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Article ; Online: Major trauma in working-age adults in New Zealand.

Judge, Monica F / Kool, Bridget / Civil, Ian

2024 Volume 137, Issue 1590, Page(s) 22–32

Abstract: Aim: To describe the demographic and injury profile of major trauma among 20-65-year-old New Zealanders.: Methods: A retrospective analysis of routinely collected data from the New Zealand Major Trauma Registry for the period 1 July 2017 to 30 June ... ...

Abstract	Aim: To describe the demographic and injury profile of major trauma among 20-65-year-old New Zealanders. Methods: A retrospective analysis of routinely collected data from the New Zealand Major Trauma Registry for the period 1 July 2017 to 30 June 2020 was conducted. Sex, age and ethnicity-based rates were then calculated using census-based population estimates to compare the rates of injury across different demographic groups. Results: Of the 4,186 major trauma incidents among 20-65-year-olds in New Zealand during the 3-year period reviewed, 235 died (5.6%). Males accounted for 77% of those injured. Māori (New Zealand's Indigenous population) had significantly higher rates of major trauma (79.2 per 100,000; 95% confidence interval [CI] 74.4-84.3) compared to non-Māori (44.4 per 100,000; 95% CI 42.9-46.0). The most common cause of injury was transport-related incidents (63%; n=2,632/4,186), followed by falls (19%; n=788/4,186). Conclusions: Demographic characteristics have a significant relationship with major trauma injuries among 20-65-year-old New Zealanders. Continued injury prevention efforts focussing on males, Māori and transport incidents are required. Interventions that improve the safety of roads, such as lane separators, speed limits and raised intersections, should be implemented in high-crash-risk areas to reduce risk.
MeSH term(s)	Adult ; Aged ; Humans ; Male ; Middle Aged ; Young Adult ; Australasian People ; Maori People ; New Zealand/epidemiology ; Retrospective Studies ; Female ; Wounds and Injuries/epidemiology
Language	English
Publishing date	2024-02-23
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	390590-1
ISSN	1175-8716 ; 0028-8446 ; 0110-7704
ISSN (online)	1175-8716
ISSN	0028-8446 ; 0110-7704
DOI	10.26635/6965.6212
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Article ; Online: Association of ethnicity with unintentional injury-related hospitalisation and mortality among older people residing in two regions of Aotearoa New Zealand.

Dwight, Emily / Cavadino, Alana / Kool, Bridget / Kerse, Ngaire / Hikaka, Joanna

Australasian journal on ageing

2024

Abstract: Objectives: To characterise unintentional injury-related hospitalisation and mortality amongst older adults (aged 50+ years) in the Lakes and Bay of Plenty District Health Boards of Aotearoa New Zealand and to examine whether hospitalisation patterns ... ...

Abstract	Objectives: To characterise unintentional injury-related hospitalisation and mortality amongst older adults (aged 50+ years) in the Lakes and Bay of Plenty District Health Boards of Aotearoa New Zealand and to examine whether hospitalisation patterns differed by ethnicity. Methods: This observational study analysed unintentional injury-related hospitalisations and deaths among older adults between 2014 and 2018. Routinely collected national data sets were used to calculate annualised, age-standardised injury rates. The independent variable of interest was ethnicity (Māori or non-Māori). Results: There were 11,834 unintentional injury-related hospitalisations in the study period (n = 1444 for Māori). Overall, there was no significant difference in the age-standardised hospitalisation rate between Māori and non-Māori (Standardised Rate Ratio [SRR] = 0.96 [95% CI 0.90, 1.02]). Falls were the most common mechanism of injury among Māori and non-Māori overall (50% and 71%) and relative risks of falls increased with age. Non-Māori were 57% less likely to be hospitalised for unintentional poisoning than Māori (SRR = 0.43, [0.34, 0.59]). Conclusions: The mechanisms of injury, and variation in unintentional injury-related hospitalisation rates between Māori and non-Māori, change throughout older age, and incidence increase0073 with age. Falls cause significant injury-related hospitalisations for older Māori and responsive injury prevention and rehabilitation efforts are warranted to achieve equitable health outcomes.
Language	English
Publishing date	2024-01-24
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1457406-8
ISSN	1741-6612 ; 0726-4240 ; 1440-6381
ISSN (online)	1741-6612
ISSN	0726-4240 ; 1440-6381
DOI	10.1111/ajag.13279
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Article ; Online: Comparison of injury severity scores derived from ICD-10-AM codes with trauma registry derived scores: A study from New Zealand.

Montoya, Luisa / Davie, Gabrielle / Lilley, Rebbecca / Dicker, Bridget / Kool, Bridget

Injury

2024 Volume 55, Issue 5, Page(s) 111511

Abstract: Introduction: Various attempts at automation have been made to reduce the administrative burden of manually assigning Abbreviated Injury Severity (AIS) codes to derive Injury Severity Scores (ISS) in trauma registry data. The accuracy of the resulting ... ...

Abstract	Introduction: Various attempts at automation have been made to reduce the administrative burden of manually assigning Abbreviated Injury Severity (AIS) codes to derive Injury Severity Scores (ISS) in trauma registry data. The accuracy of the resulting measures remains unclear, especially in the New Zealand (NZ) context. The aim of this study was to compare ISS derived from hospital discharge International Classification of Diseases Australian Modification (ICD-10-AM) codes with ISS recorded in the NZ Trauma Registry (NZTR). Methods: Individuals admitted to hospital and enrolled in the NZTR between 1 December 2016 and 30 November 2018 were included. ISS were calculated using a modified ICD to AIS mapping tool. The agreement between both methods for raw scores was assessed by the Intraclass Correlation Coefficient (ICC), and for categorical scores the Kappa and weighted Kappa index were used. Analysis was conducted by gender, age, ethnicity, and mechanism of injury. Results: 3,156 patients fulfilled the inclusion criteria. The ICC for agreement between the methods was poor (0.40, 95 % CI: 0.37-0.43). The Kappa index indicated slight agreement between both methods when using a cut-off value of 12 (0.06; 95 % CI: 0.01-0.12) and 15 (0.13 6; 95 % CI: 0.09-0.17). Conclusion: Although the overall agreement between NZTR-ISS and ICD-ISS was slight, ICD-derived scores may be useful to describe injury patterns and for body region-specific estimations when manually coded ISS are not available.
MeSH term(s)	Humans ; Injury Severity Score ; International Classification of Diseases ; New Zealand ; Australia ; Registries ; Wounds and Injuries ; Abbreviated Injury Scale
Language	English
Publishing date	2024-03-19
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2024.111511
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Article ; Online: Comparing primary caregivers' reported injury data with routinely recorded injury data to assess predictors of childhood injury.

Ghebreab, Luam / Kool, Bridget / Lee, Arier / Morton, Susan

BMC medical research methodology

2023 Volume 23, Issue 1, Page(s) 91

Abstract: Background: Linking self-reported data collected from longitudinal studies with administrative health records is timely and cost-effective, provides the opportunity to augment information contained in each and can offset some of the limitations of both ... ...

Abstract	Background: Linking self-reported data collected from longitudinal studies with administrative health records is timely and cost-effective, provides the opportunity to augment information contained in each and can offset some of the limitations of both data sources. The aim of this study was to compare maternal-reported child injury data with administrative injury records and assess the level of agreement. Methods: A deterministic linkage was undertaken to link injury-related data from the Growing up in New Zealand (GUiNZ) study to routinely collected injury records from New Zealand's Accident Compensation Corporation (ACC) for preschool children. The analyses compared: (i) the characteristics of mothers with linked data vs. those without, (ii) injury incidences from maternal recall with those recorded in ACC injury claims, and (iii) the demographic characteristics of concordant and discordant injury reports, including the validity and reliability of injury records from both data sources. Results: Of all mothers who responded to the injury questions in the GUiNZ study (n = 5836), more than 95% (n = 5637) agreed to have their child's record linked to routine administrative health records. The overall discordance in injury reports showed an increasing trend as children grew older (9% at 9 M to 29% at 54 M). The mothers of children with discordance between maternal injury reports and ACC records were more likely to be younger, of Pacific ethnicity, with lower educational attainment, and live in areas of high deprivation (p < 0.001). The level of agreement between maternal injury recall and ACC injury record decreased (κ = 0.83 to κ = 0.42) as the cohort moved through their preschool years. Conclusions: In general, the findings of this study identified that there was underreporting and discordance of the maternal injury recall, which varied by the demographic characteristics of mothers and their child's age. Therefore, linking the routinely gathered injury data with maternal self-report child injury data has the potential to augment longitudinal birth cohort study data to investigate risk or protective factors associated with childhood injury.
MeSH term(s)	Female ; Humans ; Child, Preschool ; Cohort Studies ; Reproducibility of Results ; Caregivers ; Mothers ; Longitudinal Studies
Language	English
Publishing date	2023-04-11
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041362-2
ISSN	1471-2288 ; 1471-2288
ISSN (online)	1471-2288
ISSN	1471-2288
DOI	10.1186/s12874-023-01900-0
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Article ; Online: Antenatal and early childhood exposures associated with non-fatal infant injury: evidence from a longitudinal birth cohort in New Zealand.

Ghebreab, Luam / Kool, Bridget / Lee, Arier / Morton, Susan

Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention

2023 Volume 29, Issue 6, Page(s) 532–536

Abstract: Objective: To identify antenatal and early childhood exposures of unintentional injury among infants in New Zealand (NZ).: Method: The theoretical life-course framework of child injury prevention domains was utilised to analyse data from a ... ...

Abstract	Objective: To identify antenatal and early childhood exposures of unintentional injury among infants in New Zealand (NZ). Method: The theoretical life-course framework of child injury prevention domains was utilised to analyse data from a prospective longitudinal NZ birth cohort (Growing Up in NZ). Risk and protective factors for injury were identified using Robust Poisson regression models. Result: Among children included for the analysis(n=6304), 52% were male, 55% were born to European mothers, and 37% lived in a household with high levels of deprivation. Mothers reported that 6% of infants (n=406) had sustained at least one injury by 9 months. Multivariate analysis showed injury risk among single mothers with antenatal depression were more than twice that (IRR=2.20) of children of mothers with partners and without depression. Conclusion: Understanding antenatal risk and protective factors for infant injury will assist in implementing injury prevention programmes or modifying the existing policies that affect these vulnerable age groups.
MeSH term(s)	Child ; Infant ; Humans ; Male ; Child, Preschool ; Female ; Pregnancy ; New Zealand/epidemiology ; Birth Cohort ; Prospective Studies ; Mothers ; Family Characteristics
Language	English
Publishing date	2023-11-27
Publishing country	England
Document type	Journal Article
ZDB-ID	1433667-4
ISSN	1475-5785 ; 1353-8047
ISSN (online)	1475-5785
ISSN	1353-8047
DOI	10.1136/ip-2023-044845
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Article ; Online: Ethnic variation in hospitalisation due to treatment injury and complications of healthcare in older adults residing in New Zealand.

Svensen, Georgina / Hikaka, Joanna / Cavadino, Alana / Kool, Bridget

The New Zealand medical journal

2023 Volume 136, Issue 1579, Page(s) 70–85

Abstract: Aim: To describe the incidence, characteristics, and ethnic variation of hospitalisations for treatment injury and complications of medical or surgical care in older adults in two regions of Aotearoa New Zealand.: Methods: This observational study ... ...

Abstract	Aim: To describe the incidence, characteristics, and ethnic variation of hospitalisations for treatment injury and complications of medical or surgical care in older adults in two regions of Aotearoa New Zealand. Methods: This observational study analysed treatment-related hospital admissions (<24 hours; index injury from primary or secondary care) among older adults (<50 years) between 2014-2018 in Lakes and Bay of Plenty District Health Boards. Among all admissions due to a treatment injury (n=296) or a complication of healthcare (n=13,850), age-standardised incidence rates per 100,000 were determined by ethnicity and age group. Results: The rates of admissions for treatment injuries were 30% lower among non-Māori than among Māori (New Zealand's Indigenous population). Complications of healthcare admissions rates were 43% lower among non-Māori than in Māori. Medications were the most common cause (54%) of healthcare complications. Rates of treatment injury and healthcare complications increased with age for both Māori and non-Māori, until the age of 80 years. Conclusion: Ethnic variation in treatment injuries and complications of healthcare between Māori and non-Māori provide further evidence of the existence of inequities in access to quality healthcare in New Zealand. Transparent, publicly available national monitoring of treatment injuries and complications, disaggregated by age and ethnicity, is recommended.
MeSH term(s)	Humans ; Aged ; Aged, 80 and over ; New Zealand/epidemiology ; Ethnicity ; Population Groups ; Delivery of Health Care ; Hospitalization
Language	English
Publishing date	2023-07-21
Publishing country	New Zealand
Document type	Observational Study ; Journal Article
ZDB-ID	390590-1
ISSN	1175-8716 ; 0028-8446 ; 0110-7704
ISSN (online)	1175-8716
ISSN	0028-8446 ; 0110-7704
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Article ; Online: Fetal malposition in labour and health outcomes for women and their newborn infants: A retrospective cohort study.

Barrowclough, Jennifer / Kool, Bridget / Crowther, Caroline

PloS one

2022 Volume 17, Issue 10, Page(s) e0276406

Abstract: Introduction: Occiput-posterior (OP) or occiput-transverse (OT) fetal malposition has a prevalence of 33-58% in the first-stage of labour with 12-22% persisting until delivery. Malposition is associated with significant maternal and neonatal morbidity. ... ...

Abstract	Introduction: Occiput-posterior (OP) or occiput-transverse (OT) fetal malposition has a prevalence of 33-58% in the first-stage of labour with 12-22% persisting until delivery. Malposition is associated with significant maternal and neonatal morbidity. Most previous studies report the incidence and adverse maternal and fetal outcomes of persistent fetal malposition in the second stage of labour and do not include outcomes that may be present in the first stage of labour. Aims: To assess the incidence and health outcomes for women and their newborn infants of a fetal malposition in the first or second stage of labour. Materials and methods: A retrospective cohort study of 738 maternity records (randomly selected) from a tertiary hospital in New Zealand. Maternal and neonatal characteristics are described. Outcomes for women with a fetus in an OP or OT position in labour are compared to those for women with a fetus in an occiput-anterior position (OA). Results: 499 (68%) women had an OP/OT positioned fetus and 239 (32%) had an OA positioned fetus on vaginal examination in labour. Women had similar characteristics except a body mass index ≥30 kg/m2 was more common in the OP/OT group. Fetal malposition appears to be more likely in women with a right-sided fetal occiput. Three quarters of OP/OT fetuses rotated anteriorly by birth. Fetal malposition compared to no malposition was associated with oxytocin augmentation, epidural use, a longer first stage of labour, fewer normal vaginal births, and more caesarean sections. Fetal malposition during labour was not associated with adverse neonatal outcomes. Conclusion: Interventions such as maternal posture in the first and second stage of labour could potentially reduce the incidence of malposition and improve health outcomes for mothers.
MeSH term(s)	Infant, Newborn ; Female ; Pregnancy ; Humans ; Male ; Oxytocin ; Retrospective Studies ; Labor Presentation ; Cesarean Section ; Outcome Assessment, Health Care
Chemical Substances	Oxytocin (50-56-6)
Language	English
Publishing date	2022-10-19
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0276406
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Article ; Online: Midwives' views on the acceptability of a future trial of the Sims posture for fetal malposition in labor in the context of their knowledge and practice: A mixed-methods study.

Barrowclough, Jennifer / Crowther, Caroline / Kool, Bridget

European journal of midwifery

2022 Volume 6, Page(s) 50

Abstract: Introduction: Evidence of safe and effective maternal interventions to improve fetal malposition in labor is inconclusive. A contemporary, randomized controlled trial of maternal posture would expand this evidence, however, collaboration with midwives ... ...

Abstract	Introduction: Evidence of safe and effective maternal interventions to improve fetal malposition in labor is inconclusive. A contemporary, randomized controlled trial of maternal posture would expand this evidence, however, collaboration with midwives will be critical. The aim of this study is to assess midwives' views on the acceptability of a trial of the Sims posture for fetal malposition in labor and identify current midwifery knowledge and practice surrounding fetal malposition. Methods: A mixed-methods study incorporating a web-based survey and guided focus groups with midwives was conducted in New Zealand during 2020. Midwives serving Auckland Hospital and Māori and Pasifika midwives serving South Auckland (n=136) were invited to participate in the study. Data were descriptively analyzed using chi-squared and cross-tabulation. Collaboration with a trial was contextualized by thematic content from survey and focus-group data. Results: Fifty (36%) midwives from primary and secondary/tertiary settings responded to the survey, and 19 participated in four focus groups. Most midwives thought maternal posture affects malposition, utilize changes of posture often with the peanut ball, would recommend a posture if cesareans were reduced by 20%, and would definitely or probably collaborate with a labor trial of posture. Fetal monitoring with women in the Sims posture was difficult for nearly one-fifth of midwives. Seven themes emerged regarding trial participation: trial design, relevance, practice, diagnosis, knowledge and skills, and trial compliance. Conclusions: Current practice concerning malposition utilizes flexibility of posture. Provision of some free movement and reassurance surrounding trial equipoise may enhance trial collaboration.
Language	English
Publishing date	2022-08-01
Publishing country	Greece
Document type	Journal Article
ISSN	2585-2906
ISSN (online)	2585-2906
DOI	10.18332/ejm/150377
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Article ; Online: Pregnant women's views on the acceptability, enablers, and barriers of participation in a randomized controlled trial of maternal posture for fetal malposition in labor.

Barrowclough, Jennifer / Kool, Bridget / Crowther, Caroline A

European journal of midwifery

2022 Volume 6, Page(s) 4

Abstract: Introduction: Fetal malposition in labor results in adverse maternal and infant health. Whilst evidence for effective interventions is inconclusive, based on the hypothesis that gravity corrects malposition, the feasibility and design of a randomized ... ...

Abstract	Introduction: Fetal malposition in labor results in adverse maternal and infant health. Whilst evidence for effective interventions is inconclusive, based on the hypothesis that gravity corrects malposition, the feasibility and design of a randomized controlled trial (RCT) to improve maternal and infant health outcomes should be considered. The aim was to assess pregnant women's views on the acceptability, enablers, and barriers of participation in an RCT of maternal posture for fetal malposition in labor. Methods: A web-based anonymous survey of pregnant women was conducted in Auckland during 2020. Quantitative data were summarized descriptively using a chi-squared test to assess differences in proportions. Maternal characteristics influence on women's responses was assessed using cross-tabulation. A thematic content analysis of free text responses was undertaken. Results: Most of the 206 respondents were aged 26-35 years (75%), 29-38 weeks pregnant (71%), of European (40%) or Asian (36%) ethnicity, and similarly nulliparous or multiparous. Most women (76%) knew of fetal malposition in labor; however, only 28% were aware of maternal posture to correct this. Most women (86%) were interested in labor research and although 37% would participate in an RCT, almost half (47%) were unsure and a 15% would not participate. Concerns mostly related to comfort (22%). Nearly half of women (49%) would need to consult their partner regarding participation in an RCT. Conclusions: Enablers for participation in a posture trial in labor include measures to enhance maternal comfort, increasing awareness of malposition and the role of posture, and involving partners in pre-trial counselling and recruitment.
Language	English
Publishing date	2022-01-28
Publishing country	Greece
Document type	Journal Article
ISSN	2585-2906
ISSN (online)	2585-2906
DOI	10.18332/ejm/144057
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Article ; Online: Epidemiology of major trauma in New Zealand: a systematic review.

Montoya, Luisa / Kool, Bridget / Dicker, Bridget / Davie, Gabrielle

The New Zealand medical journal

2022 Volume 135, Issue 1550, Page(s) 86–110

Abstract: Aim: To describe the incidence and characteristics of major trauma in New Zealand.: Methods: A systematic review based on a MEDLINE search strategy was performed using the databases PubMed, EMBASE, CINAHL and Scopus. Search terms included: "Wounds ... ...

Abstract	Aim: To describe the incidence and characteristics of major trauma in New Zealand. Methods: A systematic review based on a MEDLINE search strategy was performed using the databases PubMed, EMBASE, CINAHL and Scopus. Search terms included: "Wounds and Injuries," "Fatal Injuries," "Injury Severity Score," "Major Trauma," "Severe Trauma," "Injury Scale," "Epidemiology," "Incidence," "Prevalence" and "Mortality." Studies published in English up to September 2021 reporting the incidence of major trauma in New Zealand were included. The quality of studies was assessed using the GATE LITETM tool. Results: Thirty-nine studies fulfilled the inclusion criteria. The majority of studies were descriptive observational studies (n=37). The incidence of fatal trauma was highest among those injured from motor vehicle crashes (MVCs) or falls, Māori males and those sustaining head injuries. The incidence of non-fatal major trauma was highest among young Māori males. MVCs and falls were the most common mechanism of injury among trauma patients across all age groups. Length of hospital stay was greatest in patients with the highest Injury Severity Scores. Conclusions: The incidence of major trauma varies by age, sex and ethnicity. This review highlights the need for further analytical studies that can explore factors that may impact survival from major trauma.
MeSH term(s)	Accidents, Traffic ; Craniocerebral Trauma/epidemiology ; Humans ; Incidence ; Injury Severity Score ; Male ; New Zealand/epidemiology ; Wounds and Injuries/epidemiology
Language	English
Publishing date	2022-02-25
Publishing country	New Zealand
Document type	Journal Article ; Systematic Review
ZDB-ID	390590-1
ISSN	1175-8716 ; 0028-8446 ; 0110-7704
ISSN (online)	1175-8716
ISSN	0028-8446 ; 0110-7704
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