The objectives of the study were to determine helmet use rates, incidence rates (IRs) of head and facial injuries for population attributable fraction (PAF) estimation, and to elucidate the magnitude of and changes in...The objectives of the study were to determine helmet use rates, incidence rates (IRs) of head and facial injuries for population attributable fraction (PAF) estimation, and to elucidate the magnitude of and changes in PAFs as the result of helmet use changes among preschool children. A study consisting of cross-sectional (survey) and longitudinal (follow-up) component was designed by including a randomly selected group of participants (n = 322) from 10 Head Start sites provided with free bicycle helmets along with a subgroup of prior helmet owners (n = 68) from the other random group (n = 285). All participants received bicycle helmet education. Helmet use surveys were conducted in May (1st Survey) and November 2008 (2nd Survey). The helmet owners were followed up to determine IRs, and incidence rate ratios (IRRs) for head and facial injuries. PAFs were computed using IRs as well as helmet use rates and IRRs. Helmet use rates increased significantly from the 1st to the 2nd Survey. The mean follow-up person-time was 5 months. The IRs for head, face (all portions), and face (upper/mid portions) injuries were higher in non-helmeted than helmeted riders. By using IRs, PAFs for the 3 injuries among the riders in both groups of helmet owners were 77%, 22%, and 32% respectively. The PAFs for each of the above injuries decreased by about 10% as helmet use rates increased. The magnitude of and changes in preventable head and facial injuries following free bicycle helmet distribution and education among helmeted riders was elucidated in this Head Start preschool children population.展开更多
Minor head injury (MHT) is one of the most common causes of all trauma admissions and it is still controversial to manage adequately. Although the incidence of clinically significant traumatic brain injury is low in t...Minor head injury (MHT) is one of the most common causes of all trauma admissions and it is still controversial to manage adequately. Although the incidence of clinically significant traumatic brain injury is low in this group, the consequences of missing clinically important problem are potentially life threatening. Early diagnosis of intracranial hematoma by computed tomography scan (CT) followed by early surgery is very important in the treatment of such patients. Thus, there has been a tendency to use high levels of diagnostic imaging in these conditions. There are many decision rules for the use of computed tomography (CT) for patients with minor head injury. This survey is to determine the awareness and utilization rates of these head CT rules among our emergency physicians (EP). Questionnaire was randomly sent to EPs from different ministry of health hospitals in Makkah. Our participants were asked about their awareness of such rules and their applications in their careers. Data were collected and analyzed by SPSS V16.0. The awareness and utilization rate of clinical decision rules among 91 ER physicians who responded were 54.4% and 42.2% respectively. The barriers to utilize such rules were the working environment and increased chances of getting lawsuits, which were 55.4% and 61.7% respectively. 91.1% of those physicians would like to receive guidance on how to apply such rules in their daily practices. There is a misunderstanding of the definition of minor head injury, despite the high number of head traumas, which led to request more CT scan. This will be a burden on the healthcare system and will lead to more radiation exposure. More educations regarding head CT rules will result in better utilizing of our resources and reduction in radiation risks.展开更多
Background and objective:Expectations and beliefs are important predictors of outcome following minor head injury.In this paper,the primary purpose is to develop a simple symptom expectation questionnaire for minor he...Background and objective:Expectations and beliefs are important predictors of outcome following minor head injury.In this paper,the primary purpose is to develop a simple symptom expectation questionnaire for minor head injury for use in future research studies.Methods:An existing database of 179 injury-naive subjects who completed a 56-item checklist of expected symptoms for minor head injury was analyzed to determine which items could correctly identify an a priori case definition of an expecter (a subject who expected at least one of these symptoms would remain chronic following minor head injury).A total of six of the 56 items were found to be discriminatory,and these were tested in additional subject groups against the original questionnaire.Results:From the original database of 179 subjects completing a 56-item symptom expectation checklist,135 expected that at least one of the 56 symptoms would be chronic following minor head injury.The 135 expecters,however,all chose at least one of six items:headache,anxious or worried,depressed,difficulty concentrating,dizziness,and neck pain.Using these six items,in two new groups of subjects,all those who endorsed one of the 56 symptoms as likely to be chronic following minor head injury (expecters) could also be identified on the 6-item checklist.Conclusions:A shortened (6-item) symptom expectation checklist of commonly reported symptoms following minor head injury (headache,anxious or worried,depressed,difficulty concentrating,dizziness,and neck pain) correctly identifies subjects who expect that at least one symptom will be chronic following minor head injury (i.e.,an expecter).展开更多
目的 探讨成人轻型颅脑外伤（minor head injury,MHI）的高危因素。方法 对1395例符合纳入标准〔年龄≥18岁,头颅外伤后24h以内,格拉斯哥昏迷评分（glasgow coma scale,GCS）为13~15分MHI〕的患者进行前瞻性研究,以临床指标作为自变量,...目的 探讨成人轻型颅脑外伤（minor head injury,MHI）的高危因素。方法 对1395例符合纳入标准〔年龄≥18岁,头颅外伤后24h以内,格拉斯哥昏迷评分（glasgow coma scale,GCS）为13~15分MHI〕的患者进行前瞻性研究,以临床指标作为自变量,以CT显示的急性颅脑损伤结果作为因变量,采用logistic回归分析不同因素对于颅脑损伤的危险程度,并分析OR值较高的自变量与MHI的相关性。结果 与MHI高度相关的临床指标是：神经查体阳性、意识丧失、呕吐、头痛,GCS评分为13分。用这五项临床指标组合预测MHI的敏感度为77.9%,特异度为78.3%,阳性预测值为36.8%,阴性预测值为95.6%。结论 通过前瞻性临床研究,我们提出成人MHI颅内损伤的高危因素,此结果可为临床医师对患者伤情判断及治疗提供参考依据。展开更多
文摘The objectives of the study were to determine helmet use rates, incidence rates (IRs) of head and facial injuries for population attributable fraction (PAF) estimation, and to elucidate the magnitude of and changes in PAFs as the result of helmet use changes among preschool children. A study consisting of cross-sectional (survey) and longitudinal (follow-up) component was designed by including a randomly selected group of participants (n = 322) from 10 Head Start sites provided with free bicycle helmets along with a subgroup of prior helmet owners (n = 68) from the other random group (n = 285). All participants received bicycle helmet education. Helmet use surveys were conducted in May (1st Survey) and November 2008 (2nd Survey). The helmet owners were followed up to determine IRs, and incidence rate ratios (IRRs) for head and facial injuries. PAFs were computed using IRs as well as helmet use rates and IRRs. Helmet use rates increased significantly from the 1st to the 2nd Survey. The mean follow-up person-time was 5 months. The IRs for head, face (all portions), and face (upper/mid portions) injuries were higher in non-helmeted than helmeted riders. By using IRs, PAFs for the 3 injuries among the riders in both groups of helmet owners were 77%, 22%, and 32% respectively. The PAFs for each of the above injuries decreased by about 10% as helmet use rates increased. The magnitude of and changes in preventable head and facial injuries following free bicycle helmet distribution and education among helmeted riders was elucidated in this Head Start preschool children population.
文摘Minor head injury (MHT) is one of the most common causes of all trauma admissions and it is still controversial to manage adequately. Although the incidence of clinically significant traumatic brain injury is low in this group, the consequences of missing clinically important problem are potentially life threatening. Early diagnosis of intracranial hematoma by computed tomography scan (CT) followed by early surgery is very important in the treatment of such patients. Thus, there has been a tendency to use high levels of diagnostic imaging in these conditions. There are many decision rules for the use of computed tomography (CT) for patients with minor head injury. This survey is to determine the awareness and utilization rates of these head CT rules among our emergency physicians (EP). Questionnaire was randomly sent to EPs from different ministry of health hospitals in Makkah. Our participants were asked about their awareness of such rules and their applications in their careers. Data were collected and analyzed by SPSS V16.0. The awareness and utilization rate of clinical decision rules among 91 ER physicians who responded were 54.4% and 42.2% respectively. The barriers to utilize such rules were the working environment and increased chances of getting lawsuits, which were 55.4% and 61.7% respectively. 91.1% of those physicians would like to receive guidance on how to apply such rules in their daily practices. There is a misunderstanding of the definition of minor head injury, despite the high number of head traumas, which led to request more CT scan. This will be a burden on the healthcare system and will lead to more radiation exposure. More educations regarding head CT rules will result in better utilizing of our resources and reduction in radiation risks.
文摘Background and objective:Expectations and beliefs are important predictors of outcome following minor head injury.In this paper,the primary purpose is to develop a simple symptom expectation questionnaire for minor head injury for use in future research studies.Methods:An existing database of 179 injury-naive subjects who completed a 56-item checklist of expected symptoms for minor head injury was analyzed to determine which items could correctly identify an a priori case definition of an expecter (a subject who expected at least one of these symptoms would remain chronic following minor head injury).A total of six of the 56 items were found to be discriminatory,and these were tested in additional subject groups against the original questionnaire.Results:From the original database of 179 subjects completing a 56-item symptom expectation checklist,135 expected that at least one of the 56 symptoms would be chronic following minor head injury.The 135 expecters,however,all chose at least one of six items:headache,anxious or worried,depressed,difficulty concentrating,dizziness,and neck pain.Using these six items,in two new groups of subjects,all those who endorsed one of the 56 symptoms as likely to be chronic following minor head injury (expecters) could also be identified on the 6-item checklist.Conclusions:A shortened (6-item) symptom expectation checklist of commonly reported symptoms following minor head injury (headache,anxious or worried,depressed,difficulty concentrating,dizziness,and neck pain) correctly identifies subjects who expect that at least one symptom will be chronic following minor head injury (i.e.,an expecter).
文摘目的 探讨成人轻型颅脑外伤（minor head injury,MHI）的高危因素。方法 对1395例符合纳入标准〔年龄≥18岁,头颅外伤后24h以内,格拉斯哥昏迷评分（glasgow coma scale,GCS）为13~15分MHI〕的患者进行前瞻性研究,以临床指标作为自变量,以CT显示的急性颅脑损伤结果作为因变量,采用logistic回归分析不同因素对于颅脑损伤的危险程度,并分析OR值较高的自变量与MHI的相关性。结果 与MHI高度相关的临床指标是：神经查体阳性、意识丧失、呕吐、头痛,GCS评分为13分。用这五项临床指标组合预测MHI的敏感度为77.9%,特异度为78.3%,阳性预测值为36.8%,阴性预测值为95.6%。结论 通过前瞻性临床研究,我们提出成人MHI颅内损伤的高危因素,此结果可为临床医师对患者伤情判断及治疗提供参考依据。
