessed health-related quality of life (HRQOL) using the EQ-5D-5L and EQ-VAS. We used Poisson models to assess intervention effects on falls, fall-related fractures, fall injuries leading to hospital admission, and fall injuries leading to medical attention. We used hierarchical longitudinal linear models to assess HRQOL.ResultsFor recurrent event models, intervention versus control incidence rate ratios were 0.97 (95% confidence interval [CI], 0.93-1.00; p = 0.048) for falls, 0.93 (95% CI, 0.80-1.08; p = 0.337) for self-reported fractures, 0.89 (95% CI, 0.73-1.07; p = 0.205) for adjudicated fractures, 0.91 (95% CI, 0.77-1.07; p = 0.263) for falls leading to hospital admission, and 0.97 (95% CI, 0.89-1.06; p = 0.477) for falls leading to medical attention. Similar effect sizes (non-significant) were obtained for dichotomous outcomes (e.g., participants with ≥1 events). The difference in least square mean change over time in EQ-5D-5L (intervention minus control) was 0.009 (95% CI, -0.002 to 0.019; p = 0.106) at 12 months and 0.005 (95% CI, -0.006 to 0.015; p = 0.384) at 24 months.ConclusionsAcross a standard set of outcomes typically reported in fall prevention studies, we observed modest improvements, one of which was statistically significant. Future work should focus on patient-, practice-, and organization-level operational strategies to increase the real-world effectiveness of interventions, and improving the ability to detect small but potentially meaningful clinical effects.Clinicaltrialsgov identifier: NCT02475850.

Project description:BackgroundRecreational equipment sales rose significantly during the COVID-19 pandemic. This study investigated changes in the incidence of pediatric emergency department (PED) visits related to outdoor recreational activities during the COVID-19 pandemic.MethodsA retrospective cohort study was conducted at a large children's hospital with a level 1 trauma center. Data were obtained from PED electronic medical records of children 5-14 years with a visit from March 23-September 1 in years 2015-2020. Patients with an ICD-10 code for injury associated with recreation and use of common outdoor recreational equipment were included. Initial pandemic year, 2020, was compared with pre-pandemic years (2015-2019). Data collected included patient demographics, injury characteristics, deprivation index, and disposition. Descriptive statistics were used to characterize the population and Chi-squared analysis was used determine relationships between groups.ResultsThere were 29,044 total injury visits during the study months with 4715 visits (16.2%) due to recreational mechanisms. A higher proportion of visits due to recreational injury visits occurred during the COVID pandemic (8.2%) compared to before (4.9%). Comparing patients included within the two times, were no differences in sex, ethnicity, or ED disposition. During the COVID pandemic, there was a higher percentage of White patients (80% vs 76%) and patients with commercial insurance (64% vs 55%). There was a significantly lower deprivation index for patients injured during the COVID pandemic. There were more injuries due to bicycles, ATV/motorbike, and non-motorized wheeled vehicles during the COVID pandemic.ConclusionsDuring the COVID-19 pandemic, there was an increase in bicycle, ATV/motorbike, and non-motorized wheeled vehicle injuries. White patients with commercial insurance were more likely to be injured compared to years prior. A targeted approach to injury prevention initiatives should be considered.

Dataset Information

Weather Conditions and Outdoor Fall Injuries in Northwestern Russia.

Publications

Weather Conditions and Outdoor Fall Injuries in Northwestern Russia.

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