The demographics of dog bites in the United States

Dog bites are a significant public health issue. There is no comprehensive study of dog bite demographics. It was the purpose of this study to perform such an analysis across the US. The National Electronic Injury Surveillance System All Injury Program data for the years 2005 through 2013 was accessed; dog bite injuries were extracted and analyzed. Statistical analyses were performed with SUDAAN 11.0.01™ software to account for the weighted, stratified nature of the data. Incidence values were calculated using population data from the US Census Bureau. A P 85 years of age, 4.88 [2.89, 8.24] 75-84 years, and 2.79 [1.77, 4.39] those ≤4 years of age, with the 10-14 year age group the reference group. The average annual incidence was 1.1 per 1,000, and was slightly higher in males (1.18 vs 1.02 per 1,000). The estimated cost was at least 400 million US$ per year. Potential prevention strategies are educational programs directed at both children and parents/caretakers outlining the responsibilities of owning a dog. This information can be disseminated in health care facilities, radio/TV/Internet venues, and dog kennels/shelters

Slipped capital femoral epiphysis: a spectrum of surgical care and changes over time

Purpose To survey the spectrum of surgical care in children with slipped capital femoral epiphysis (SCFE). This information is valuable in counselling the patient about the future treatment course. Methods Data for this study were obtained from the Pediatric Hospital Information System (PHIS) between 2004 and 2015. For all patients with an ICD9 diagnosis of 732.2, gender, ethnicity, hospital, medical record number, date of birth/admission/discharge, type of admission, length of stay, disposition and treatment(s) rendered were collected. Results A total of 13 168 procedures were performed in 11 058 unique SCFE patients, or 1.2 procedures per patient. Primary procedures were those performed for the initial treatment of the SCFE and secondary procedures as reconstructive and salvage. The majority (11 693, 88.8%) were primary. There was significant variation in the ratio of primary and secondary procedures by institution. There was a decline in in situ fixation as the initial SCFE treatment with an increase in open reduction and internal fixation over the 12-year span. Similarly, there was a significant increase in the number of secondary procedures over time as well as complications and implant removal. There was no change over time in the diagnosis of avascular necrosis. Conclusions The average number of surgical procedures in patients was in the range of 1 to 6 and varied widely by hospital. Each physician should know his/her own hospital’s data for the percentage of subsequent procedures so as to counsel the patient and family properly. The increasing number of complications over time may reflect the increasing number of more complex procedures

The Demographics of Non-motor Vehicle Associated Railway Injuries Seen at Trauma Centers in the United States 2007 - 2014

Introduction The majority of railway injury studies are limited by small sample size, restricted to a small geographical distribution, or located outside the United States (US). The aim of our study was to assess the demographic patterns associated with non-motor vehicle railway injuries in the US using a national trauma center database. Materials and Methods Data from the National Trauma Data Bank data from 2007 - 2014 were used; 3,506 patients were identified. For all statistical analyses, a p-value < 0.05 was considered significant. Results The patients were 81% male with an average age of 38.6 + 17.1 years and an Injury Severity Score (ISS) of 16.8 + 13.8. Males compared to females were younger (37.7 vs 42.5 years, p = 0.000002), had greater length of stays (12.7 vs 9.8 days, p = 0.000006), and higher ISS scores (17.1 vs 15.4, p = 0.0007). The geographic distribution within the US was most common in the South (32.0%) and least in the Northeast (18.9%). The racial composition was 67.5% White, 19.1% Black, 11.5% Hispanic/Latino, and 1.9% others. The most common mechanisms of injury were hitting/colliding with rolling stock (38.6%), followed by a fall in or from a train (19.5%), and collision with an object (13.5%). The majority of patients were pedestrians or passengers (68.5%); employees accounted for 12.5%. Although the majority were pedestrian/passengers for all regions, the Midwest had a greater proportion of employees (22.0%) compared to the other regions (7.8% to 12.2%) (p < 10-6), and thus injuries were more commonly work-related (24.6% vs 6.7% - 13.7%, p < 10-6). Work-related injuries were less severe (ISS 11.2 vs 17.3 - p < 10-6) and more commonly occurred due to a fall (32.8% vs 17.9%, p < 10-6). Alcohol and/or drug involvement was present in 40.7% and was less in those with work-related injuries (2.2%). Overall mortality was 6.4% and was less in those having a work-related injury (2.0 vs 6.6% p = 0.000004). Conclusion For non-motor vehicle USA railway injuries, the average age was 38.5 years; 80.6% were male. The injuries were least common in the Northeast and most common in the South. Racial distribution mirrored that of the US population. Alcohol involvement was present in 29%, lower than in previous studies. Mortality was 6.4%, also lower than previously reported

Demographics and Fracture Patterns of Patients Presenting to US Emergency Departments for Intimate Partner Violence

Orthopaedic surgeons are in a position to assist in identifying intimate partner violence (IPV) patients. It was the purpose of this study to analyze the demographics and fracture patterns of IPV patients in the United States

Injuries associated with bunk beds that occur in jail

Background There are many studies of bunk bed injuries, but none specifically addressing those occurring in jails. It was the purpose of this study to investigate the magnitude and patterns of bunk bed injuries occurring in correctional institutions. Methods The National Electronic Injury Surveillance System (NEISS) data for the 10 year period 2006 through 2015 due to bunk beds was accessed. Injuries involving bunk beds were identified and the mechanism of injury determined. Statistical analyses were performed with SUDAAN 10™ software. A p < 0.05 was considered statistically significant. Results There were an estimated 639,505 ED visits for bunk bed associated injuries; 51,204 occurred in jail. All jail cases occurred in the age groups ≥10 years (177,165); 29% of these 177,165 sustained the injury in jail. Those who sustained a bunk bed injury in jail compared to those who did not were older, more commonly male, seen in smaller hospitals, more likely admitted, and more frequently associated with a seizure. For those injuries occurring in jail, the most common injury in the trunk and lower extremity was a strain/sprain; the upper extremity a contusion/abrasion; and the head/neck a laceration or traumatic brain injury. A fall off the bunk bed accounted for 71.8% of the injuries, had the highest hospital admission rate (7.4%), accounted for all of the spine injuries, 96% of the head injuries, and had the highest proportion of fractures (14.4%). Inmates having a seizure before the injury sustained fewer fractures, more lacerations, and more head/neck injuries. Conclusions Injuries in jail account for 29% of all bunk bed injuries resulting in an ED visit in the USA in those age groups ≥10 years. A fall from the bed occurred in 72% and a seizure disorder was 4.5 times more common in jail inmates compared to non inmates. Possible prevention strategies include railings/ladders to reduce the incidence of falls, changes in flooring surfaces, and seizure education and placing inmates with seizure and/or alcohol related disorders on the bottom bunk. This will require a multidisciplinary approach involving the disciplines of medicine, material engineering, and criminal justice

Demographics of hip dysplasia in the Maine Coon cat

Objectives The aim of this study was to report the demographics of feline hip dysplasia (FHD) in the Maine Coon cat. Methods The complete hip dysplasia registry (public and private) collected by the Orthopedic Foundation for Animals through April 2015 was accessed. There were 2732 unique cats; 2708 (99.1%) were Maine Coons, and only these were studied. Variables analyzed were sex, month/season of birth and hip dysplasia score. Two groups were created: those with and without FHD. P <0.05 was considered statistically significant. Results The youngest cat with FHD was 4 months of age. The majority of the radiographs (2604/2708 [96.2%]) were performed between 4 and 60 months of age. Non-borderline scores for these 2604 cats were available in 2548, and were the data used for this study. The overall prevalence of FHD was 24.9% (635/2548), and was slightly higher in males (279/1023 [27.3%]) than females (356/1525 [23.3%]) (P = 0.025). Those with more severe dysplasia were older. The percentage of bilateral FHD was 56%, and bilateral cases had more severe dysplasia than unilateral cases but with no age difference. Month/season of birth or geographic region of origin did not influence the prevalence of FHD. Conclusions and relevance This is the largest demographic study of FHD in the Maine Coon cat. The overall prevalence in the Orthopedic Foundation for Animals registry was 24.9%, and slightly higher in males (27.3%) than females (23.3%). Dysplasia was more severe in bilateral than unilateral cases and with increasing age. Caution should be used when extrapolating these findings to other feline breeds or other groups of Maine Coon cats. Further studies need to be performed among other breeds and geographic locations to better understand the demographics of feline hip dysplasia

Seasonal Variation in Slipped Capital Femoral Epiphysis: New Findings Using a National Children’s Hospital Database

Background: Slipped capital femoral epiphysis (SCFE) demonstrates seasonal variation in certain latitudes but not others. Is such variation influenced by temperature differences, sunlight exposure and subsequent vitamin D production, or other climate variables? It was the purpose of this study to further investigate the seasonal variation in month of presentation for SCFE. Methods: Data for this study originated from the Pediatric Hospital Information System for all children with a diagnosis of SCFE from January 1, 2004 through December 31, 2014. From this database the patient’s sex, ethnicity, hospital location, and month of presentation was determined. Only those patients treated primarily for SCFE were included. Geographic and climate data [latitude, average annual temperature, precipitation, climate type (Köppen-Geiger and Liss), horticultural plant zone hardiness, and sunlight exposure] for each of the 49 Pediatric Hospital Information System hospitals was determined. Seasonal variation was analyzed using cosinor analysis. A P<0.05 was considered statistically significant. Results: There were 10,350 cases of SCFE with an overall peak presentation in mid August. For those living at a latitude of >35-degree N there was single peak, a less prominent double peak for those 31- to 35-degree N, and no variation for those <31-degree N. As the average annual temperature increased there was less seasonal variability. Humid, temperate and cold winter climates demonstrated seasonal variation, whereas other climate types did not. Those living in areas having <2500 hours of sunlight per year demonstrated seasonal variation. Further, areas having a photovoltaic solar production potential <5.0 kWh/m2/d also demonstrated seasonal variation. Conclusions: We discovered new seasonal variation findings regarding SCFE. These are a double peak pattern for those between 31- and 35-degree N latitude; less variability as the average annual temperature increases; and sunlight exposure correlates with seasonal variability. Potential explanations are a rachitic state due to seasonal variation in vitamin D production, and seasonal variation in physeal growth and strength. These new findings will require further investigation

Events Due to Snowblower Use Seen in US Emergency Departments From 2003 Through 2018

Objective To comprehensively analyze emergency department (ED) visits associated with snowblower use in the United States. Methods Data on National Electronic Injury Surveillance System ED visits due to snow blowers from 2003 through 2018 were analyzed by age, sex, diagnosis, anatomic location of the injury, and year, month, or weekday. The mechanism of injury and alcohol use were noted. Statistical analyses were performed, accounting for the weighted, stratified nature of the data. Results There were an estimated 91,451 patients with an average age of 51 years; 91.2% were male. Amputation, fracture, or laceration accounted for 43,524 (47.6%) of the ED visits. The mechanism of injury was placing the hand into the chute (44.5%), a fall/slip (13.3%), medical events (6.1%), and miscellaneous (33.8%). Most (68.9%) occurred at home. Alcohol was rarely involved (0.4%). There were 648 deaths; 647 were due to cardiac events. The five major injury diagnoses were fracture (25.9%), laceration (20.2%), strain/sprain (15.0%), amputation (11.2%), and contusion/abrasion (10.2%); 99.8% of the amputations involved fingers. The incidence of ED snowblower visits was 1.845 per 100,000 US population with no change over time. There was a general correlation between the number of visits and the annual snow cover. Conclusions Ample opportunity for injury prevention exists, as there was no change in the incidence over time. Cardiac events accounted for essentially all of the deaths

Seasonal variation in adult hip disease secondary to osteoarthritis and developmental dysplasia of the hip

AIM: To determine if there was a seasonal variation in adults undergoing total hip arthroplasty for end stage hip disease due to osteoarthritis (OA) or sequelae of developmental dysplasia of the hip (DDH). METHODS: The total hip registry from the author's institution for the years 1969 to 2013 was reviewed. The month of birth, age, gender, and ethnicity was recorded. Differences between number of births observed and expected in the winter months (October through February) and non-winter mo (March through September) were analyzed with the χ2 test. Detailed temporal variation was mathematically assessed using cosinor analysis. RESULTS: There were 7792 OA patients and 60 DDH patients who underwent total hip arthroplasty. There were more births than expected in the winter months for both the DDH (P < 0.0001) and OA (P = 0.0052) groups. Cosinor analyses demonstrated a peak date of birth on 1st October. CONCLUSION: These data demonstrate an increased prevalence of DDH and OA in those patients born in winter