{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:51:09Z","timestamp":1782496269776,"version":"3.54.5"},"reference-count":40,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2026,5,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>External causes of morbidity and mortality are leading contributors to disability and death. However, epidemiological research on the causes remains limited, mostly in low- and middle-income countries. We aimed to investigate these causes using large-scale data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study used International Classification-coded data from health information system and trauma registry at trauma hospitals (2011\u20132023). Associations were examined using generalised ordered logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 329\u2009989 patients (mean age: 36.2 years), 58.94% were male. The most common single and multiple injuries were head and wrist\/hand injuries, respectively. Deceased patients were younger than those discharged. Severe\/fatal limb injuries were linked to shorter hospital stays. Leading causes included falls, mechanical forces, exposure to temperature\/poison\/nature and road traffic crashes. Females were more likely to be discharged, or survive compared with males. Adults and older adults showed worse outcomes than those \u226417 years. (severe\/death, coefficient: 1.43, 95%\u2009CI 1.318 to 1.535, p&lt;0.001). A longer stay (\u226510 days) was significantly associated with worse outcomes (coefficient: 2.58, 95% CI 2.453 to 2.707, p&lt;0.001). Road traffic crashes showed the strongest association with severe\/fatal outcomes (coefficient: 2.66, 95%\u2009CI 2.546 to 2.764, p&lt;0.001), followed by assaults, exposure to temperature\/poison\/nature and falls. The model demonstrated good fit (\u03c7\u00b2(8)=7.85, p=0.165; pseudo R\n                      <jats:sup>2<\/jats:sup>\n                      =0.22).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Falls were the most frequent external cause. Road traffic crashes were most strongly linked to severe outcomes. Mechanical forces and exposure to temperature\/poison\/nature contributed to the injury burden. Prevention strategies should address fall prevention, residential and occupational safety and road traffic safety and public education, particularly for adult and older males.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/ip-2025-045982","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T17:20:37Z","timestamp":1782494437000},"page":"ip-2025-045982","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiology of external causes of morbidity and mortality in Tabriz, Iran: a multicentre hospital-based study using linked health information system and trauma registry data, 2011\u20132023, classified by International Classification of Diseases"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4985-3042","authenticated-orcid":false,"given":"Nasrin","family":"Shahedifar","sequence":"first","affiliation":[{"name":"Injury Epidemiology and Prevention 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