Drugs in fall versus non-fall accidents with major trauma - A population-based clinical and medico-legal autopsy study
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Drugs in fall versus non-fall accidents with major trauma - A population-based clinical and medico-legal autopsy study. / Acosta, S; Andersson, L; Bagher, A; Clinical Sciences, Malmö, Sweden, Department.
I: Forensic Science International, Bind 296, 03.2019, s. 80-84.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Drugs in fall versus non-fall accidents with major trauma - A population-based clinical and medico-legal autopsy study
AU - Acosta, S
AU - Andersson, L
AU - Bagher, A
AU - Clinical Sciences, Malmö, Sweden, Department
N1 - Copyright © 2019 Elsevier B.V. All rights reserved.
PY - 2019/3
Y1 - 2019/3
N2 - BACKGROUND: The main aim of the present population-based study was to compare drugs in fall versus non-fall accidents causing major trauma, including both clinical and medico-legal autopsy data.METHODS: All individuals with accidents resulting in major trauma, a new injury severity score (NISS)>15 or lethal outcome was identified at hospital and/or the Department of Forensic Medicine between 2011 and 2013. Modified Downton Fall Risk Index ranged from 0 to 7, and was based on specific pharmaceuticals (max 5 points), previous fall (1 point) and cognitive impairment (1 point).RESULTS: One hundred and four individuals with major traumatic accidents were identified, 38 (36.5%) died. The median modified Downton Fall Risk Index was 2 for fall accidents and 0 for non-fall accidents (p < 0.001). Modified Downton Fall Risk Index was an age-independent factor associated with fall accident (p < 0.001). The medico-legal autopsy rate for in-hospital patients was 50% (6/12) for fatal fall accidents in comparison with 92.3% (12/13) for fatal non-fall accidents (p = 0.03). In individuals undergoing medico-legal autopsy, the proportion of individuals with any detected drug was 77% in fall accidents compared to 39% in non-fall accidents (p = 0.036). The presence of sedatives (p = 0.002) and bensodiazepines (p = 0.023) were higher for fall accidents compared to non-fall accidents.CONCLUSION: This population-based study on accidents with major trauma showed that drugs had high impact on fall accidents with major trauma. It seems warranted from a public health perspective to study if implementation of medication review guidelines at hospital managing polypharmacy issues may prevent fall accident recidivism.
AB - BACKGROUND: The main aim of the present population-based study was to compare drugs in fall versus non-fall accidents causing major trauma, including both clinical and medico-legal autopsy data.METHODS: All individuals with accidents resulting in major trauma, a new injury severity score (NISS)>15 or lethal outcome was identified at hospital and/or the Department of Forensic Medicine between 2011 and 2013. Modified Downton Fall Risk Index ranged from 0 to 7, and was based on specific pharmaceuticals (max 5 points), previous fall (1 point) and cognitive impairment (1 point).RESULTS: One hundred and four individuals with major traumatic accidents were identified, 38 (36.5%) died. The median modified Downton Fall Risk Index was 2 for fall accidents and 0 for non-fall accidents (p < 0.001). Modified Downton Fall Risk Index was an age-independent factor associated with fall accident (p < 0.001). The medico-legal autopsy rate for in-hospital patients was 50% (6/12) for fatal fall accidents in comparison with 92.3% (12/13) for fatal non-fall accidents (p = 0.03). In individuals undergoing medico-legal autopsy, the proportion of individuals with any detected drug was 77% in fall accidents compared to 39% in non-fall accidents (p = 0.036). The presence of sedatives (p = 0.002) and bensodiazepines (p = 0.023) were higher for fall accidents compared to non-fall accidents.CONCLUSION: This population-based study on accidents with major trauma showed that drugs had high impact on fall accidents with major trauma. It seems warranted from a public health perspective to study if implementation of medication review guidelines at hospital managing polypharmacy issues may prevent fall accident recidivism.
KW - Accidental Falls/mortality
KW - Accidents/mortality
KW - Adult
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Drug-Related Side Effects and Adverse Reactions
KW - Emergency Service, Hospital
KW - Female
KW - Forensic Medicine
KW - Forensic Toxicology
KW - Hospital Mortality
KW - Humans
KW - Illicit Drugs/adverse effects
KW - Injury Severity Score
KW - Male
KW - Middle Aged
KW - Pharmaceutical Preparations/analysis
KW - Polypharmacy
KW - Sweden/epidemiology
KW - Wounds and Injuries/mortality
KW - Young Adult
U2 - 10.1016/j.forsciint.2019.01.012
DO - 10.1016/j.forsciint.2019.01.012
M3 - Journal article
C2 - 30710812
VL - 296
SP - 80
EP - 84
JO - Forensic Science International
JF - Forensic Science International
SN - 0379-0738
ER -
ID: 364627285