Patterns of injuries sustained by pedestrians in road traffic accidents at the singapore general hospital

Abstract

Study objectives: Every year, more than 1.17 million people die in road traffic accidents around the world. Sixty-five percent of deaths involve pedestrians, and 35% of the pedestrians who die are children. More than 10 million people are crippled or injured each year. In Singapore, injuries from road traffic accidents are the fifth major cause of death. Pedestrians were the second most vulnerable group of road users in the past year. Of the total number of fatalities, pedestrians made up almost 30% compared with 24.6% in 2002. There were 63 pedestrians killed in 2003 compared with 49 in 2002. Among the 63 pedestrians killed, elderly pedestrians were a concern. This study captures the injuries sustained by pedestrians with a view to identifying areas for further intervention and hence prevent their occurrence. Methods: This retrospective study was conducted during a 6-month period from July 1, 2003, until December 31, 2003. We reviewed the 104 pedestrian injuries that were treated at the Singapore General Hospital Department of Emergency Medicine during this period. The data were tracked down from the emergency department's (ED) case records, the hospital's trauma registry, and inpatient case records. The information collected was analyzed using the Statistical Package for Social Sciences (SPSS) version 10.1. Results: Male patients made up 47.1% and female patients 52.9% of the injuries. There were 2 age group peaks for the road traffic accident victims: 17 to 36 years and older than 57 years of age. The victims younger than 16 years were treated at the Kandang Kerbau Children's hospital unless the injuries were life threatening. The highest incidence of accidents occurred between 11 am and 2:59 pm . Pedestrians were hit while crossing the road in 35.6% of cases. Other locations included collisions at pavements (4.8%), traffic lights (4.8%), zebra crossings (2.9%), car parks (1.9%), and bus stops (1%). Cars were the most frequently involved vehicles (62.5%); 4.8% of victims were intoxicated during the accident. The most common injury sustained was to the lower limbs (40.4%). Upper limbs were next (19.2%), followed by head (13.5%), chest (12.2%), spine (6.4%), face (6.4%), and abdomen (1.9%). Seventy-four percent of patients were discharged and 23% were admitted, with 5 to ICUs; 1.9% (2) died at the ED. The most common discipline admitted to was orthopedics (50%), followed by general surgery (29.2%), neurosurgery (16.6), and hand surgery (4.2%); 22.1% of patients had resultant inpatient surgical treatment. Conclusion: Road traffic accidents have significant health and societal costs. This study highlights the following factors. Individuals older than 57 years have the greatest vulnerability because of dulled senses and delayed motor skills. More has to be done to educate this group of road users. Drivers should also be more cautious and aware of this group's vulnerability. Collision by motor vehicles causing lower limb injuries was the most frequently treated injury.