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Purpose: To compare mortality among severe and critically injured patients who were directly admitted (DA) to level I trauma center (TCI) or level II trauma center (TCII) with those who were transferred to a TCI after being initially admitted to a TCII. Methods: A cohort study of severe and critically injured patients (Injury Severity Score 16–75) hospitalized between 2010 and 2019 using data from the National Program for Trauma Registration. Multivariate logistic regression models estimated mortality risk, including stratified analyses. Results: Of the 27,131 hospitalizations, 9.5% were transfers, 60.1% were DA to TCI and 30.4% were DA to TCII. Children ages ≤ 17 years, Non-Jews (minority), critical injuries (ISS 25–75), head injuries (AIS ≥ 3) and fall injuries were significantly more frequent among transfers, compared with the DA groups. Evacuation by emergency medical services was less frequent among transfers. After accounting for possible confounders, transfers had a greater risk of in-hospital mortality [DA to TCI vs transfer, OR (95% CI) 0.61 (0.52–0.72); DA to TCII vs transfer, OR (95% CI) 0.78 (0.65–0.94)]. In stratified analyses, these mortality differences persisted among the sub-group of patients who sustained critical injuries, among the patients with non-penetrating injuries, among the elderly ages ≥ 65 year and during the first 2 weeks of hospitalization. Conclusion: This study has intervention implications that should be directed primarily at prehospital triage and the inter-hospital transfer processes. In addition, there may be a need to optimize the capabilities of regional trauma systems along with continuous performance evaluations and actions as required. [ABSTRACT FROM AUTHOR]

Objectives: To explore the influence of income on Low Birth Weight (LBW), taking into account other socio-economic measurements. Methods: This retrospective cohort study is based on the Israel National Insurance Institute (NII) database. The study population included 58,454 women who gave birth between 2008 and 2013 to 85,605 infants. Only singleton births at term (gestational age in weeks = 37 and later) were included. Logistic regression models with a Generalized Estimating Equation approach were used in order to assess the independent effect of income and Socio-Economic Regional Index (SERI), maternal age, family status, population group and occupational status on LBW. In addition, sibling analysis was conducted to assess the influence of a change in income on birth weight (BW) among 21,998 women. Results: Lower income was associated with higher odds of LBW (odds ratio (OR) = 1.266; 95% CI:1.115–1.437. Immigrants from Ethiopia, Bedouins from the Negev, the youngest, the oldest, and single mothers had higher odds for LBW newborns. Compared to women whose income quartile had not changed between the most recent and the first births, for women who experienced a deterioration of three and two quartiles in family income, significantly lower birth weight was observed at the time point with lower income: 103 g (p =.049) and 71 g (p =.008), respectively. Improvement in income revealed an almost linear increase in birth weight. Conclusions for Practice: In an effort to prevent LBW associated mortality and diseases, interventions should be focused first of all on women from population groups who are disadvantaged. [ABSTRACT FROM AUTHOR]

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]

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]