RESUMEN
This retrospective analysis of burn patients and victims of other forms of trauma from Ribeirão Preto and nearby cities admitted to hospitals in the city of Ribeirão Preto, São Paulo, Brazil, was carried out to determine the frequency of injuries of all types in order to identify the extent of the problem of burns relative to other forms of trauma. Data concerning 921 patients with burns and 60,344 patients with other traumatic injuries hospitalized during the period from 1991 to 1997 are described. Burns corresponded to 1.5% of the total number of traumatic injuries. When data are reported as absolute numbers or as incidence rate of hospitalized burn patients, burns were two times more frequent among men in most age groups. The case fatality ratio due to burns was 8.4% (77 deaths among 921 patients), with a rate of 6.4% for men and 12.2% for women. The case fatality ratio was higher among women than men regardless of the city of residence. The case fatality ratio was 3.2 and 4.4 times greater for men and women burn victims from other towns than for burn victims from Ribeirão Preto, indicating the need for additional equipment and training of medical and paramedical personnel in the initial measures to be taken with burn patients.
Asunto(s)
Quemaduras/epidemiología , Heridas y Lesiones/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Quemaduras/mortalidad , Causas de Muerte , Niño , Preescolar , Femenino , Hospitalización , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia , Heridas y Lesiones/mortalidadRESUMEN
The authors studied 33,494 deaths occurring in Londrina, State of Paraná, Brazil, from 1936 to 1982. The deaths were divided into two groups: residents and invaders, who lived outside the Londrina municipal limits. Invaders were studied as to origin, place of occurrence, cause, and diagnostic confirmation and compared with residents across proportional mortality. An attempt was made to identify a relationship between invaders' deaths and Londrina's historical development, especially migratory phenomena and health care improvements. Results showed that over the course of the period studied, most of the outsiders who had died in Londrina (over 80%) were from northern Paraná. Identification of the proportion of in-hospital deaths, diagnostic confirmation, and criteria from several chapters of the International Classification of Diseases showed that outsiders had received proportionally more medical care. Londrina's medical care attracted outsiders from the beginning of the period onward, a trend that was further consolidated after 1970.
Asunto(s)
Emigración e Inmigración/tendencias , Mortalidad/tendencias , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Certificado de Defunción/historia , Atención a la Salud/tendencias , Emigración e Inmigración/estadística & datos numéricos , Femenino , Historia del Siglo XX , Humanos , Persona de Mediana Edad , Embarazo , Sistema de Registros , Características de la Residencia , Estadísticas VitalesAsunto(s)
Abuso de Ancianos/estadística & datos numéricos , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Abuso de Ancianos/diagnóstico , Abuso de Ancianos/legislación & jurisprudencia , Abuso de Ancianos/prevención & control , Femenino , Humanos , Masculino , Notificación Obligatoria , Persona de Mediana Edad , Vigilancia de la Población , Estudios Retrospectivos , Factores de RiesgoRESUMEN
The chart of 3468 patients with head injury assisted in the Hospital das Clínicas-Ribeirão Preto Medical School, from 1990 through 1992 were analyzed aiming to determine their main characteristics. Regarding sex, there was predominance of male. Accidental fall among children and traffic accidents among adults were the main causes of trauma. Daily distribution of assistance revealed an increase between 8 and 12 PM and during the week there was a constant flow from Tuesday to Friday and progressively increased on Saturday to Sunday. Approximately 75% of the patients presented mild head injury (score equal or superior to 13 in the Glasgow Coma Scale). Headache among children and vomiting, headache and alcoholic abuse among adults were the most frequent signs and symptoms at admission. At discharge 87.2% of patients had no symptoms and mortality was 5.7%. Peculiarities of head injury in Ribeirão Preto are discussed.
Asunto(s)
Lesiones Encefálicas/epidemiología , Adulto , Lesiones Encefálicas/etiología , Niño , Estado de Conciencia , Femenino , Escala de Coma de Glasgow , Humanos , Masculino , Persona de Mediana Edad , Periodicidad , PronósticoRESUMEN
OBJECTIVES: To analyse the concordance between clinical and autopsy diagnoses. DESIGN: Nine-hundred-and-ninety-seven autopsies were studied comparing the diagnoses of the autopsy requests with those of the death certificates and autopsy reports. The cases were grouped according to the 17 categories of diseases of the International Classification of Diseases (ICD) and the concordance was analysed with the kappa (kappa) coefficient of concordance. SETTING: The Hospital da Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (HCFMRPUSP), Ribeirão Preto, SP, Brazil. SUBJECTS: The patients autopsied at HCFMRPUSP during the period between 1978 and 1980. MAIN OUTCOME MEASURES: kappa statistics offer an alternative approach to measuring the concordance between clinical and autopsy diagnoses. RESULTS: The kappa-value obtained was equal to 0.601 with a variance of 1.545 x 10(-4) when comparing the clinical diagnoses and the autopsy diagnoses, and equal to 0.661 with a variance of 1.531 x 10(-4) comparing the clinical diagnoses with those obtained after the gross examination. These values are significant at the level of 5%, i.e. there is an overall statistical concordance between clinical and autopsy diagnoses although the value is not absolute (kappa = 1.00). CONCLUSIONS: If autopsies are heeded without bias, they will continue to give important feedback concerning medical diagnosis.
Asunto(s)
Autopsia , Errores Diagnósticos , Hospitales de Enseñanza/normas , Brasil , Humanos , Estudios Retrospectivos , Estadística como AsuntoRESUMEN
Information about women's mortality during the childbearing years has become of increasing interest in the health area in view of women's health programs. On this basis, the mortality of women aged between 15 and 49 years of the municipality of Ribeirão Preto, S. Paulo, Brazil, was studied for the period from 1985 to 1989 and compared to that of the period from 1970 to 1974. Mortality data were obtained from the civil Registry Offices of the municipality and population data were estimated on the basis of the last 2 censuses. Mortality was analyzed according to origin, marital status, seven 5-year age groups, and causes according to CID, 9th Revision, 1975. A total of 1,471 deaths occurred during the period under study, 705 of them being of town residents. The 4 major causes of residents' deaths in decreasing order of importance after calculation of proportional mortality rates, were: Chapters VII, II, XVII and I. Chapters III and V, which were very infrequent during the period from 1970 to 1974, had tended to increase owing to AIDS and chronic alcoholism, respectively. The 4 major causes continued to be the same as those of 1970, thought in a different order. The mean quinquennial death coefficients according to causes and age groups showed a gradual increase with age, more marked from 35 years on for Chapters VII, I and II. Chapter XVII showed a lower amplitude of variation from younger to older women in the periods studied. When the data were compared for a 15-year period, the general trend was a decrease in coefficient values, especially in Chapter I.(ABSTRACT TRUNCATED AT 250 WORDS)