RESUMO
This study aimed to describe the distribution of injury mechanisms and to assess the impact of those mechanisms on the morbidity and mortality of trauma. All patients admitted to Puerto Rico Trauma Hospital (2002-2011) for road-traffic collisions (RTCs, 5,371), gunshot wounds (GSWs, 2,946), falls (2,319), pedestrian accidents (1,652), and stab wounds (SWs, 1,073) were selected. Gunshot victims were 1.19 (95%CI: 1.07-1.33) times as likely as road-traffic victims to have an ISS ≥25. Pedestrians were 1.76 (95%CI: 1.49-2.09) times more likely to have a GCS ≤8 than road-traffic victims were. The risk of dying was 2.64 (95%CI: 2.20-3.16) times higher for gunshot victims and 1.51 (95%CI: 1.23-1.86) times higher for pedestrians compared to patients who had had RTCs. Gunshot victims and pedestrians had the worst clinical outcomes. Accordingly, these patients should receive the most aggressive clinical management. Furthermore, it is imperative to develop public health campaigns on trauma prevention.
Assuntos
Mortalidade Hospitalar , Ferimentos e Lesões/etiologia , Ferimentos e Lesões/mortalidade , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Pedestres/estatística & dados numéricos , Porto Rico/epidemiologia , Estudos Retrospectivos , Estações do Ano , Fatores de Tempo , Centros de Traumatologia , Ferimentos e Lesões/epidemiologia , Ferimentos por Arma de Fogo/mortalidade , Ferimentos Perfurantes/mortalidade , Adulto JovemRESUMO
The purpose of the study was to determine if an educational program for parents of newborns can be useful to prevent Shaken Baby Syndrome in Puerto Rican families. Staff training was performed, parents observed an educational video & infant crying management strategies were discussed. Pre-post tests, follow up phone calls and medical chart reviews (53%) were conducted. A total of 65 newborns participated (62 mothers, 11 fathers). Parents reported that 50% had college studies, 78.7% lived together and 83.1% had government insurance. Pre-post tests demonstrated increase in knowledge (p < 0.05). Over 75% were contacted; 94% recalled learned strategies & 98% reported the infants had been well. Two infants were removed from home; no incidents of head trauma were reported. Almost half (44.5%) indicated taking care of the baby was difficult; managing the baby's crying was most difficult. All reported the program helped them. The program should be offered in other hospitals.