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Road traffic crash is of growing public health importance worldwide contributing significantly to the global disease burden. There is paucity of published data on road traffic crashes in our local environment. This study was carried out to describe the injury characteristics and outcome of road traffic crash victims in our local setting and provide...
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This paper discusses the characteristics and injury patterns of serious road injuries (MAIS2+ inpatients) in the Netherlands.
In the Netherlands, the actual number of serious injuries is estimated by linking police data to hospital data. The distribution of serious road injuries over 1) travel mode and gender and 2) crash type and age are compared...
Background:
From the viewpoint of prehospital emergency medicine, a greater proportion of pelvic fractures not of a life-threatening status but combined with other injuries need more comprehensive recognition.
Methods:
A 12-year nationwide health database of inpatients was reviewed. All cases diagnosed as pelvic fractures were enrolled. The asso...
Citations
... Malaysian universities have expressed their commitment to implementing sustainable practices, but few universities have taken steps to create sustainable campuses. However, the campus physical development plan has several shortcomings, which have led to the lack of an environment conducive to learning and living [6]. Furthermore, the physical development plan of Malaysia's campus is less IOP Publishing doi:10.1088/1755-1315/1347/1/012062 2 sensitive to changes and does not meet the needs of students, who are the campus' main "customers" [7]. ...
The increased number of registered vehicles among students at the universities, such as cars and motorcycles, were causing some problems on the campus and around the hostels, such as traffic congestion, crowded parking, which also lead to disturbances in universities communities. The aims of this study were to identify the types of transportation preferred among Universiti Tun Hussein Onn Malaysia (UTHM) students, and to analyze the factors that influence mode choice among UTHM students. The study was carried out using a self-guided questionnaire with a determined sample of 120 respondents among undergraduate students that included those who lived on campus nor off-campus residences. The data collected were analyzed using descriptive statistics and multiple regression, and the tools used were Microsoft Excel and SPSS (Statistical Package for the Social Sciences). The Finding of this study showed that the preferred mode choice was bus. However, only a few independent variables were statistically significant for each transport mode, respectively, in multiple regression analyzes. Generally, the main factors that affected the mode choice among UTHM students were security and convenience. In utility functions, walking was predicted to have the highest preference among UTHM students.
... The current study found that 12.6% of road traffic accident victims died in the follow-up period, which is comparable to a study done in Ethiopia at 12.9% [19]. It is lower than the study conducted in D.R. Congo (19.6%) [20], and Tanzania (17.5%) [21]; on the other hand, this finding is higher than studies done in Kenya (7.7%) [22], Rwanda (9.4%) [23], and Ethiopia (9.5%) [24]. This study indicated the incidence of mortality among road traffic accidents was 7.34 per 10,000 person-hours of observations. ...
... The current study revealed that the incidence of mortality among road traffic accident victims in the age group above 50 years was high, which is not consistent with studies undertaken in Yemen, Ghana, the D.R. Congo, and Ethiopia where the rate of death was higher among the age group below 50 Years [12,20,21,25]. The possible reason behind this is the fact that the older age group might have decreased immunity and comorbidities, making them more susceptible to nosocomial infection and unable to respond to treatment. ...
... Low systolic blood pressure at admission was a significant predictor for mortality among road traffic accident victims in our study. This finding is in agreement with previous studies that confirmed victims with low systolic blood pressure were at increased risk of death, which might be due to acute blood loss [12,21,26,36]. Poor blood perfusion to the vital organs due to low systolic blood pressure leads to a decompensation state with multiple organ failure and could increase mortality among road traffic accident victims [37]. ...
Background
Globally, road traffic accidents are the eighth-leading cause of death for all age groups. The estimated number of road traffic deaths in low income countries was more than three times as high as in high-income countries. Africa had the highest rate of fatalities attributed to road traffic accidents. Ethiopia has the highest number of road traffic fatalities among Sub-Saharan African countries. The main objective of this study was to determine the incidence and predictors of mortality among road traffic victims admitted to hospitals in Hawassa City.
Methods
A facility-based retrospective cohort study was conducted using secondary data from hospital records. A total of 398 road traffic accident victims admitted to selected hospitals in Hawassa city from January 2019 to December 2021 participated in the study. Data were analyzed using STATA version 14.1. The Cox regression model was used to determine the predictors of mortality. A hazard ratio with a 95% confidence interval and a cut-off value of P<0.05 was used to declare the risk and statistical significance, respectively.
Result
The incidence rate of mortality for road traffic accident victims was 7.34 per 10,000 person-hours. The predictors of mortality were the value of GCS at admission <8 (aHR = 5.86; 95% CI: 2.00–17.19), GCS at admission 9–12 (aHR = 3.27; 95% CI: 1.28–8.40), the value of SBP at admission ≤89mmHg (aHR = 4.41; 95% CI: 2.22–8.77), admission to the ICU (aHR = 3.89; 95% CI: 1.83–8.28) and complications (aHR = 5.48; 95% CI: 2.74–10.01).
Conclusion
The incidence of mortality among road traffic victims admitted to hospitals in Hawassa city was high. Thus, thorough follow-up and intensive management should be given to victims with critical health conditions.
... Prolonged hospitalization is associated with a remarkably high burden on healthcare systems; lengthy hospitalization may impact population productivity via spending time within healthcare facilities. Therefore, reducing LOS is an inseparable part of the quality of care (4)(5)(6)(7). Despite not being a comprehensive indicator of hospital costs (8), LOS is a practical representative of hospital costs (9). ...
... A patient with an injury in at least two body zones with AIS greater than two was deemed a case of multiple trauma (22,23). GCS was divided into three categories based on the literature (24): mild injury (13-15), moderate (9)(10)(11)(12), and severe (3)(4)(5)(6)(7)(8). ...
Background
Lengthy hospitalization may lead to an increased hospital-acquired patient complication, including infections, as well as increased costs for both healthcare systems and patients. A few studies evaluated the impact of various clinical and demographic variables on patients' length of stay (LOS). Hence, in this study, we aimed to investigate the impact of various variables on traumatic patients' LOS.
Methods
This is a retrospective single-center, registry-based study of traumatic patients admitted to Taleqani, a major trauma center in Kermanshah, Iran. A Minimal Dataset (MDS) was developed to retrieve traumatic data on demographic and clinical aspects. We used univariable and multiple quantile regression models to evaluate the association between independent variables, including ISS, GCS, and SBP, with LOS. LOS is practically defined as the time interval between hospital admission and discharge. The LOS durations have been presented as median (Q1 to Q3) hours. A p-value of <0.05 was considered statistically significant.
Results
A total of 2708 cases were included in this study, with 1989 (73.4%) of them being male. The median LOS was 87.00 (48.00 to 144.00) hours. When adjusted for systolic blood pressure (SBP), Glasgow Coma Scale (GCS), Injury Severity Score (ISS), and cause of injury, the two characteristics of spine/back and multiple trauma were significantly associated with the higher LOS, with 43 (20.5 to 65.48) and 24 (10.39 to 37.60) hours more than extremities (P < 0.001 and P = 0.005). Besides, the patients admitted due to road traffic injuries (RTI) were discharged 16 and 41 hours later than falling and cutting/stabbing (P = 0.008 and < 0.001, respectively). Moreover, the patients with ISS≥16 and 9≤ISS≤15 had a median of 51 (21 to 80) and 34 (22 to 45) LOS hours more, compared to 1≤ISS≤8, respectively (P < 0.001). The trauma cases experiencing SBP ≤ 90 mmhg on admission had a median of 41 (20 to 62) hours more hospitalization period than those with SBP> 90 mmhg (P < 0.001). At last, the patients with GCS of 9 to 12 and GCS of 3 to 8 were hospitalized for 39 and 266 hours more than GCS of 13 to 15 (P < 0.001).
Conclusion
Determining independent determinants of prolonged LOS may lead to better identifying at-risk patients on admission. Trauma care providers should consider the following risk factors for increased LOS: higher ISS, Lower GCS, and SBP, multiple trauma or spine injury, and trauma resulting from falling or cutting/stabbing. As a result, the impact of extended LOS might be reduced by intervening in the related influencing factors.
... The injury burden was particularly higher in younger males with 93% being ≤50 years old. This socio-demographic distribution of injuries has been reported in similar regional and international studies (Isaac M. Chalya et al., 2012;Cox et al., 2018;Demyttenaere et al., 2009;Dhaffala et al., 2013;Haagsma et al., 2015;Juillard et al., 2011;Kobusingye & Lett, 2000;Laing et al., 2014;Lozano et al., 2013;Lutge et al., 2016;Seidenberg et al., 2014;Taibo et al., 2016;Vosswinkel et al., 2014) . The median age of 27 years was like other regional studies (I. ...
... Mwandri et al. also found STIs to be most prevalent, followed by long-bone fractures and head injuries (Mwandri & Hardcastle, 2018). In Tanzania, Chalya et al. found STIs, fractures and head injuries to be the most common diagnoses (Chalya et al., 2012). A local study that focused on orthopedic injuries found that STIs were the third most common diagnoses in patients admitted to orthopedic wards (Manwana et al., 2018). ...
... Fractures/dislocations of the upper limb were the second most common diagnoses (22.4%), while those of the lower limbs were third (12.2%). These findings were similar to those from regional studies (Chalya et al., 2012;Mwandri & Hardcastle, 2018). Such findings are worrisome because orthopedic injuries, especially in the young population, are associated with substandard quality of life and long-term disability (Balogh et al., 2012). ...
Purpose: Injuries constitute a leading and growing cause of emergency department (ED) visits in sub-Saharan Africa. Characteristics of ED injury patients have been well-described in many parts of the world; however, data remain scarce throughout Africa, Botswana included. We aimed to describe in detail injury-related ED visits at an urban public referral hospital in Botswana. Methodology: We conducted a retrospective chart review of all patients who presented to Princess Marina Hospital in Gaborone, Botswana, over a period of 4 randomly selected consecutive months. Demographic data, injury mechanism, type, severity and ED disposition were abstracted from the medical record into a Microsoft Access database designed for this study. Study variables were analyzed with summary statistics for frequencies, percentages, means, medians and relationships using SPSS. Injury severity was calculated for each patient using the modified Kampala Trauma Score. Results: 6715 ED visits occurred during the study period, and 1709 (25.5%) were injury related. Of these, 63.9% were male, 24.7% <14 years old, 6.7% age 14-19, 49.1% 20-40, and 19.5% >40. 35.9% were due to falls, 23.6% assault and 18.8% road traffic crashes. 40.5% isolated soft tissue injuries, 34.7% isolated extremity injuries, 9.4% multiple injuries and 5.3% head and neck injuries. Kampala Trauma Score II (KTS) was available for 76% of patients. 1.7% scored ≤6, 5.9% 7-8, and 92.4% 9-10. For patients with KTS ≤6, 18% died in the ED, 82% were admitted and 0% discharged home. For KTS 7-8, 0% died, 93.5% were admitted, 6.5% were discharged home. For KTS II 9-10, 0% died, 26% were admitted, 74% were discharged home. Unique Contribution to Theory, Practice and Policy: This study is among the first in Botswana to assess the burden of injuries using a validated injury severity scoring tool. Based on the study findings and applicability of the KTS II in our setting, we recommend that PMH ED incorporates and promotes a severity scoring system to help in planning and resource allocation. PMH ED receives many low acuity injuries therefore improving the availability of basic resources in local clinics may reduce overcrowding. Future studies should aim to involve multiple centers to get a true representation of injury burden in Botswana.
... This finding is lower than the study conducted in Taiwan in 2016 that showed that those who had head injuries were >14 times more likely to die compared to those who did not have a head injury (AOR = 14.6, 95% CI [7.7, 27.8]) (25). A study done in Tanzania also reported that head injuries are the most common type of injury sustained, which predisposed victims to prolonged hospitalization and mortality (26). This may be due to the seriousness of a head injury, which has the potential to cause death in injured victims. ...
... It is in line with a similar study conducted in Iran in 2016 that showed males accounted for almost 78.7% of RTIs (27). Similarly, a study conducted in Tanzania in 2012 also showed that the maleto-female ratio of RTI fatalities was 2.1:1 (26). A cross-sectional study conducted at Tikur Anbesa Specialized Hospital composed of 71.7% male and 28.3% female RTA victims resulted in a male-tofemale fatality ratio of 2.6:1 (21). ...
... Motor tra c accidents (71%) in the study were the most common mechanisms of injury in young people, while falls caused fractures in older population 16 . Also, lower limb injuries were the most common motorcyclerelated musculoskeletal injury among multiply injured young male patients in Bugando, Tanzania 17 . ...
Background
Globally, physical injuries are the leading causes of disability-adjusted life years (DALYs), morbidity, and mortality, and account for nearly four and a half million lives lost per year, or approximately 8% of the world's annual deaths. In Uganda, physical injuries are a substantial problem that has reached epidemic proportions, with Boda-boda accidents being the leading cause of injuries. This study aimed to determine the factors associated with femur fracture and treatment outcomes at Gulu Regional Referral Hospital in 2022.
Materials and Methods
An IRB-approved retrospective review of patients 18 years and above who sustained femur fractures and were treated at Gulu Regional Referral Hospital's Department of Surgery in 2022 was conducted. A systematic sampling of patients' files from the records in the surgery department was conducted. Two groups of patients were classified based on whether they received an operative or nonoperative femur fracture reduction at Gulu Hospital. The study's primary outcome was the factors associated with femur fracture and the discharge status of the patients after treatment. Multivariate regression analyses were conducted to determine factors associated with femur fracture and status at discharge. A p-value of < 0.05 was considered significant at 95% Confidence Intervals (CI).
Results
One hundred and fifty-four femur fracture patients were treated at GRRH with most, 91(58.8%) being males; in the age group of 18–30 years 38(24.8%); caused by road traffic crashes, 96(63.0%) and passengers, 60(60.6%); with mainly the shaft of femur affected 55(35.2%); of transverse fracture lines, 56/154(36.4%) and were closed fractures, 13(88.4%). At multivariate regression analyses, the factors associated with femur fracture were the age groups of 61–75 years (adjusted Odds Ratio = aOR,13.9, 95%CI:1.68-114.09;p = 0.015); age group > 75 years (aOR, 2.50,95%CI:1.22–4.95;p = 0.012); and diploma/degree holders (aOR,5.01,95%CI:1.03–15.68;p = 0.046). The factors associated with improved status at discharge after treatment at GRRH were occupations (aOR,4.02,95%CI:1.52–10.63;p = 0.005); open fractures (aOR, 0.13,95%CI:0.05–0.360;p < 0.000); oblique fracture lines (aOR,4.95,95%CI:1.62–15.12;p < 0.000); spiral fracture lines (aOR, 5.50, 95%CI:1.71–17.90;p = 0.004); transverse fracture lines (aOR,4.34,95%CI:1.68–11.23;p = 0.002). However, there was no significant difference in the method and treatment outcomes of femur fracture at GRRH in 2022.
Conclusion
Femur fracture is a significant surgical and public health problem among Gulu Regional Referral Hospital patients. It is associated with older age groups and diploma/degree holders. The factors associated with improved status at discharge were occupations (peasant farmers and persons employed in the informal sectors of the economy), spiral, transverse, and oblique fracture lines. It was less likely for patients with open femur fractures to be discharged in an improved status. In addition, there was no significant difference in the treatment method and outcomes among the patients at GRRH. We recommend more strategies to reduce the incidence and prevalence of femur fractures by designing and reinforcing policies that reduce motor vehicle accidents in the region. In addition, more efforts should be made to supply enough implants for the management of patients with fractures using open reduction and internal fixation.
... Результати аналізу клініко-епідеміологічної характеристики дорожньо-транспортної травми в Україні вказують на те, що одночасно мають місце дві тенденції. У цілому клініко-епідеміологічна характеристика дорожньо-транспортної травми має багато спільних рис із такою ж характеристикою в інших країнах і певною мірою збігається із загальносвітовими даними [16][17][18][19]. З іншого боку, в Україні спостерігається тенденція, що значно відрізняється від подібних результатів інших країн, насамперед це стосується структури клініко-епідеміологічних характеристик. ...
Background. Road traffic injuries remain one of the main causes of death in Ukraine even during the war. The Code of Civil Protection of Ukraine (Article 2, Clause 6) recognizes a traffic accident as a type of emergency. The purpose of the study: to form a comprehensive characterization of a traffic injury as a medical and sanitary consequence of a man-made emergency. Materials and methods. Typical territorial formations of Ukraine, namely cities with a population of more than 1,000,000 people, a typical regional center and rural areas, were included in the general research model. These components were chosen in compliance with the law of large numbers, regarding the requirements of typicality and the scope of the study. To meet these requirements, we selected a total of 1,696 victims of road traffic accidents who were included in the research array from the array of 21,000 victims using the random number method, while maintaining the component proportionality criterion. This study was conducted using the methods of epidemiological natural modeling, formal logic, fractal analysis, clinical standardization and medical statistics. Results. The specific weight of men injured in road accidents is 66.86 %, which is twice the number of women injured in road accidents. A significant effect of gender on the survival rate of victims was found: men survive in 88.71 %, and women in 91.99 % of cases. In the general array, majority of patients are persons of the most working age — 21–50 years old (63.33 %). In general, there is a tendency to decrease the specific weight of road accident victims starting from the age of 21, as the age factor increases. The highest rate of survival was recorded in the group of 21–30 years — 93.81 %, and the lowest — in people over 71 years of age — 75.27 %. Pedestrians have the largest specific weight in the total array, almost 40 %, and passengers have the lowest one — 24.65 %. In general, active road users make up 75.35 % of the total number. In the array of drivers who died, the specific weight of men is 90.32 %, and the fatality rate is 5.32 %. At the same time, the mortality rate for women is 3.95 %. The specific gravity of deceased male pedestrians is 70.64 %, while the fatality rate is 18.16 %, and among women this rate is 12.75 %. In all age groups, there is a different nature of the distribution of the negative outcome of traumatic process based on participation in the movement. At the same time, in all age groups, most victims who died are pedestrians. It was found that the age has a significant influence on the occurrence of a fatal outcome in traffic participants, with its greatest influence in victims older than 50 years. Conclusions. The clinical and epidemiological characteristics of victims of road accidents in Ukraine, as a medical and sanitary consequence of a man-made emergency, indicates that road traffic injuries are a significant medical and social problem in our country. This is due to the fact that they predominantly affect the most economically active segment of the population, which contributes significantly to the national product. The clinical and epidemiological characteristics of road traffic injuries in Ukraine have certain aspects, unlike other countries of the world, as a reflection of the peculiarities of life of population in our country. All clinical and epidemiological signs are risk-creating factors for the occurrence of a negative outcome of traumatic process due to the presence of a probable influence on this result and require verification of risks.
... A pilot-tested extraction checklist tool was developed from previous studies, 1,[16][17][18][19] containing sociodemographic characteristics, traumatic and medical causes of ED visit, immediate cause of death, comorbidities, and related variables. The calculated Cronbach's alpha from the pilot test was 0.86. ...
... This study finding is directly in line with studies done in Ethiopia and Kenya on the pattern and predictors of early mortality at adult emergency departments that showed or reported that emergency department early mortality is less likely among those who have no severe brain injury by 73% and 83%, respectively. 2,18 It is also consistent with a study conducted in Addis Ababa, which revealed that severe head injury is the most common cause of early death among ED patients. 9 Additionally, this study's finding was consistent with a study conducted in Tehran which showed that patients with severe brain injury were 4.6 times (AOR=4.6; ...
Introduction
Mortality in the emergency department is still high in developing countries with resources scarce. Most of emergency department mortality occurred within the first three days; the majority of these deaths are avoidable with proper intervention. Therefore, the purpose of this study was to assess the mortality risks and therapeutic benefits of early and late death.
Methods
Case-control study approach with 87 cases and 174 controls (case to control ratio of 1:2) was used on 261 study participants. Data were extracted from the patient charts using a pretested extraction tool. Then, checked data were entered into Epi-data manager 4.6 versions and analyzed using SPSS 25 versions. Binary logistic regression was used to construct bivariate and multivariable analyses following the descriptive analysis. Finally, a predictor variable in the multivariate logistic regression was deemed to have a significant association if its P-value was less than 0.05 at a 95% confidence level.
Results
Patients who were triaged into the red zone had a 2.3-fold greater risk of dying early than those who were placed in another triage category [(AOR=2.3; 95% CI: 1.10, 5.55) P=0.001]. Besides, having cardiovascular disease (AOR=4.79; 95% CI: 1.73, 13.27), age ≥65 years [(AOR=3.2; 95% CI: 1.74, 7.23) P=0.003)], having rural residency (AOR=6.57; 95% CI: 1.39, 31.13), and having been diagnosed with respiratory failure [(AOR=3.2; 95% CI: 1.04, 7.69), P=0.013)] were associated with early mortality.
Conclusion
The common causes of early mortality were respiratory failure, cardiovascular disease, and road traffic accident. Being aged, having rural residence, being triaged into red zone, and diagnosed for respiratory failure and cardiac failure increase early mortality compared with late death.
... In the current study, pedestrians' injuries were more during daytime accidents. Different studies with relative results were obtained over world across longtime (Al-Senan et al., 1993;Chalya et al., 2012;Al-Omari & Obaidat., 2013;Singh et al., 2016;Ahmad et al., 2018;Shakeer Kahn et al., 2018 andAl musawi &Baiee, 2021). ...
... Previous studies demonstrated effectiveness of helmets in reducing death by 42% and head injury by 69% in road traffic injuries (RTIs) [9]. Unfortunately, there is poor helmet usage among motorcycle users in Kenya [14]. In East African countries, studies have shown that 58.8% of road traffic injuries are attributed to motorcycle injuries resulting into high comorbidities, fatalities and disability [15]. ...
... This could be attributed to over-speeding, recklessness by the riders, alcohol use and poor use of helmets in Kenya. In addition, motorcycle riders and pedestrians are most affected road users by motorcycle crashes [10,14]. In Kisumu City, motorcycle crashes account for between 41% and 62% of road traffic injuries respectively [13,19]. ...
... Previous studies globally have reported that use of helmets by both the motorcyclists and their pillion passengers significantly reduce the incidence of fatal head injury [48]. However, the use of crash helmets is still very low in Kenya [14]. Helmet use among motorcycle riders and their pillion passengers varies across developing countries [48,49]. ...
Introduction:
motorcycle injuries comprise considerable morbidity, disability and mortality of road traffic casualties. The study aimed to assess the pattern and characteristics of motorcycle crash injuries that sought care at the Emergency Departments in Tier III hospitals in Kisumu City during a six-month period from May to November 2019.
Methods:
this was a cross-sectional study of all motorcycle injury patients presenting to three tier III public and private hospitals in Kisumu City. Using a structured questionnaire, data were collected on human and injury characteristics. Multiple logistic regression model was used to determine the predictors of fatality. Statistical significance was set at p<0.05.
Results:
a total of 1073 of motorcycle crash injury patients sought and obtained care at the hospitals. The majority (73.6%) were males. Seventy-three cases resulted in death (case-fatality rate of 6.80%. The age range was 2-84 years, with a mean of 29.6 years (± SD 12.19). Majority, (43.3%) were aged 21-30 years. Most of the crashes occurred during the daytime (79.1%). Of all motorcycle riders and pillion passengers 30.6% wore helmets at the time of the crash. Head injuries (43.6%) were the most common. Injury seventy scores (ISS) ranged from 1 to 51. Glasgow comma scale <3, un-helmeted patients and major trauma (ISS > 16), significantly influenced mortality (P< 0.001).
Conclusion:
these findings confirmed and strengthened the documented substantial morbidity, mortality that motorcycle crashes place on individuals and society, contribute to the body of literature on motorcycle injuries and potentially assist in policy decisions on motorcycle transport safety.
