Trends in Medically Attended Injuries in Czech Adolescents

By Ng, Kwok; Sigmundová, Dagmar et al. | Central European Journal of Public Health, July 2017 | Go to article overview

Trends in Medically Attended Injuries in Czech Adolescents


Ng, Kwok, Sigmundová, Dagmar, Sigmund, Erik, Pavelka, Jan, Hamřík, Zdeněk, Molcho, Michal, Kalman, Michal, Central European Journal of Public Health


INTRODUCTION

Injury is a serious public health concern. The World Health Organization (WHO) estimates that the cause of death in 36% of young adolescents were injuries (1). Non-life threatening injuries may have short or long-term effects on health, which may also lead to disabilities. Reduced life expectancies and lower number of school days are commonly associated with injuries that require medical attention (2). National records solely on injuries have not been available in the European Commission Injury Database, making comparisons to other EU countries difficult. Recent reports in European countries have indicated that 41% of children report at least one medically attended injury in the past 12 months (3).

However, according to the national register, the number of hospitalisations as a result of injuries of children aged between 10-14 years old decreased from 5,761 in 2008 to 3,228 in 2012 (4, 5). These figures demonstrate the burden on national health systems with 32.7% of hospitalisations for injuries requiring operations (4).

From the main public health perspectives, effective strategies towards injuries are based on prevention (6). To prevent injuries, it is important to carry out surveillance of injuries before identifying risk factors. Only then can the development and evaluation of interventions take place before the implementation of public health injury prevention. Behavioural risk factors for injury include: alcohol consumption, fighting, sports participation, and other multiple risk behaviours (7-9). Czech adolescents have one of the highest rates of reporting one medically attended injury when compared to other European and North American countries (8), however, fewer adolescents report more than one injury in the past year, bringing the overall injury rates in the Czech Republic to below the median.

As proposed by Valent and colleagues (6), surveillance is important to see how injury prevention programmes are working. Therefore, the purpose of this study was to report the temporal trends of injuries of Czech adolescents between 2002 and 2014.

MATERIALS AND METHODS

Participants

In the spring of2002, 2006, 2010 and 2014, randomised selection of schools from all 14 regions of the Czech Republic was chosen to create a representative sample. The school response rates were 93.5%, 95.6%, 94.5% and 99.5% in the respective years. Using the international Health Behaviour in School-aged Children (HBSC) study protocol, only one class from one grade per school was selected randomly to fulfil the necessary quota for a national representative sample. Pupils in that selected class used up one class period, lasting 45 minutes, and completed the HBSC survey with teacher or trained researcher present (when teacher was absent). Pupils that were absent during that period did not complete the survey, therefore, the overall pupil response rates were 88.8%, 88.5%, 87% and 89.2% in the respective years. The final sample consisted of 20,038 adolescents (Table 1). The study was performed according to the ethical requirements formulated by the Convention on Human Rights and Biomedicine and under the principles of the Helsinki Declaration. The study in the Czech Republic was approved by the Ministry of Health and the National Institute of Public Health in each year of survey data collection.

Medically Attended Injuries

Measures of medically attended injuries included the question: "How many times during the past 12 months have you been injured so that you have been treated by a doctor or a nurse?" Responses included: I have not been injured over the last 12 months; once; twice; three times; four or more times. The responses were dichotomised between the following: have not been injured (none) and at least one medically attended injury (once, twice, three, four or more) for multiple binominal logistic regression analysis.

Statistical Analyses

Descriptive statistics were performed to identify an overview of incidences of injuries. …

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