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1.  Health service use in adults 20–64 years with traumatic brain injury, spinal cord injury or pelvic fracture. A cohort study with 9-year follow-up 
BMJ Open  2012;2(5):e001521.
Objectives
To estimate the health service use over 9 years after the injury year for patients with traumatic brain injury (TBI), spinal cord injury (SCI) and pelvic fracture (PF), and compare with non-injured.
Design
A register-based cohort design with a 9-year follow-up period.
Setting
The Danish population.
Participants
The study included 434, 100 and 278 hospital-treated incident patients with TBI, SCI and PF, respectively, among 20-year-olds to 64-year-olds identified using the National Patient Register. Controls for each patient group were drawn from the population register, matched by age, sex and health service use during 1995. All were followed during 1996–2005 by linkage to national health registers. The observations were excluded when the patients left Denmark or died.
Outcome measures
The use of hospital treatments, contacts with general practitioners and the use of physiotherapy.
Results
Compared to the controls, more patients with TBI and SCI were hospital admitted all 9 years after the injury year, on average 0.36 and 0.50 times annually, respectively. For patients with PF hospital admissions returned to baseline year 2 after the injury year. For patients with SCI the use of general practitioner services remained at an increased level year 9 after the injury year, while it returned to baseline level year 4 after the injury year for patients with TBI and year 2 for patients with PF. For patients with SCI physiotherapy use remained increased over 9 years after the injury year, while it returned to baseline the fifth year for patients with TBI and the third year after for patients with PF.
Conclusions
TBI and SCI increase the use of health services over 9 years after the injury year, while most health service use after PF returned to baseline 2 years after the injury year.
doi:10.1136/bmjopen-2012-001521
PMCID: PMC3488711  PMID: 23103605
Accident & Emergency Medicine; Epidemiology; Public Health
2.  Are there differences in injury mortality among refugees and immigrants compared with native-born? 
Injury Prevention  2012;19(2):100-105.
Background
The authors studied injury mortality in Denmark among refugees and immigrants compared with that among native Danes.
Method
A register-based, historical prospective cohort design. All refugees (n=29 139) and family reunited immigrants (n=27 134) who between 1 January 1993 and 31 December 1999 received residence permission were included and matched 1:4 on age and sex with native Danes. Civil registration numbers were cross-linked to the Register of Causes of Death, and fatalities due to unintentional and intentional injuries were identified based on ICD-10 diagnosis. Sex-specific mortality ratios were estimated by migrant status and region of birth, adjusting for age and income and using a Cox regression model after a median follow-up of 11–12 years.
Results
Compared with native Danes, both female (RR=0.44; 95% CI 0.23 to 0.83) and male (RR=0.40; 95% CI 0.29 to 0.56) refugees as well as female (RR=0.40; 95% CI 0.21 to 0.76) and male (RR=0.22; 95% CI 0.12 to 0.42) immigrants had significantly lower mortality from unintentional injuries. Suicide rates were significantly lower for male refugees (RR=0.38; 95% CI 0.24 to 0.61) and male immigrants (RR=0.24; 95% CI 0.10 to 0.59), whereas their female counterparts showed no significant differences. Only immigrant women had a significantly higher homicide rate (RR=3.09; 95% CI 1.11 to 8.60) compared with native Danes.
Conclusions
Overall results were advantageous to migrant groups. Research efforts should concentrate on investigating protective factors among migrants, which may benefit injury prevention in the majority population.
doi:10.1136/injuryprev-2012-040336
PMCID: PMC3607096  PMID: 22627779
Injury; mortality; migration; ethnicity; immigrants; mental health; epidemiology; registry; suicide/self; harm; drowning; bicycle; fall

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