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PubMed · 4445006

"Off to casualty again".

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J Standen. 1974-12-05. "Off to casualty again".. https://pubmed.ncbi.nlm.nih.gov/4445006/

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Determinants of accident proneness: a case-control study in railway workers.

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Association between severity of musculoskeletal injury and risk of subsequent injury in children and adolescents on the basis of parental recall.

OBJECTIVES: To describe the frequency of subsequent injuries in children who were seen at an emergency department (ED) for a musculoskeletal injury and to explore factors associated with sustaining a subsequent injury within a year. DESIGN: This was a prospective cohort study of children aged 1 through 17 years who sought care at an ED for an injury. Subsequent injuries were assessed through telephone interviews. SETTING: Subjects were recruited from a national database of childhood injury after they presented to a hospital ED at 1 of the 2 pediatric trauma centers in Montreal, Quebec. PATIENTS/ PARTICIPANTS: A consecutive sample of 7640 children aged 1 through 17 years who sought care for a fracture or a soft-tissue injury to an arm or a leg; 6182 completed both telephone interviews (80.9% response rate). Main Exposure Having a more severe injury was defined in 2 ways: (1) fracture of a limb or (2) injury that required follow-up or admission. Main Outcome Measure Having a subsequent injury during 12-month follow-up. RESULTS: Subjects with an index fracture were at lower risk of subsequent injury than were those with a soft-tissue injury (13.5% compared with 17.7%; adjusted odds ratio, 0.74; 95% confidence interval, 0.63-0.87). Subjects whose injury needed a follow-up were also at lower risk of subsequent injury than those whose injury was treated only in the ED (17.7% compared with 14.3%; adjusted odds ratio, 0.79; 95% confidence interval, 0.67-0.93) as were those who were admitted (17.7% compared with 8.7%; adjusted odds ratio, 0.51; 95% confidence interval, 0.26-0.99). CONCLUSIONS: Having had a severe musculoskeletal injury may be associated with a decreased risk of subsequent injury in children and adolescents. A possible explanation could be reduced exposure to risk.

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Adolescents with attention deficit and hyperactivity disorder/learning disability and their proneness to accidents.

OBJECTIVE: The aim of the study was to determine if attention deficit and hyperactivity disorder (ADHD)/ learning disability (LD) adolescents are more prone to accidents and to investigate the parental mode of coping with that risk. METHODS: One hundred and eight high school pupils diagnosed with ADHD/LD and studying in an institute of "special education" were examined and interviewed on the subject of accidents. Eighty-seven pupils, studying in a nearby academic high school, served as a control group. RESULTS: The results showed that pupils in the study group had been involved in 0.57 +/- 1.6 accidents (until the present study) in comparison to 0.23 +/- 0.4 accidents in the control group (p=0.001). The accidents in the ADHD/LD study group had occurred at the mean age of 11.1 +/- 3.4 yr. Eight decimal three percent of these pupils had been involved in recurrent accidents. Circumstances and locations where the accidents occurred were: falls while running or participating in sports activities (38.5%), home environment (23%), school environment (19.2%) and road accidents (11.5%). CONCLUSION: The study shows that there is a real risk for ADHD/LD adolescents to be involved in all kinds of accidents. Parents should be counting on the help of professional advisors to decrease that risk. Physicians should caution these adolescents and their parents about that risk and advise them on ways and means of accident prevention.

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