[Accidents Caused by Gardening - Trivial or Serious? 5-Year Retrospective Analysis at the University Emergency Department Berne]. / Unfälle durch Gartenarbeit ­ Bagatelle oder Ernst?

Accidents Caused by Gardening - Trivial or Serious? 5-Year Retrospective Analysis at the University Emergency Department Berne Abstract. Gardening is a popular leisure activity in Switzerland. Approximately 1 million non-occupational accidents are recorded each year; 600,000 of these occur at home or in pursuit of a hobby, including approx. 16,000 accidents while gardening. The aim of this study is to investigate gardening-related accidents. The data for this study were generated from the database of the management system of Berne University Hospital, Switzerland, and retrospectively analyzed. Patients were enrolled who were at least 16 years old - since younger patients in Switzerland are normally treated in specialised Emergency Departments for Paediatrics. The study was restricted to patients who suffered an accident that resulted in physical impairment while working in their own garden. The data were then analysed based on age, sex, triage category, mechanism, causing object, lesion site, diagnoses, severity of injury (monotraumatic or combined with more than one region or polytrauma), in-patient or out-patient treatment. Gardening-related accidents were mainly suffered by middle aged adults (40-69 years). Men were more often affected than women. At consultation, the injury was mostly monotraumatic and could be treated in an out-patient setting. Patients mainly complained of eye injuries and lacerations. The exposed areas of the eyes, fingers and the head or face were the most affected body regions. Falls and stumbling often led to accidents. Injuries were mainly caused by organic material or by the improper use of gardening tools. The data analysis showed that many injuries could have been avoided by simple preventive measures.

Risk assessment models for venous thromboembolism in acutely ill medical patients. A systematic review.

Although the use of thromboprophylaxis is recommended for acutely ill medical patients at increased risk of venous thromboembolism (VTE), it remains unclear which risk assessment model (RAM) should be routinely used to identify at-risk patients requiring thromboprophylaxis. We therefore aimed to describe existing RAMs, and to compare these tools in terms of validity and applicability for clinical decision-making. We performed a comprehensive systematic search in MEDLINE from the date of initiation until May 2016 for studies in acutely ill medical patients investigating validity of RAMs for VTE. Two reviewers independently screened the title, abstract, and full text, and evaluated the characteristics of studies, and the composition, evidence of validation, and results on validity of the RAMs. We included 11 studies assessing eight RAMs: 4-Element RAM, Caprini RAM, a full logistic model, Geneva risk score, IMPROVE-RAM, Kucher Model, a "Multivariable Model", and Padua Prediction Score. The 4-Element RAM, IMPROVE-RAM, Multivariable Model, and full logistic model had derivation by identifying factors with predictive power. The other four RAMs were empirically generated based on consensus guidelines, published data, and clinical expertise. The Kucher Model, the Padua Prediction Score, the Geneva Risk Score and the IMPROVE-RAM underwent multicenter external validation. The Kucher Model, the Padua Prediction Score, and the Geneva Risk Score improved rates of thromboprophylaxis or clinical outcomes. In conclusion, existing RAMs to evaluate the need of thromboprophylaxis in acutely ill medical patients are difficult to compare and none fulfills the criteria of an ideal RAM. Nevertheless, the adequacy of thromboprophylaxis may be improved by implementing one of the validated RAMs.