Air temperature and the incidence of fall-related hip fracture hospitalisations in older people
- Authors: Turner, R. M. , Hayen, Andrew , Dunsmuir, William , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. 22, no. 4 (2011), p. 1183-1189
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, hip fracture rates are higher in both males and females aged 75+ years when there is a lower air temperature. This study investigated whether there was an association between fall-related hip fracture hospitalisations and air temperature at a day-to-day level, after accounting for seasonal trend and autocorrelation. Observation-driven Poisson regression models were used to investigate mean daily air temperature and fall-related hip fracture hospitalisations for the period 1 July 1998 to 31 December 2004, inclusive, in the Sydney region of New South Wales, Australia, which has a population of 4 million people. Lower daily air temperature was significantly associated with higher fall-related hip fracture hospitalisations in 75+-year-olds: men aged 75-84 years, rate ratio (RR) for a 1A degrees C increase in temperature of 0.98 with 95% confidence interval (0.96, 0.99), men 85+ years RR = 0.98 (0.96, 1.00), women 75-84 years RR = 0.99 (0.98, 1.00), women 85+ years RR = 0.98 (0.97, 0.99). Moreover, there were fewer hospitalisations on weekends compared to weekdays ranging from RR = 0.81 (0.73, 0.90) in women aged 65-74 years to RR = 0.89 (0.80, 0.98) in men aged 85+ years. After adjustment for season, day-of-week effects, long-term trend and autocorrelation, fall-related hip fracture hospitalisation rates are higher in both males and females aged 75+ years when there is a lower air temperature.
Relative benefits of population-level interventions targeting restraint-use in child car passengers
- Authors: Du, Wei , Finch, Caroline , Hayen, Andrew , Bilston, Lynne , Brown, Julie , Hatfield, Julie
- Date: 2010
- Type: Text , Journal article
- Relation: Pediatrics Vol. 125, no. 2 (2010), p. 304-312
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objectives: Because public health resources for injury prevention are limited, methods for comparing competing strategies are needed. We aimed to estimate potential injury reductions for 4 population-level interventions that target restraint practices for child car passengers aged 0 to 12 years. Methods: Population-attributable risk fraction (parf) is a populationlevel estimate of excess risk from exposure to a risk factor. Parfs were calculated for each intervention scenario by using published age-specific mortality/injury relative-risk estimates; restraint practices among injured child car passengers from police-collected data; and observational data for correctness of restraint use in new south wales, australia. Parf reductions were estimated for population uptakes of 25%, 50%, and 75%. Results: Assuming a 50% population uptake, (1) promoting ageappropriate restraint use could prevent additional fatalities (5.1%, infants; 3.4%, 1- To 6-year-olds) and nonfatal injuries (3.2%, infants; 16.2%, 1- To 6-year-olds) compared with promoting any restraint use; (2) further encouraging correct age-appropriate restraint use could also prevent additional fatalities (9.1%, infants; 14.3%, 1- To 6-year-olds) and nonfatal injuries (9.2%, infants; 10.7%, 1- To 6-year-olds); and (3) for children aged 7 to 12 years, promoting correct use of restraints could prevent an additional 3.4% fatalities and 3.1% nonfatal injuries compared with promoting any restraint use. Conclusions: Interventions that target child passenger-restraint practices offer population-level benefits in terms of reduction in fatalities and injuries. These tangible benefits call for action internationally, not only to promote restraint use but correct age-appropriate restraint use for child car passengers. Copyright © 2010 by the American Academy of Pediatrics.
Spatial temporal modeling of hospitalizations for fall-related hip fractures in older people
- Authors: Turner, R. M. , Hayen, Andrew , Dunsmuir, William , Finch, Caroline
- Date: 2009
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. , no. (2009), p. 1-7
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Summary: The study determined the spatial temporal characteristics of fall-related hip fractures in the elderly using routinely collected injury hospitalization and sociodemographic data. There was significant spatial temporal variation in hospitalized hip fracture rates in New South Wales, Australia. Introduction: The study determined the spatial temporal characteristics of fall-related hip fractures in the elderly using routinely collected injury hospitalization data. Methods: All New South Wales (NSW), Australia residents aged 65+ years who were hospitalized for a fall-related hip fracture between 1 July 1998 and 30 June 2004 were included. Bayesian Poisson regression was used to model rates in local government areas (LGAs), allowing for the incorporation of spatial, temporal, and covariate effects. Results: Hip fracture rates were significantly decreasing in one LGA, and there were no significant increases in any LGAs. The proportion of the population in residential aged care facilities was significantly associated with the rate of hospitalized hip fractures with a relative risk (RR) of 1.003 (95% credible interval 1.002, 1.004). Socioeconomic status was also related to hospitalized hip fractures with those in the third and fourth quintiles being at decreased risk of hip fracture compared to those in the least disadvantaged (fifth) quintile [RR = 0.837 (0.717, 0.972) and RR = 0.855 (0.743, 0.989) respectively]. Conclusions: There was significant spatial temporal variation in hospitalized hip fracture rates in NSW, Australia. The use of Bayesian methods was crucial to allow for spatial correlation, covariate effects, and LGA boundary changes. © 2009 International Osteoporosis Foundation and National Osteoporosis Foundation.
- Description: 2003008191
Association between different restraint use and rear-seated child passenger fatalities a matched cohort study
- Authors: Du, Wei , Hayen, Andrew , Bilston, Lynne , Hatfield, Julie , Finch, Caroline , Brown, Julie
- Date: 2008
- Type: Text , Journal article
- Relation: Archives of Pediatrics & Adolescent Medicine Vol. 162, no. 11 (Nov 2008), p. 1085-1089
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- Description: Objective: To investigate the association between restraint use and death in rear-seated child passengers and to examine whether the estimated association varies by restraint type and age. Design: Matched cohort study. Setting: All reported crashed passenger vehicles with at least 2 rear-seated child passengers of whom at least 1 died from the US Fatality Analysis Reporting System for 1998 to 2006. Participants: Rear-seated child passengers aged 2 to 6 years. Interventions: Three models of restraint use: (1) no restraint use, any restraint use; (2) no restraint use, recorded improper restraint use (including improper use of seat belts or child restraints, use of shoulder-only seat belts, and use of an unknown type of restraint), any other restraint use; and (3) no restraint use, improper restraint use, seat belts, and child restraints. Main Outcome Measure: Death within 30 days of a crash. Results: Compared with no restraint use, being restrained reduced the risk of death in rear-seated child passengers (relative risk [RR], 0.33; 95% confidence interval [CI], 0.22-0.49). Compared with improper restraint use, any other restraint use reduced the risk of death (RR, 0.46; 95% CI, 0.20-0.63). The RR of death for using child restraints compared with seat belts was 0.91 (95% CI, 0.57-1.14). Child restraints performed slightly better in fatality risk reduction in children aged 2 to 3 years (RR, 0.24; 95% CI, 0.09-0.33) than in children aged 4 to 6 years (RR, 0.32; 95% CI, 0.11-0.44) compared with traveling unrestrained. Conclusions: This study demonstrates the protective effects of restraints for child passengers and highlights the importance of using restraints correctly.
Comparison of methods to correct the miscounting of multiple episodes of care when estimating the incidence of hospitalised injury in child motor vehicle passengers
- Authors: Du, Wei , Hayen, Andrew , Finch, Caroline , Hatfield, Julie
- Date: 2008
- Type: Text , Journal article
- Relation: Accident Analysis and Prevention Vol. 40, no. 4 (2008), p. 1563-1568
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- Description: This study evaluates the performance of different case selection criteria to account for multiple episodes of care when estimating the hospitalisation rate due to road trauma amongst children. The internally linked NSW Inpatient Statistics Collection (ISC) dataset for the period between 1st July, 2000 and 30th June, 2003 was used to identify the "single" episode of care for each hospitalised child motor vehicle passenger residing in NSW. We used two hospitalised injury definitions of a case based on (1) all-diagnoses and (2) principal diagnosis only. We then developed case selection criteria, based on (a) linkage methods only available from linked ISC datasets; (b) selected variables available in both the linked and unlinked ISC datasets, to exclude repeat episodes of care for an injury. Changes in the estimated hospitalisation rate, and sensitivity and specificity, were calculated for each selection criteria compared to the findings from linkage methods as the "gold standard". None of the correction methods for multiple episodes of care was clearly superior in terms of incidence estimation, sensitivity, and specificity concurrently. However, the correction criterion which is optimal may vary depending on different study objectives and different types of hospitalised injuries. © 2008 Elsevier Ltd. All rights reserved.
Relative survival after hospitalisation for hip fracture in older people in New South Wales, Australia
- Authors: Hindmarsh, Diane , Hayen, Andrew , Finch, Caroline , Close, Jacqueline
- Date: 2008
- Type: Text , Journal article
- Relation: Osteoporosis International Vol. , no. (2008), p. 1-9
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- Description: Summary: Survival after hospitalisation for hip fracture by age group and sex relative to survival in the general population was assessed in people aged 65+. Men had double the risk of death compared with women to 1 year, but age effects lasted only to 3 months. Clinical outcomes need to be improved. Introduction: We assessed the relative survival of hospitalised fall-related hip fracture patients aged 65+ years leaving hospital in New South Wales, Australia, between July 2000 and December 2003. Method: We carried out a population-based study of all hospital separations for NSW residents with a principal diagnosis of hip fracture (ICD-10-AM S72.0 to S72.2) and first external cause of fall (ICD-10-AM codes W00 to W19), linked to NSW death data. A total of 16,836 cases were included. Relative survival 3 to 36 months post-admission by 10-year age groups and sex was calculated, using NSW life tables for 2002-2004. Relative excess risk was modelled using a generalised linear model with Poisson error structure, using the life table data. Results: One-year cumulative relative survival in 65- to 74-year-olds was 82% (men), 90% (women); in 85+-year-olds 65% (men), 80% (women). Men have a relative excess risk of death of 2.2 (95% CI 2.03-2.38) times that of women. Only 21% of deaths mention the hip fracture as contributing to death. Conclusion: There is a need to reduce the number of hip fractures and improve clinical outcomes for older people hospitalised with hip fractures. © 2008 International Osteoporosis Foundation and National Osteoporosis Foundation.
- Description: C1
- Description: 2003008189
The impact of environmental, vehicle and driver characteristics on injury severity in older drivers hospitalized as a result of a traffic crash
- Authors: Boufous, Soufiane , Finch, Caroline , Hayen, Andrew , Williamson, Ann
- Date: 2008
- Type: Text , Journal article
- Relation: Journal of Safety Research Vol. 39, no. 1 (2008), p. 65-72
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- Description: Introduction: Compared to younger age groups, older people are more likely to be seriously injured or to die as a result of a traffic crash. Method: The aim of the study is to examine the impact of environmental, vehicle, crash, and driver characteristics on injury severity in older drivers involved in traffic crashes by using recently linked police crash records and hospitalization data from New South Wales, Australia. The severity of injury resulting from traffic crashes was measured using the International Classification of Diseases, 10th revision (ICD-10) Injury Severity Score (ICISS). Results: Multivariate analysis identified rurality, presence of complex intersections, road speed limit, driver error, speeding, and seat belt use as independent predictors of injury severity in older people. The type of intersection configuration explained over half of the observed variations in injury severity. Impact on Industry: Environmental modification such as intersection treatments might contribute to a decrease in the severity of injury in older people involved in road crashes.
- Description: 2003006544
Determining the intra- and inter-observer reliability of screening tools used in sports injury research
- Authors: Hayen, Andrew , Dennis, Rebecca , Finch, Caroline
- Date: 2007
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 10, no. 4 (2007), p. 201-210
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- Description: Sports injury etiological studies explore the relationships between potential injury risk factors and injury outcomes. The ability of such studies to clearly identify intrinsic risk factors for sports injury depends on the accuracy of their measurement. Measurements need to be reproducible over time and repeatable by different observers, as well as within a given individual. The importance of the reliability of pre-participation screening protocols and other clinical assessment tools has been identified in a number of published studies. However, a review of these studies indicates that a variety of statistical techniques have been used to calculate intra- and inter-observer reliability. While the intra-class correlation coefficient (ICC) is the most often cited measure, a range of statistical approaches to estimating ICCs have been used. It is therefore difficult to determine which statistical method is most appropriate in the context of measuring intrinsic risk factors in sports injury research. This paper summarises a statistical method for the concurrent assessment of intra- and inter-observer reliability and presents an argument for why this approach should be adopted by sports injury researchers using screening protocols that collect continuous data.
- Description: C1
- Description: 2003005882
Trends in hospitalisation rates for road traffic injuries in child motor vehicle passengers in New South Wales, July 1998 June 2005
- Authors: Du, Wei , Finch, Caroline , Hayen, Andrew , Hatfield, Julie
- Date: 2007
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 187, no. 9 (Nov 2007), p. 515-518
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- Description: Objective: To analyse changes in the incidence of injuries requiring hospitalisation for child passengers in motor vehicle crashes. Design, setting and participants: Population-based study of children (aged 0-15 years) residing in New South Wales and admitted to hospital for injuries resulting from a traffic crash in the period 1 July 1998 - 30 June 2005, identified from the NSW Inpatient Statistics Collection. Main outcome measures: Age-standardised rates of hospitalisation for injuries, and trends by inpatient demographics, severity of injuries, and injury sites and types. Results: 2297 children were hospitalised for injuries sustained in a motor vehicle crash over the study period. The overall hospitalisation rate for injuries was relatively constant, with a non-significant decline of -0.4% (95% Cl, -3.1% to 2.3%). The rate of hospitalisation for serious injuries also declined non-significantly (-5.5% [95% Cl, -11.8% to 1.1%]). Only hospitalisation rates for traumatic brain injuries declined significantly (-11.1% [95% Cl, -19.0% to -2.8%]) over the study period. Conclusion: The rate of hospitalisation for injuries to NSW-resident child motor vehicle passengers due to traffic crashes has not significantly decreased. High hospitalisation rates and the subsequent burden to the community and public health system make further injury prevention efforts for child motor vehicle passengers a priority.
- Description: C1
- Description: 2003005874