Drugs in fall versus non-fall accidents with major trauma - A population-based clinical and medico-legal autopsy study

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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

Acosta, S, Andersson, L, Bagher, A & Clinical Sciences, Malmö, Sweden, D 2019, 'Drugs in fall versus non-fall accidents with major trauma - A population-based clinical and medico-legal autopsy study', Forensic Science International, bind 296, s. 80-84. https://doi.org/10.1016/j.forsciint.2019.01.012

APA

Acosta, S., Andersson, L., Bagher, A., & Clinical Sciences, Malmö, Sweden, D. (2019). Drugs in fall versus non-fall accidents with major trauma - A population-based clinical and medico-legal autopsy study. Forensic Science International, 296, 80-84. https://doi.org/10.1016/j.forsciint.2019.01.012

Vancouver

Acosta S, Andersson L, Bagher A, Clinical Sciences, Malmö, Sweden D. Drugs in fall versus non-fall accidents with major trauma - A population-based clinical and medico-legal autopsy study. Forensic Science International. 2019 mar.;296:80-84. https://doi.org/10.1016/j.forsciint.2019.01.012

Author

Acosta, S ; Andersson, L ; Bagher, A ; Clinical Sciences, Malmö, Sweden, Department. / Drugs in fall versus non-fall accidents with major trauma - A population-based clinical and medico-legal autopsy study. I: Forensic Science International. 2019 ; Bind 296. s. 80-84.

Bibtex

@article{b2d0397d610a456e856afc4a36c29901,

title = "Drugs in fall versus non-fall accidents with major trauma - A population-based clinical and medico-legal autopsy study",

abstract = "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.",

keywords = "Accidental Falls/mortality, Accidents/mortality, Adult, Age Factors, Aged, Aged, 80 and over, Drug-Related Side Effects and Adverse Reactions, Emergency Service, Hospital, Female, Forensic Medicine, Forensic Toxicology, Hospital Mortality, Humans, Illicit Drugs/adverse effects, Injury Severity Score, Male, Middle Aged, Pharmaceutical Preparations/analysis, Polypharmacy, Sweden/epidemiology, Wounds and Injuries/mortality, Young Adult",

author = "S Acosta and L Andersson and A Bagher and {Clinical Sciences, Malm{\"o}, Sweden}, Department",

year = "2019",

month = mar,

doi = "10.1016/j.forsciint.2019.01.012",

language = "English",

volume = "296",

pages = "80--84",

journal = "Forensic Science International",

issn = "0379-0738",

publisher = "Elsevier Ireland Ltd",

}

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

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