DOI QR코드

DOI QR Code

The Pyramid of Injury: Estimation of the Scale of Adolescent Injuries According to Severity

  • Han, Hyejin (Department of Preventive Medicine, Ewha Womans University School of Medicine) ;
  • Park, Bomi (Department of Preventive Medicine, Ewha Womans University School of Medicine) ;
  • Park, Bohyun (Department of Preventive Medicine, Ewha Womans University School of Medicine) ;
  • Park, Namsoo (Department of Health Management, Hyupsung University) ;
  • Park, Ju Ok (Department of Emergency Medicine, Hallym University College of Medicine and Dongtan Sacred Heart Hospital) ;
  • Ahn, Ki Ok (Department of Emergency Medicine, Myoungji Hospital) ;
  • Tak, Yang Ju (Department of Paramedic Science, Korea National University of Transportation) ;
  • Lee, Hye Ah (Clinical Trial Center, Ewha Womans University Mokdong Hospital) ;
  • Park, Hyesook (Department of Preventive Medicine, Ewha Womans University School of Medicine)
  • Received : 2018.01.31
  • Accepted : 2018.05.23
  • Published : 2018.05.31

Abstract

Objectives: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. Methods: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. Results: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. Conclusions: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

Keywords

References

  1. Lim D, Lee WK, Park H. Disability-adjusted life years (DALYS) for mental and substance use disorders in the Korean Burden of Disease Study 2012. J Korean Med Sci 2016;31 Suppl 2: S191-S199. https://doi.org/10.3346/jkms.2016.31.S2.S191
  2. Centers for Disease Control and Prevention. $WISQARS^{TM}$-your source for U.S. injury statistics [cited 2018 Apr 5]. Available from: https://www.cdc.gov/injury/wisqars/facts.html.
  3. Statistics Korea. Cause-of-death statistics; 2016 [cited 2018 Apr 5]. Available from: https://meta.narastat.kr/metasvc/index.do?confmNo=101054&inputYear=2016 (Korean).
  4. Freid VM, Makuc DM, Rooks RN. Ambulatory health care visits by children: principal diagnosis and place of visit. Vital Health Stat 13 1998;(137):1-23.
  5. Yoon J, Oh IH, Seo H, Kim EJ, Gong YH, Ock M, et al. Disability-adjusted life years for 313 diseases and injuries: the 2012 Korean Burden of Disease Study. J Korean Med Sci 2016;31 Suppl 2:S146-S157. https://doi.org/10.3346/jkms.2016.31.S2.S146
  6. World Health Organization. Maternal, newborn, child and adolescent health: adolescent development [cited 2017 Dec 27]. Available from: http://www.who.int/maternal_child_adolescent/topics/adolescence/development/en/.
  7. Global Burden of Disease Pediatrics Collaboration, Kyu HH, Pinho C, Wagner JA, Brown JC, Bertozzi-Villa A, et al. Global and national burden of diseases and injuries among children and adolescents between 1990 and 2013: findings from the Global Burden of Disease 2013 Study. JAMA Pediatr 2016; 170(3):267-287. https://doi.org/10.1001/jamapediatrics.2015.4276
  8. Statistics Korea. Statistics on the youth; 2016 [cited 2018 Apr 5]. Abailable from: http://kostat.go.kr/portal/eng/pressReleases/1/index.board?bmode=read&aSeq=354961.
  9. Heinrich HW, Petersen D, Roos N, Brown JV, Hazlett S. Industrial accident prevention. 5th ed. New York: McGraw-Hill; 1980, p. 1-468.
  10. Wadman MC, Muelleman RL, Coto JA, Kellermann AL. The pyramid of injury: using ecodes to accurately describe the burden of injury. Ann Emerg Med 2003;42(4):468-478. https://doi.org/10.1067/S0196-0644(03)00489-X
  11. Gallagher SS, Finison K, Guyer B, Goodenough S. The incidence of injuries among 87,000 Massachusetts children and adolescents: results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System. Am J Public Health 1984; 74(12):1340-1347. https://doi.org/10.2105/AJPH.74.12.1340
  12. Lee LK, Fleegler EW, Forbes PW, Olson KL, Mooney DP. The modern paediatric injury pyramid: injuries in Massachusetts children and adolescents. Inj Prev 2010;16(2):123-126. https://doi.org/10.1136/ip.2009.022723
  13. Korean Statistical Information Service. Annual report on the causes of death statistics 2015 [cited 2018 Apr 5]. Available from: http://kosis.kr/publication/publicationThema.do?pub-code=YD (Korean).
  14. Korea Centers for Disease Control and Prevention. Korean National Hospital Discharge In-depth Injury Survey, 2013 [cited 2018 Apr 5]. Available from: https://chs.cdc.go.kr/chs/injury/sub06_cdc/sub06_01_cdc.do (Korean).
  15. Korea Centers for Disease Control and Prevention. Guideline for Emergency Department-based Injury Sample In-depth Surveillance Data, 2013. Cheongju: Korea Centers for Disease Control and Prevention; 2013 (Korean).
  16. Park HS, Park BH, Lee HA, Lim D, Park JO, Lee WK. Evaluation and integration of hospital-based injury surveillance systems in Korea; 2016 [cited 2018 Apr 5]. Available from: http://www.ndsl.kr/ndsl/search/detail/report/reportSearchResultDetail.do?cn=TRKO201600015684 (Korean).
  17. Jung SY. Estimation and analysis of the incidence of suicidal attempts extrapolated from the emergency department based injury surveillance system [dissertation]. Seoul: Ewha Womans University; 2017 (Korean).
  18. Park K, Eun SJ, Lee EJ, Lee CE, Park DY, Han K, et al. The incidence and patterns of unintentional injuries in daily life in Korea: a nationwide study. J Prev Med Public Health 2008;41(4): 265-271 (Korean). https://doi.org/10.3961/jpmph.2008.41.4.265
  19. Lee WK, Lim D, Park H. Disability-adjusted life years (DALYs) for injuries using death certificates and hospital discharge survey by the Korean Burden of Disease Study 2012. J Korean Med Sci 2016;31 Suppl 2:S200-S207. https://doi.org/10.3346/jkms.2016.31.S2.S200

Cited by

  1. Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis vol.16, pp.22, 2018, https://doi.org/10.3390/ijerph16224581
  2. Comparison of Intentional and Unintentional Injuries Among Chinese Children and Adolescents vol.30, pp.12, 2018, https://doi.org/10.2188/jea.je20190152
  3. Identifying intentional injuries among children and adolescents based on Machine Learning vol.16, pp.1, 2018, https://doi.org/10.1371/journal.pone.0245437
  4. Joinpoint Regression About Injury Mortality and Hospitalization in South Korea vol.37, pp.3, 2018, https://doi.org/10.3346/jkms.2022.37.e10