The purpose of this study was to outline the epidemiologic criteria of humerus fractures after traumatic injuries. All patients admitted to the trauma service at the authors' institution between 2005 and 2011 were entered into a prospective database. The authors obtained data on age, sex, injury mechanism, presence and location of humerus fracture, associated injuries, mortality, Injury Severity Score, treatment, and length of stay. Patients were matched to a group of patients with pelvic fractures with similar Injury Severity Scores to investigate whether significant differences existed between the 2 groups. Of the 11,007 trauma patients admitted, 209 (1.9%) had a humerus fracture. Associated fractures occurred in 154 (73.7%) patients. The mortality rate for all trauma patients during this period was 4.5%; it was 12% among those with humerus fractures and 21% among those with humeral shaft injuries. Several significant differences existed between the humerus fracture group and the pelvic fracture group. Visceral injuries were more common in the pelvic group, whereas associated fractures and head injuries were more common in the humerus fractures group. Age, sex, and length of stay were also significantly different between the 2 groups, but mortality was not significantly different. Humerus fractures in polytrauma patients are often associated with multiple injuries and a high mortality rate, especially for patients with humeral shaft fractures. A comprehensive evaluation of the patient is necessary.
Globally, the capacity of healthcare systems across continents has been strained and put to the test with the emergence of the Coronavirus disease 2019 (COVID-19) pandemic. The timely need to ensure the availability of healthcare facilities to isolate and manage the surge in COVID-19 cases without overwhelming existing hospital capacity has posed challenges in many countries. In this paper, we discuss the conceptualisation, preparations and operationalisation of a community healthcare facility that was set up within a short time frame to attend to the convalescent needs of a large number of COVID-19 patients in the early phase of handling the pandemic. In the first month of operations, we monitored a total of 2129 clinical encounters, with the majority of patients between 17–35 years of age and between day 2 to day 6 of illness upon admission. Overall, there was a good outcome for the patients, with only 2.3% requiring transfer back to restructured hospitals. There was also no mortality. We hope that the sharing of our experiences of the challenges and learning lessons gleaned may be useful to guide individuals in planning for the future preparedness of healthcare systems in managing pandemics.
Childhood injury is one of the leading causes of death globally. Singapore is no exception to this tragic fact, with childhood injuries accounting up to 37% of Emergency Department visits. Hence, it is important to understand the epidemiology and risk factors of childhood injuries locally. A search for relevant articles published from 1996–2016 was performed on PubMed, Cochrane Library and Google Scholar using keywords relating to childhood injury in Singapore. The epidemiology, mechanisms of injury, risk factors and recommended prevention strategies of unintentional childhood injuries were reviewed and described. Epidemiological studies have shown that childhood injury is a common, preventable and significant public health concern in Singapore. Home injuries and falls are responsible for majority of the injuries. Injuries related to childcare products, playground and road traffic accidents are also important causes. Healthcare professionals and legislators play an important role in raising awareness and reducing the incidence of childhood injuries in Singapore. For example, despite legislative requirements for many years, the low usage of child restraint seats in Singapore is worrisome. Thus, greater efforts in public health education in understanding childhood injuries, coupled with more research studies to evaluate the effectiveness and deficiencies of current prevention strategies will be necessary.
The purposes of the current investigation are to evaluate the epidemiology of water sport injuries at a coastal tertiary trauma center and to determine the association of these activities with spinal column injury and to determine whether aquatic trauma injuries differ significantly from those that occur terrestrially. A retrospective review of a consecutive series of 105 patients with aquatic-based mechanisms of injury admitted to a Level II trauma center over a 3-year period, as well as a matched control cohort with terrestrial-based mechanisms of injury, was conducted. Patients were treated at a Level II trauma center from January 1, 2008, to December 31, 2010. All patients received a full trauma work-up on arrival. Patients were identified retrospectively from a prospectively collected database (N=5298). Eligible patients were identified from billing/coding data as having mechanisms of injury related to an aquatic setting. Patients were evaluated using standard trauma protocols. Spinal column and cord injury occurrence and differences between groups were reviewed. Personal watercrafts accounted for the majority of injuries (n=39). Cervical (33.3%), closed-head (25.7%), and thoracolumbar (21.9%) injuries accounted for the majority of injury types. The cervical spinal column and the spinal cord were at an increased risk of injury in the aquatic injury cohort (P<.0001). The current data show the high incidence of spinal column and cord injuries in this patient population relative to controls. Practitioners who care for trauma patients near an aquatic environment should be aware of the high prevalence of these injuries, with proper spinal cord preservation protocols in place to optimize outcome.
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