Age-related trends in unintentional injuries among children and adolescents in an urban Danish population 1980-2021. A cohort study of 292,737 children and adolescents.

OBJECTIVE: This study describes the age-related trends in unintentional injuries in children and adolescents in an urban population 1980-2021. A retrospective study of all children and adolescents aged 0-17 years treated for unintentional injuries at Odense University Hospital, Denmark 1980-2021. METHODS: Information about age, gender, place of injury, and diagnoses from the emergency department register. We estimated gender specific annual incidence rates (IRs) in different age groups (0-4, 5-9, 10-14, and 15-17 years) per 1000 population/years. The severity was classified by mild or severe injuries. RESULTS: Overall, 292,737 unintentionally injured children and adolescents were included. The median age was 10 years and 57.4 % were boys. The overall IR was 241 (CI: 240-242) for boys and 188 (CI: 187-188) for girls per 1000 population/years. In the study period, the overall incidence decreased by 44 % in boys and by 38 % in girls. The overall IR for severe injuries did not change in the study period, whereas the IR of mild injuries decreased significantly in all age groups in both gender. The upper limbs were the most frequently injured in all age groups for both gender, except for children aged 0-4 years, where lesions mostly occurred in the head or neck. In the youngest age groups 0-4 years and 5-9 years wounds were the most common type of lesion, while bruises were the most common type of lesion in the oldest age groups. Fractures accounted for 14.5 % of the lesions with the highest proportions in the 5-9 years and 10-14 years age group. CONCLUSION: The study provides information, which is useful when coordinating the resources at emergency departments and for planning preventive campaigns targeting different age groups.

The completeness of routine registration of the counterpart in deliberate interpersonal violence in an urban emergency department.

Most studies of violence from the health care system lack reliable information about the counterpart, which is important for distinguishing between different types of violence. Since 2014, the emergency department at Odense University Hospital in Denmark has routinely registered information about the counterpart. The purpose of this study was to evaluate the completeness of registering information about the counterpart during routine registration of victims of interpersonal violence in the emergency department. We included 11,200 victims treated at the emergency department 2014-2021. Using the patient registration data, we estimated the proportion of missing information on the counterpart, stratified by age group and gender of the victim as well as type of incident and severity of injury. Information about the counterpart was registered in 91.5 % of all cases. In 43.1 % (CI: 42.2-44.0) of the cases, the counterpart was unknown to the victim, in 24.3 % (CI: 23.5-25.1) the counterpart was an acquaintance, in 10.5 % (CI: 10.0-11.1) the counterpart was a partner, and in 4.2 % (CI: 3.8-4.5) the counterpart was another family member. The proportion of cases with no information about the counterpart varied with gender, age group, time of violence, place of violence, weapon use, and severity of injury. Half of the victims injured with firearms (46.2 %, CI: 30.1-62.8) and one-fourth of the victims injured with knives (25.9 %, CI: 21.9-30.2) did not reveal information about the counterpart. The majority of the victims revealed information about the counterpart, making it possible to analyse different types of violence separately.

Significantly reduced rates of interpersonal violence in an urban Danish population 2003-2021.

This study aimed to describe changes in annual incidence rates and the severity of deliberate interpersonal violence based on hospital and forensic data in a Danish urban population 2003-2021. Included in the study were local victims of violence admitted to Odense University Hospital and/or subjected to medico-legal autopsy at the Institute of Forensic Medicine, University of Southern Denmark from 2003 to 2021. Based on population counts, we estimated overall and gender specific annual incidence rates in different age groups. For the 14,788 victims included in the study, the gender-specific incidence rates were 5.7 for males and 2.4 for females per 1000 population/year. The incidence rates decreased almost fourfold for both genders in all age groups. In both gender, the incidence rate of violence involving mild injuries decreased significantly, whereas incidence rate of violence involving severe injuries remained unchanged over the study period. The proportion of superficial lesions decreased and the proportion of wounds, bone fractures, and deep lesions increased. The proportion of victims with injuries from knifes increased from 3.0 to 5.4% in the study period. Overall, 0.3% died from their injuries. The present study showed a significant decreased in the incidence rate of violence based on hospital and forensic data. The decrease involved solely victims with less severe injuries. We recommend studies combining hospital, forensic, and police data.

The incidence of physeal fractures in the lower limb and the frequency of premature physeal closure: a cohort study of 236 patients.

BACKGROUND AND PURPOSE: Physeal fractures represent 15-20% of all pediatric fractures and may lead to premature physeal closure (PPC). The aim of our study was to determine the incidence rates of physeal fractures in the lower limb and the proportion of PPC that lead to limb length discrepancy (LLD), and/or angular deformity (AD). PATIENTS AND METHODS: This retrospective study included 236 consecutive children with physeal fracture in the tibia, distal femur, or distal fibula. We estimated incidence rates and reviewed medical records and radiographs to obtain information regarding the development of PPC leading to LLD and AD. Of the 236 children, 100 had planned growth control or were referred for growth control due to symptoms of PPC. RESULTS: The total incidence rate was 35 (95% CI 30-39) per 100,000 person-years, with 1.2 (CI 0.5-23) for distal femur, 5.7 (CI 3.1-7.8) for proximal tibia, 14 (CI 11-17) for distal tibia, and 14 (CI 11-17) for distal fibula. The overall prevalence of PPC was 9.7% (CI 6.3-14), while the prevalence was 38% (CI 8.5-76) for distal femur, 15% (CI 5.9-31) for proximal tibia, 14% (CI 7.4--22) for distal tibia, and 1.1% (CI 0.3--59) for distal fibula. We found a significant higher hazard of PPC in fractures with ≥ 3 mm displacement (hazard ratio: 12, CI 1.5-97). CONCLUSION: 10% of children with physeal fractures developed PPC that led to LLD or AD. The highest hazard ratio was in children who had an initial fracture displacement. This study highlights the importance of routine and uniform growth evaluation after a physeal fracture.

Fractures in the lower leg in children.

Fractures in the lower leg are common in children and are most often due to accidental falls. A significant part of the fractures involves the growth plates. This review describes a broad range of techniques for treatment ranging from immobilization in a cast to open reduction and fixation with K-wires, screws, or flexible intramedullary nails. Premature growth arrest is relatively common following the physeal fractures in proximal or distal tibia. We recommend early consultation with a tertiary care centre for guidance and planning of the best treatment.

Surgical procedures in infants with early diagnoses of developmental dysplasia of the hip. A prospective 4-year follow-up study.

Background: Dysplastic hips infants may normalize spontaneously without any intervention due to the natural growth. However, some infants need one or more surgical interventions to achieve stable and non-dysplastic hips. The purpose of this study is to determine the proportion of infants diagnosed with DDH before the age of 6 months undergoing surgical procedures of the hip(s) before the age of four years and to determine the number and types of surgical procedures in each infant. Methods: A prospective and consecutive study of all infants aged 0-6 months diagnosed with dysplasia of the hips in the combined paediatric orthopaedic and radiologic examination in the Region of Southern Denmark 2013-2017. From medical records, we obtained information about all surgical procedures in the hips including open or closed reductions, arthrographies, tenotomies, and pelvic osteotomies before the age of 4 years. Results: Overall, 281 infants with hip dysplasia were included. The median age at first examination was 48 days. In 254 (90%) of the infants, the hips resolved spontaneously, and 27 (10%) needed one or more surgical interventions. Overall, the 27 infants had 47 surgical intervention as 12 infants had more than one intervention. One infants had five surgical interventions. The most frequent surgical procedures were closed reduction and arthrography with or without adductor tenotomy (58%) and pelvic osteotomy (27%). Among infants with surgical interventions, 23 (8.2%) had unstable hips, and four (1.4%) had stable hips. All four infants with stable hips had an arthrography and none required a pelvic osteotomy. Discussion: This study supports the propensity for spontaneous normalization early dysplasia of the hips in infants. Only a small proportion of the infants needed surgical interventions to achieve stable and non-dysplastic hips.

Developmental dysplasia of the hip in infants referred for a combined pediatric orthopedic and radiologic examination. A prospective cohort study.

INTRODUCTION:  The study aimed to determine the proportions of infants with developmental dysplasia of the hip (DDH) and hip dislocation in infants referred for combined pediatric orthopedic and radiologic assessment, and to describe the association between DDH and different reasons of referral. METHODS:  A prospective study of all infants aged 0-6 months referred for a combined examination of the hips 2013-2019. The proportion of DDH and unstable hip(s) stratified by different reasons of referral were calculated. Acetabular index > 30° in radiography or Graf Type 2b or worse in ultrasonography was considered diagnostic of DDH. RESULTS:  Of the 1,989 infants included, 17% had stable dysplastic hip(s), and 4.7% had unstable dysplastic hip(s). The proportions of infants with DDH among infants with a single reason of referral were 36% for breech position, 25% for familial disposition, 14% for hip click, 8% for asymmetry, and 3% for twins. The proportions of infants with unstable hip(s) were 14% for familial disposition, 12% for breech position, 3% for hip click, 3% for twins, and 1% for asymmetry. CONCLUSION:  The study demonstrates that a considerable proportion of infants referred for the combined examination have radiological signs of DDH and that DDH were regularly diagnosed in infants referred due to hip click or asymmetry.

A population-based study of seasonal variation in children's fractures.

INTRODUCTION Few Scandinavian studies have studied seasonal variations in paediatric fractures, and the studies that have focused on individual fracture sites. Furthermore, their findings do not coincide as they have described peaks in different seasons. Therefore, we described seasonal variation in the incidence rate (IR) of all paediatric fractures in the 1996-2019 period within a Danish population. METHODS We extracted data from the existing emergency room register at Odense University Hospital and included all fractures sustained by children aged 0-14 years and living in Odense Municipality. Seasonal and monthly IR were calculated using population counts stratified by age, gender and fracture site. RESULTS We recorded a significant increase in IR in spring and summer, except for a drop in July. For boys, the IR ranged from 206 in December to 404 per 10,000 person-years in June. For girls, the incidence ranged from 156 in December to 317 in May. Fractures were more frequent in the upper extremities and were up to six-fold more frequent in the epiphysis and metaphysis than in the shafts. All fracture sites showed a peak in spring and summer, suggesting that all fracture sites are subject to seasonal variation, especially the ones near the epiphysis. CONCLUSIONS The fracture peak observed in spring and summer corresponds to an increase in physical activity. The low incidence registered in July corresponds to a low level of sport activities during the summer vacations and families going on vacation in the countryside or travelling abroad. This study gives useful information for coordinating the right resources at hospitals. FUNDING none TRIAL REGISTRATION not relevant.

Characteristics of severely injured children admitted to a Danish trauma centre.

INTRODUCTION: The epidemiology of children admitted to Scandinavian trauma centres remains largely unknown. This study aimed to describe the characteristics of severe injuries in children admitted to a Danish university-level trauma centre. METHODS: A descriptive study of all severely injured (Injury Severity Score ≥ 16) children aged 0-15 years who were admitted to the university level trauma centre at Odense University Hospital, Denmark, in the 2002-2018 period. Data were extracted from the South Danish Register and from medical records. RESULTS: A total of 152 children were included. The median age was 11 (range: 0-15) years. Boys accounted for 57% of the cases. Accidents accounted for 99% of the cases. In the youngest age group (0-4 years), the majority of injuries occurred in domestic areas, in the daytime, in the summer and around the weekends. In the oldest age group (11-15 years), most injuries occurred in traffic areas, in the autumn, on weekdays and in the afternoon. In all age groups, the majority of lesions were sustained to the head/face/neck, limbs and thorax. The overall median number of days in hospital was six. Overall, 39 (26%) children died. Almost half of the injuries were traffic related and this proportion increased with increasing age group. One-third of the traffic injured children died. CONCLUSIONS: Based on a regional trauma register, we described the characteristics of severely injured children. The study included several aspects regarding injury pattern and severity, which may be useful for risk identification, prevention of accidents and for hospital resource planning. FUNDING: none TRIAL REGISTRATION: not relevant.

Pain, osteolysis, and periosteal reaction are associated with the STRYDE limb lengthening nail: a nationwide cross-sectional study.

Background and purpose - Observing serious adverse events during treatment with the Precice Stryde bone lengthening nail (NuVasive, San Diego, CA, USA), we conducted a nationwide cross-sectional study to report the prevalence of adverse events from all 30 bone segments in 27 patients treated in Denmark.Patients and methods - Radiographs of all bone segments were evaluated regarding radiographic changes in February 2021. We determined the number of bone segments with late onset of pain and/or radiographically confirmed osteolysis, periosteal reaction, or cortical hypertrophy in the junctional area of the nail.Results - In 30 bone segments of 27 patients we observed radiographic changes in 21/30 segments of 20/27 patients, i.e., 19/30 osteolysis, 12/30 periosteal reaction (most often multi-layered), and 12/30 cortical hypertrophy in the area of the junction between the telescoping nail parts. Late onset of pain was a prominent feature in 8 patients. This is likely to be a prodrome to the bony changes. Discoloration (potential corrosion) at the nail interface was observed in multiple removed nails. 15/30 nails were still at risk of developing complications, i.e., were not yet removed.Interpretation - All Stryde nails should be monitored at regular intervals until removal. Onset of pain at late stages of limb lengthening, i.e., consolidation of the regenerate, should warrant immediate radiographic examination regarding osteolysis, periosteal reaction, and cortical hypertrophy, which may be associated with discoloration (potential corrosion) of the nail. We recommend removal of Stryde implants as early as possible after consolidation of the regenerate.

Changes in the pattern of paediatric bicycle injuries in relation to helmet use 1980-2014.

INTRODUCTION: This study aimed to describe long-term changes in injury pattern in bicycle accidents among children in relation to the increasing use of bicycle helmets. METHODS: This was a descriptive register study of all children aged 6-14 years with injuries from bicycle accidents who were treated at a Danish university hospital in the 1980-2014 period. Diagnoses and helmet use were analysed and stratified by gender and age group. Diagnoses were grouped into head injuries, severe head injuries, facial injuries, bone fractures, spinal injuries and internal injuries. We defined severe head injuries as skull fractures and intracranial injuries including concussions, haemorrhages and lacerations. RESULTS: We included 13,294 children, 58.7% were boys. From 1980-1984 to 2010-2014, the use of helmets increased from 0% to 49.9% in boys and from 0% to 57.1% in girls. The proportion of boys and girls with head injuries decreased from 31.3% to 17.4% and from 29.6% to 10.1%, respectively. A similar reduction was found in the proportion of children with severe head injuries. In the study period, the proportion of children with facial injuries, fractures, spinal injuries and internal injuries in trunk remained unchanged. Eighteen children died from their injuries, none of whom wore a helmet. CONCLUSIONS: In the study period, the proportion of head and severe head injuries decreased by 50% along with an increase from 0% to 50% in helmet use. The proportion of facial injuries, spinal injuries, bone fractures and injuries to the internal organs remained unchanged. FUNDING: none. TRIAL REGISTRATION: not relevant.

Development of the annual incidence rate of fracture in children 1980-2018: a population-based study of 32,375 fractures.

Background and purpose - Pediatric fractures are a common cause of morbidity. So far, no larger Danish study has described the development in the incidence rates. Therefore, we describe the development in the incidence rates of pediatric fractures in the time period 1980-2018 and the frequency of the most common type of fractures.Patients and methods - This is a retrospective register study of all children aged 0-15 years with a fracture treated in the Emergency Department at Odense University Hospital, Denmark, between 1980 and 2018. For all cases, information on age, sex, date of treatment, diagnosis, and treatment was obtained from the patient registration system. Based on official public population counts we estimated age and sex-specific annual incidence rates.Results - 32,375 fractures were included. In the study period the incidence rate decreased by 12%. The incidence increased until the early 1990s. Thereafter incidence rates decreased until 2004-09, from then onward increasing towards the end of the study period. The highest age-specific incidence rate in boys of 522 per 10,000 person-years was at 13 years of age. In girls the age of the highest incidence rate decreased from 11 years in 1980 to 10 years in 2018. Fracture of the lower end of the forearm, the clavicle, and the lower end of the humerus had the highest single fracture incidence rates.Interpretation - The incidence rate of pediatric fractures decreased in the study period by 12%. The highest single fracture incidence rates were for fracture of the lower end of the forearm, the clavicle, and the lower end of the humerus. As the first longitudinal Danish study of pediatric fractures this study is a baseline for evaluating future interventions and future studies.

Children and adolescents admitted to a university-level trauma centre in Denmark 2002-2011.

INTRODUCTION: The epidemiology of children or adolescents admitted to a Scandinavian trauma centre is largely unknown. The aim of this paper was to describe the epi-demiology and severity of potentially severely injured children and adolescents admitted to a university hospital trauma centre. METHODS: This was a descriptive study of all children and adolescents aged 0-17 admitted to the university level trauma centre at Odense University Hospital, Denmark in the 2002-2011 period. Data were extracted from the Southern Danish Trauma Register and from medical records. RESULTS: A total of 950 children and adolescents were included. The median age was 13 (range: 0-17) years. Boys accounted for 60.6% of the cases. Accidents accounted for 97.2%, violence 1.4% and self-inflicted injuries 0.4%. More than three fourths of the injuries occurred either in traffic or at home. The occurrence was greatest in the summer (34.0%), during weekends (48.9%) and in the hours between 12.00 and 20.00 (59.2%). Overall, 58.5% of the in-juries were due to traffic. Of these injuries, 39.7% were in-juries suffered by passengers in motor vehicles, 27.5% drivers/passengers of a scooter/MC, 21.8% bicyclists and 10.3% pedestrians. The median Injury Severity Score (ISS) and Abbreviated Injury Scale was 4 (range: 1-75) and 2 (range: 1-6), respectively. Head/face injuries accounted for 36.5% and injuries to the extremities for 30.9% of all injuries. A total of 153 (16.1%) suffered from severe injuries (ISS > 15). Overall, 49 (5.2%) died due to their injuries. CONCLUSIONS: Based on a local trauma register, we described the epidemiology and severity of potentially se-verely injured children and adolescents admitted to a university trauma centre. FUNDING: none. TRIAL REGISTRATION: not relevant.

Trends in weapon-related injuries from violence in Odense Municipality, Denmark 1991-2009.

INTRODUCTION: The aim of this study was to examine the development in incidence rates and the severity of weapon-related physical interpersonal violence in Odense Municipality, Denmark from 1991 to 2009. METHODS: All victims of physical interpersonal violence with weapon-related injuries treated at the Emergency Department in the 1991-2009 period at Odense University Hospital, Denmark, and/or subjected to medico-legal autopsy at the Institute of Forensic Medicine in the 1991-2009 period at the University of Southern Denmark were included. Incidence rates were estimated following stratification by gender and age. The development in the incident rates was examined. RESULTS: Overall, 2,957 victims were included. The overall incidence rate was 8.5 per 10,000 population/year (14.6 and 2.7 for males and females, respectively). The rates did not change significantly in the study period. Most victims were injured with bottles/glass and blunt weapons (44.8% versus 28.2%), whereas 24% were injured with sharp weapons and 3% with firearms. Most lesions were sustained to the head/neck (56.1%) and to the upper limbs (26.2%). A total of 182 (6.1%) victims had lesions that were considered severe. The mortality rate was 4.8 per 1,000 victims in males and 29.1 per 1,000 victims in females. More than half (57%) of the homicides were caused by lesions due to sharp weapons. CONCLUSION: Weapon-related injuries are rare in the Odense Municipality. The incidence rate of weapon-related violence did not increase in the study period. Additionally, no evidence of an increased proportion of severe injuries was found. Women had a seven-fold higher mortality than males. FUNDING: none. TRIAL REGISTRATION: not relevant.

Violence- and alcohol-related acute healthcare visits in Greenland.

AIMS: The aim of this study was to describe emergency admissions in Greenland's healthcare system, and the extent to which admissions were associated with alcohol abuse or violence. Furthermore, we aimed to test whether data on emergencies in Greenland could be registered in a reliable way by simple means. METHODS: Registration of all emergencies presented in 15 out of 17 of Greenland's health districts in the period 21 May to 7 June 2010. RESULTS: In the 17-day registration period, 2403 emergencies were registered. In 10% of cases the patients were clinically alcohol intoxicated. When reason for presentation were mental or social problems, attempted suicide, accidents, or violence, 24, 50, 15, and 59% respectively were intoxicated. Alcohol intoxication was statistically significantly more often associated with advanced treatment (e.g. evacuation, hospitalisation, or follow up by doctor or nurse). CONCLUSIONS: This study confirms that violence- and alcohol-related emergencies put a considerable strain on Greenland's healthcare system. Due to the short observation period, we have not been able to describe the actual extent of the problem in detail, nor was it possible to estimate whether this problem is more pronounced in Greenland than in other countries, for example Denmark.

Do repeat victims of interpersonal violence have different demographic and socioeconomic characters from non-repeat victims of interpersonal violence and the general population? A population-based case-control study.

AIM: To study if adult repeat victims of violence have different demographic and socioeconomic character from non-repeat victims of violence and the general population. METHODS: Case-control study comparing demographic and socioeconomic characteristics before first-time victimisation among repeat victims of violence to that of non-repeat victims and population-based controls. Repeat and non-repeat victims were included from an urban emergency department and an institute for forensic medicine. Data was analysed using logistic regression in unadjusted, semi-adjusted, and fully-adjusted models. RESULTS: For almost all demographic and socioeconomic factors in our study, the strongest associations were found when repeat victims were compared to population-based controls, whereas associations obtained from comparison with non-repeat victims were less pronounced. Compared to non-repeat victims, factors most strongly associated with repeat victimisation were being a pensioner (OR 3.21), being unemployed (OR 2.11), high level of lifetime unemployment (OR 1.50), high level of household crowding (OR 1.49), and living without a partner (OR 1.30). Compared to population-based controls, factors most strongly associated with victimisation were being a pensioner (OR 6.83), being unemployed (OR 3.01), living without a partner (OR 3.15), high level of lifetime unemployment (OR 2.40), high levels of household crowding (OR 2.35), large age difference to partner (OR 1.82), and citizenship in a country outside Europe (OR 1.61). CONCLUSIONS: The study indicates that repeat victims of violence may be a demographic and socioeconomic subgroup of adult victims of violence characterised by certain pronounced risk factors which are already present at the time of the first episode of violent victimisation.

Demographic and socioeconomic risk factors of adult violent victimization from an accident and emergency department and forensic medicine perspective: a register-based case-control study.

OBJECTIVES: To describe demographic and socioeconomic risk factors of adult violent victimization leading to contact with an emergency department and/or an institute of forensic medicine based on a case-control study design. DESIGN: A register-based case-control study comparing demographic and socioeconomic characteristics of 10,799 adult victims of violence (cases) and 53,986 randomly selected population-based controls matched for age, gender, and date. DATA SOURCES: Cases were included from a Danish emergency department and a Danish institute of forensic medicine. Demographic and socioeconomic data for cases and controls were extracted from two national longitudinal registers. STATISTICS: Data were analysed using logistic regression in a semi-adjusted model adjusting for age, gender, and year, and a fully adjusted model including several variables. RESULTS: Factors positively associated with adult violent victimization were "being a pensioner" (OR: 4.71; 95% CI: 4.18-5.30), "being unemployed" (OR: 3.15; 95% CI: 2.85-3.48), and "not living with a partner" (OR: 2.93; 95% CI: 2.74-3.14), whereas the factors strongly negatively associated with adult violent victimization was "being a student" (OR: 0.72; 95% CI: 0.63-0.83). In the semi-adjusted analysis a foreign citizenship of a country outside Europe was significantly associated with adult violent victimization (OR: 1.79; 95% CI: 1.60-2.00), whereas in the fully adjusted analyses the association decreased to an insignificant level. CONCLUSIONS: Our findings emphasize the multifaceted nature of injuries from violence. The findings from this study indicated potential risk factors, which should be specifically addressed when planning preventive strategies.

What is the lifetime risk of contact with an A&E Department or an Institute of Forensic Medicine following violent victimisation?

OBJECTIVE: The aim of the study was to estimate the age and gender specific incidence rates of first time contact with an A&E Department and/or an Institute of Forensic Medicine due to violent victimisation in a Danish low-risk urban population and, secondly to estimate the corresponding lifetime risk of violence based upon these incidence rates. METHODS: All first time contacts of victims of violence with the A&E Department at Odense University Hospital and/or the Institute of Forensic Medicine, University of Southern Denmark 1991-2002 were included. Based on estimated age and gender specific annual incidence rates of first time violence and on the survival rates of the background population, the lifetime risk was estimated assuming calendar time stationarity of incidence and survival rates. RESULTS: The overall annual incidence rate of first time violence was 9.2 [95% CI: 9.0-9.4] per 1000 population/year for males and 2.6 [95% CI: 2.5-2.7] per 1000 population/year for females. The estimated lifetime risk was 0.440 [95% CI: 0.438-0.442] for males and 0.180 [95% CI: 0.178-0.181] for females. The highest cumulative risk for both males and females was in the age group 15-24 years, 0.192 [95% CI: 0.188-0.195] for males and 0.048 [95% CI: 0.046-0.051] for females. CONCLUSION: The current study shows, that even in a country with a relatively low risk of violent victimisation a considerable part of the population over a lifetime will need medical assistance after violent victimisation.

[Development in violence in Odense City from 1991-2002]. / Udviklingen i forsaetlig vold i Odense 1991-2002.

The study included 14,316 consecutive victims of violence registered by Odense University Hospital and/or the Institute of Forensic Medicine, University of Southern Denmark from 1991-2002. The incidence rate was 9.9 and 3.4 per 1,000 population/year for males and females respectively. The incidence rate for males decreased during the period of the study. The proportion of less serious lesions increased and the proportion of potential severe lesions such as bone fractures and deep lesions decreased during the period of the study. The proportion of patients with injuries from knives or firearms did not change during the period of the study.

The epidemiology of repeat contacts with an Emergency Department or an Institute of Forensic Medicine due to violent victimization in a Danish urban population.

OBJECTIVE: The aim of this study was to describe the epidemiology of repeat contacts with an urban emergency department (ED) and/or an institute of forensic medicine. METHODS: All victims of violence in contact with the ED at Odense University Hospital and/or the Institute of Forensic Medicine, University of Southern Denmark 1991-2002 were included. Victims who had two or more contacts were identified as repeat victims and a recurrence proportion was estimated. Survival analysis was made with time of observation from the first to the second contact due to violence and a repetition percentage was estimated as the proportion with repeated characteristics in the incident leading to the second contact compared to the index contact and a repetition percentage was estimated. RESULTS: Overall 10,216 individuals with 14,307 incidents were included in the study. Overall, the recurrence proportion was 22% and repeat victims who were responsible for 44% of all contacts to the ED and/or the Institute of Forensic Medicine in the study period. The median time from first to the next incident was 1.75 years for males and 1.64 years for females. Overall 34% of the males and 37% of the females experienced the next incident within 1 year. The time span decreased significantly with increasing age for both males and females. The frequency of weapon use was low with a repetition percentage of 17% for males and 7% for females. For potential severe lesions such as bone fractures and internal lesions the repetition percentage was 28% and 19% for males and 23% and 25% for females. CONCLUSIONS: The present study showed that contact with an ED due to violent victimization often is followed by subsequent contacts with the same ED and/or the IFM due re-victimization and that recurrent incidents share characteristics.