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Work absenteeism following an injury creates an economic burden on society and the individual. Programs encouraging return to work (RTW) should be implemented for high risk populations. The aim of this study was to identify the predictors for duration until RTW following an injury. The Israeli National Trauma Registry and the National Insurance Institute database (2008–2013) were linked. Logistic-regression models tested the probability not RTW within 1 month, 1 year and 2 years among 67% of the population and the quality of the model was examined among 33% of the population. The study population comprised 45,291 casualties (aged 21–67 and employed prior to injury as salaried workers). The majority of the study population (61%) RTW within 1 month from the injury event. Injury severity, multiple injuries, brain injury, traffic related injuries and fall injuries were significantly associated with work absenteeism. A dose–response relationship was found between income and not RTW: the lower the income the greater was the chance of not RTW. Among casualties with occupational injuries the odds for not RTW within a month, a year and 2 years were respectively, 3.7, 2.4 and 2 times significantly greater in comparison with casualties not injured at work. Underprivileged ethnic groups (Arabs and immigrants from Ethiopia) had a greater chance for long out of work stay following an injury. The outcomes of this study identified casualties at high risk for not RTW and enables health professionals to develop intervention programs focusing on returning to a productive lifestyle. [ABSTRACT FROM AUTHOR]

Purpose: To examine whether hours of a day and days of a week influence injury pattern, means of evacuation, and hospital resource utilization. Methods: A study based on the Israeli National Trauma Registry of patients hospitalized due to injury between 2008 and 2015. Results: Of 293,077 subjects included; 32.8% were admitted on weekends (weekend-days 16.7% and weekend-nights 16.1%), 20.0% on weeknights and 47.2% on weekdays. Compared with weekday admissions, weekend and weeknight admissions had higher risk of hospitalization from violence and fall-related injuries, but lower risk from road traffic injuries (RTI) except for weekend-day admissions adjusted for age, gender, and ethnicity. Hospitalization due to burn injuries was greater on weekends, particularly on weekend-days. Hospitalization for violence and burn injuries was greater on weekend-nights vs weeknights, while injuries from other unintentional causes were greater on weeknights than weekend-nights. Furthermore, patients admitted on weekends and weeknights were more likely to have severe and critical injuries, greater utilization of intensive care unit and to be referred for rehabilitation, but were less likely to receive prehospital emergency medical service. In stratified analyses, RTI-related hospitalization was greater on weekends among youth and adults aged 15–64 years, males and Arabs, while burn injuries were more likely among weekend admissions for children aged 0–14 years, female and Jews. Conclusions: Injury pattern and resource utilization are related to time. Therefore, injury prevention and intervention efforts should account for hours of a day and days of a week, particularly in relation with age, gender, and ethnicity. [ABSTRACT FROM AUTHOR]

This article describes the characteristics of injuries of illegal immigrants admitted to a Level I trauma center after being shot at the southern border of Israel. This is a retrospective descriptive study. Some of the variables were compared to a group of soldiers who sustained penetrating injury at the same region where the illegal migrant were injured. The study includes 162 patients. The lower body absorbed a higher percentage of the injuries (61 %). The hospitalization time is longer for the migrant patients compared to the soldiers (13 ± 2 vs. 3 ± 0.3 days p = 0.0001). This study on wounded immigrants shows that a conjoint military and civilian system can result in favourable outcomes. The manuscript is an attempt to bring this unique situation, its type of injuries, and the difficulties of the health system in coping with it, to the notice of all authorities that may address a similar challenge. [ABSTRACT FROM AUTHOR]

In recent years Israel has become a destination for many migrants from Africa that illegally cross the Egyptian-Israeli border. The objective of this paper is to describe the epidemiological characteristics of injuries among illegal migrants in Israel. The study was carried out retrospectively using data from 19 trauma centers that participated in the Israel National Trauma Registry between 1 January 2006 and 31 December 2011. Illegal migrants from Africa were compared to the local population. Migrants were injured more often than the local population from intentional injuries (57.11 %). Migrants were also less likely than the local population (58.38 %) to sustain a minor injury (i.e., injury severity ≤8). The study also shows the hospitalization cost as a result of injuries among migrants from Africa. Preventive measures among illegal migrants from Africa should prioritize intentional injuries and industrial site injuries. [ABSTRACT FROM AUTHOR]

Purpose: Rib fractures are a marker of severe injury, predicting a higher incidence of associated injuries. The purpose of this study was to assess whether an increasing number of rib fractures predicts the severity of liver injury in blunt trauma patients. Methods: We performed a retrospective cohort study involving blunt trauma patients with concomitant liver injuries and rib fractures who were registered in a national trauma registry. Results: Of 57,130 patients with blunt torso injuries, 14,651 patients sustained rib fractures, and 2,899 patients suffered liver injuries. Concomitant liver injury occurred in 1,087 of the patients with rib fractures (7.4 %), while 1,812 patients sustained liver injury without rib fractures (4.3 %). The presence of six or more rib fractures predicted a higher incidence of liver injury. Among the patients with liver injury, those with concomitant rib fractures had a higher Injury Severity Score (ISS), but similar mortality rates. Among the patients with concomitant rib fractures and liver injury, there was no relationship between the number of fractured ribs and the severity of the liver injury. Conclusions: Although the presence of rib fractures was associated with an increased probability of liver injury in patients with blunt torso trauma, there is no relationship between the number of fractured ribs and the severity of liver injury. [ABSTRACT FROM AUTHOR]

Cultural variations between communities may impact injury rates, especially among children. We conducted a retrospective study of three communities in Israel using data from the Israel National Trauma Registry (1998-2007). Pediatric injury hospitalization rates in urban communities with varied levels of socio-economic status (low, medium, and high) were compared for all injuries and cause-specific injuries. Age-standardized and age-specific rates were calculated. Age-standardized injury hospitalization rates were lowest for the low socio-economic status (SES) community (299.7, 95% confidence interval [CI] 289.8-309.6) compared to the medium SES (658.2, 95% CI 629.1-687.3) and high SES (443.7, 95% CI 422.2-465.3) communities. Similar rates were observed for injuries from falls, transportation, accidental striking and intentional causes. For example, rate ratios for falls were 149.1 (95% CI 142.0-156.2), 340.8 (95% CI 319.5-362.1) and 245.7 (229.9-261.5) in the low, medium and high SES communities, respectively. Deviations from these overall trends were noted, however, for pedestrian injuries and burns that were relatively higher in the low SES community and injuries from motorized vehicles that were greater among children living in the high SES community. These results suggest that strong social capital is associated with reduced pediatric injury risks regardless of community wealth. However, targeted interventions for reducing injuries in at-risk populations that rely solely on injury rates may omit culturally distinct communities and overlook their uneven burden to the trauma care system. [ABSTRACT FROM AUTHOR]

Background: Previous analyses of the safety of the conservative versus the operative approach to the treatment of liver and spleen blunt injuries in children often failed to account for differences in quality of care and expertise among dedicated pediatric trauma center, non-pediatric centers, centers without trauma units, and non-trauma centers. To eliminate this potential bias, the present study examined changes in the rate of surgery and their impact on outcome within the same medical centers over time.Methods: The Israel Trauma Registry was searched for patients <18 years who were treated for non-penetrating liver or spleen injuries from 1998 to 2004. Patients were grouped by period, 1998-2000 and 2001-2004, and compared for type of injury, severity of injury, type of treatment, and inpatient mortality.Results: The earlier period (1998-2000) was characterized by a significantly higher rate of operations compared with the later period (2001-2004) (P = 0.001) and higher in-hospital mortality (P = 0.04). Injury severity scores, type of organs injured, and accompanying injuries were similarly distributed in the two groups.Conclusions: Despite the similarity in the severity and characteristics of the intraabdominal injuries in 1998-2000 and in 2001-2004, the proportion of children treated conservatively increased over time, concomitant with a significant drop in inpatient mortality. We attribute this shift over a relatively short interval to increased experience and greater acceptance of conservative management in this setting. [ABSTRACT FROM AUTHOR]