Abstract
Relevance. Currently, there is a general increase in the severity of injuries due to the dominance of high-energy multiple and concomitant injuries, especially on high-speed federal highways.Intention: To evaluate specialized medical care and hospital mortality in victims of road traffic accidents on the Federal Highway M-8 “Kholmogory” in the Arkhangelsk Region.Methodology. We selected 906 case histories of patients (form 003/y) injured in accidents on the federal highway M-8 “Kholmogory” and urgently admitted to hospitals of the Arkhangelsk region in 2012 - 2018. Registration forms were selected according to the criteria of retrospective full-design documentary observation. Differences between the observation groups were considered statistically significant at p < 0.05 with correction for multiple comparisons (Bonferroni).Results and Discussion. In the healthcare organizations of the Arkhangelsk region, patients with polytrauma received surgical treatment, with percentage of selective and urgent surgeries, average hospital bed days and time in intensive care units significantly higher (p = 0.001) compared to other patients, while isolated injuries were more often (p = 0.001) treated non-sur-gically. Hospital mortality was 6.0%, deceased patients were significantly older (p = 0.015), and pedestrians comprised half of them (p <0.001). Polytrauma was a cause of all deaths, with average severity of 38 points by the ISS severity scale [22; 48] (p = 0.001); more than a half died 1 day after an accident (p = 0.001).Conclusions. One of the possible ways to improve the medical care to victims of road traffic accidents on the federal highways at all stages of medical evacuation is to develop, scientifically justify and implement a systemic register of the health consequences of road traffic injuries in the practice of public health in the regions of Russian Federation.
Highlights
There is a general increase in the severity of injuries due to the dominance of high-energy multiple and concomitant injuries, especially on high-speed federal highways
Registration forms were selected according to the criteria of retrospective full-design documentary observation
Differences between the observation groups were considered statistically significant at p < 0.05 with correction for multiple comparisons (Bonferroni)
Summary
1–2 0,001 1–3 0,001 1–2 0,001 1–3 0,001 1–2 0,002 1–3 0,001 в клинику. Среди них наибольший удельный. 51 (41,1 %) человек с множественными и 254 оперативные вмешательства: повторные опе (44,2 %) – с сочетанными повреждениями, рации на черепе (удаление гематом различной что статистически значимо (p = 0,001) боль локализации, пластика и замещение дефек ше, чем у травмированных с изолированными тов костей); грудной клетке (реторакотомия, травмами – 33 (15,9 %) Среди всей группы травматизма на федеральных автодорогах не погибших их количество составило полови обходимы разработка, научное обоснование ну – 27 (50 %), а при рассмотрении их удель и внедрение системного Регистра медико-са ного веса среди всех травмированных пеше нитарных последствий дорожно-транспортно ходов – 10 %. Данное распределение погибших вать их состояние, проводить детальный ана в ДТП на ФАД М‐8 «Холмогоры» вполне объ лиз летальности на всех этапах медицинской яснимо тем, что пешеходы являются наименее эвакуации, а также позволит оценить масштаб защищенными субъектами при возникновении дорожно-транспортного травматизма как ДТП, а скорость на ФАД достаточно высока, что в субъекте или регионе, так и в России в целом.
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