Deaths caused by injury among people of working age (18–64) are decreasing, while those among older people (64+) are increasing

Abstract

BackgroundInjury is an important cause of death in all age groups worldwide, and contributes to many losses of human and economic resources. Currently, we know a few data about mortality from injury, particularly among the working population. The aim of the present study was to examine death from injury over a period of 14 years (1999–2012) using the Swedish Cause of Death Registry (CDR) and the National Patient Registry, which have complete national coverage.MethodCDR was used to identify injury-related deaths among adults (18 years or over) during the years 1999–2012. ICD-10 diagnoses from V01 to X39 were included. The significance of changes over time was analyzed by linear regression.ResultsThe incidence of prehospital death decreased significantly (coefficient −0.22, r 2 = 0.30; p = 0.041) during the study period, while that of deaths in hospital increased significantly (coefficient 0.20, r 2 = 0.75; p < 0.001). Mortality/100,000 person-years in the working age group (18–64 years) decreased significantly (coefficient −0.40, r 2 = 0.37; p = 0.020), mainly as a result of decrease in traffic-related deaths (coefficient −0.34, r 2 = 0.85; p < 0.001). The incidence of deaths from injury among elderly (65 years and older) patients increased because of the increase in falls (coefficient 1.71, r 2 = 0.84; p < 0.001) and poisoning (coefficient 0.13, r 2 = 0.69; p < 0.001).ConclusionThe epidemiology of injury in Sweden has changed during recent years in that mortality from injury has declined in the working age group and increased among those people 64 years old and over.

Registry-Based Mortality Analysis Reveals a High Proportion of Patient Decrees and Presumed Limitation of Therapy in Severe Geriatric Trauma

“…Contrary to the preclinical assumption of a traumatic cause of the admission, in 25 patients (18.6%), an internal cause (e.g., syncopal fall from a standing position) was the cause of the hospitalization and death. (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) points, p = 0.382). The median (IQR) NISS was 36 (24-57) points.…”

Risk-Adjustment for Swedish In-Hospital Trauma Mortality using International Classification of disease Injury Severity Score (ICISS) : issues with description and methods

“…First (1) is the body regions (head and neck, face, chest, abdomen and pelvis, extremities, external), which come from the sections: head, face, neck, thorax, abdomen and pelvis, spine, upper extremity, lower extremity and external. The second item (2) covers anatomical aspects (whole area, vessels, nerves, organs, skeletal, loss of consciousness), and then specific anatomical structures (3,4) (such as skin abrasion, laceration, amputation, level of consciousness, cervical, lumbar, and so on) followed by the specific injuries (5,6), which are assigned a two-digit number. Last (7) the injuries are then assigned an internal score on a six-grade scale from minor to un-survivable (1 to 6) and a separate "not further specified" score, a score of nine (9).…”

“…Mechanisms of blunt injury in Scandinavia are most common, and of these most happen outside hospital. [3][4][5][6] One of the possible explanations is that in rural areas reporting of incident is delayed, transport times are longer and injuries are more likely to be lethal. 7,8 The most serious mechanisms of injury among patients who survive long enough to get to hospital are three major groups; fall, traffic, and assault.…”

Injury mortality in Sweden; changes over time and the effect of age and injury mechanism

“…Intentional self-harm is a major contributor to injury mortality (33,40,70). The decline in intentional self-harm in penetrating injuries could in part be attributed to changing trends in suicide methods as there seems to be a changing trend over time (71,72).…”

“…Although there is a difference in the numbers there are some similarities, the most common cause of mortality by handguns is self-inflicted followed by assault in both the United States and Sweden (64). It has been showed that access to firearms contribute to suicides with firearms (70,73). Self-harm injuries with firearms are known to be more lethal than other methods (71).…”