Fatal Traumatic Injury Research Articles

Asphyxialdeath due to fracture of thyroid cartilage, cricoid cartilage and arytenoid cartilage as result of blunt trauma of neck in a motorcycle accident:An Autopsy report

Laryngeal fracture is rare but fatal traumatic injury which is mainly caused by severe blunt trauma from interpersonal violence, motor vehicle accident or sports injuries. Laryngeal fracture can lead to severe airway collapse and death.Mortality decreases to less than 5% once the airways made patent and laryngeal injuries are corrected.People must take motorcycle riding safety course to learn how to ride safely. Always follow traffic rules. The motor vehicle accident can be prevented largely through public awareness and education

Fatalities in Swedish fire-related car crashes from a toxicologic perspective

Objective: Vehicle materials developments raise concerns about new patterns of vehicle fire toxic gas emissions. This study aimed to describe toxicologic components in a recent material of fatal car crashes on Swedish roads in which the vehicle caught fire and compare the results to a previous material. Methods: Retrospective registry study. All fatal car crashes with fire in Sweden 2009–2018 were extracted from the Swedish Transport Administration’s In-Depth Studies Database and compared with an earlier study of the time period 1998–2008. Results: A total of 79 crashes and 94 fatalities were included. Carbon monoxide (COHb) blood levels >10% were found in 13 cases. Hydrogen cyanide (HCN) blood levels 0.1–1.7 µg/g were found in 10 cases. In 29 of the cases the person had a blood alcohol level (BAC) >0.2‰, which is the legal driving limit in Sweden. A total of 15 people died due to burn injuries and 2 individuals died due to toxic gas emissions without any other fatal traumatic injury. Total number of deaths in fire-related crashes halved from 181 (1998–2008) to 94 (2009–2018) but the percentage of fatalities in burning vehicles was unaltered (5% vs. 6%). The proportion of fatalities with HCN in the blood increased from 2% between 1998–2008 to 10% during 2009–2018 (p = 0.006). The age of the car involved in a crash increased by 0.26 years per calendar year (p = 0.001). Conclusions: The proportion of fatalities with measured levels of HCN in the blood has increased. Eleven of the 15 burn injury fatalities had high levels of alcohol, HCN, or COHb, possibly contributing to an inability to leave a burning vehicle. Faster rescue brought by improved specific education and training of ambulance and rescue services personnel may be of future importance, as may on-scene antidote administration and revised regulations of vehicle flammability.

A Comparative Study of Intravital CT and Autopsy Findings in Fatal Traumatic Injuries.

Objectives: Traumatic injuries are one of the severe health problems of our time. In the 21st Century, approximately 4.5 million people worldwide die each year due to trauma. Computed tomography (CT) is widely used to diagnose injuries and offers information on the specific location and extent of organ and tissue damage. In cases of severe trauma, whole-body CT is increasingly used as a standard diagnostic technique. An autopsy is the final diagnostic examination and is still considered the gold standard in diagnostic methods in medicine. The aim of the study was to assess the reliability and accuracy of CT scan results, as well as limits in detecting trauma for forensic purposes. It aims to compare traumatic findings in the antemortem CT results to those observed at autopsy. Materials and Methods: We conducted a retrospective–prospective study involving 510 deaths due to trauma. We compared selected traumatic changes in the antemortem CT scan results with the autopsy findings. We obtained data with a detailed analysis of autopsy protocols, photographic documentation from the autopsies, and the interpretation of CT scans from medical documentation. In cases of discrepancies in the findings, we borrowed CT scans, which were repeatedly reviewed by clinical radiologists. Results: By comparing the findings of selected injuries detected by antemortem CT and autopsy, we found a correlation of findings in 75.3% and a discrepancy of findings in 24.7% in a set of 510 cases. After repeated targeted assessment of CT images by clinical radiologists in cases of discrepancies in the findings, which were detected by autopsy and undescribed by CT, the discrepancy decreased to 17%. Conclusions: The results of the study are comparable with data from many studies and professional publications. They show that CT compared to autopsy is a good method for diagnosing gunshot wounds to the head and bone fractures, with a limited diagnosis of cranial base fractures, while an autopsy is better for detecting minor injuries to organs and soft tissues.

Safe at Home: A Quasi-Experimental Evaluation of a Municipal Intervention to Prevent Falls among Low-Income Elderly.

Falls are the leading cause of fatal traumatic injury among people over 65 and the rate continues to increase. We evaluated a recently implemented municipal program providing no-cost baseline and follow-up home assessment and home modifications to reduce fall hazards among low-income elderly or disabled residents. Program participants received writ ten invitations to return informed consent for phone interviews that included process and outcome evaluation. Data analysis used repeat measures ANOVA and non parametric Wilcoxon signed rank tests. During its first year, the program served 230 elderly or disabled low-income residents. Among 51 participants interviewed an average of 281 days after home modification, fear of falling was reduced, and annualized rate of falls decreased from an average of 0.92 (SD = 1.6) per person per year to 0.24 (SD = .74) (p<.001). Home assessments and modest infrastructure improvements significantly reduced falls in a non-research, municipal setting.

Diagnosis and management of laryngeal fracture: a case report

<p class="abstract">Laryngeal fracture is a rare and potentially fatal traumatic injury. Because of the rarity of this type of injury, many laryngeal fractures are often undiagnosed or poorly managed, leading to significant problems with airway patency, voice production, and swallowing. We report a case of a 49 year old man admitted to the emergency room after a motor cycle accident with cervical trauma. The patient presented with hoarseness, anterior neck pain, cervical subcutaneous emphysema, and increasing respiratory distress that led to the tracheostomy of the patient. The computed tomography (CT) of the neck revealed a comminuted fracture of the thyroid cartilage, a hematoma of the left piriform sinus and cervical subcutaneous emphysema. The three-dimensional CT showed a double fracture of thyroid cartilage with displaced intermediate fragment. The patient underwent an open reduction and internal fixation of the thyroid cartilage with miniplates along with laryngeal stenting. He has no significant swallowing or breathing problem and reasonably good voice 6 months after surgery. We conclude that early diagnosis and appropriate therapy favorably alters the prognosis in terms of long-term voice and airway outcome.</p>

The epidemiology of Scottish trauma: A comparison of pre-hospital and in-hospital deaths, 2000 to 2011

AimsTo characterise the temporal trends and urban-rural distribution of fatal injuries in Scotland through the analysis of mortality data collected by the National Records of Scotland. MethodsThe prospectively collected NRS database was queried using ICD-10 codes for all Scottish trauma deaths during the period 2000 to 2011. Patients were divided into pre-hospital and in-hospital groups depending on the location of death. Incidence was plotted against time and linear regression was used to identify temporal trends. ResultsA total of 13,100 deaths were analysed. There were 4755 (36.3%) patients in the pre-hospital group with a median age (IQR) of 42 (28–58) years. The predominant cause of pre-hospital death related to vehicular injury (27.8%), which had a decreasing trend over the study period (p = 0.004). In-hospital, patients had a median age of 80 (58–88) years and the majority (67.0%) of deaths occurred following a fall on the level. This trend was shown to increase over the decade of study (p = 0.020). In addition, the incidence of urban incidents remained static, but the rate of rural fatal trauma decreased (p < 0.001). ConclusionsAround a third of Scottish trauma patients die prior to hospital admission and the predominant mechanism of injury is due to road traffic accidents. This contrasts with in-hospital deaths, which are mainly observed in elderly patients following a fall from standing height. Further research is required to determine the preventability of fatal traumatic injury in Scotland.

Line of duty deaths among U.S. firefighters: an analysis of fatality investigations

Firefighting is a high hazard occupation. In the U.S. alone, over 100 firefighters die in the line-of-duty each year and over 80 000 are injured. In this presentation, we summarise...

Tendencias temporales de las lesiones mortales (traumáticas) por accidente de trabajo en España (1992-2002)

Objective To describe time trends in fatal traumatic occupational injuries by economic activity, type of contract, age, and gender between 1992 and 2002 in Spain. Methods The number of fatal traumatic occupational injuries occurring during the study period in salaried workers was 8,510. The annual percentage of change in fatal occupational injury rates was calculated by economic activity, type of employment, age group, and gender assuming a Poisson distribution. The incidence in 2002 was standardized by economic activity to adjust for the potential effect of changes in the labor market from 1992. Economic activities were regrouped according to their percentages of change in employees during the study period. Results The incidence of fatal traumatic injuries decreased by an annual percentage of –4.3% (95% CI, –5.3 to –3.4%) from a rate of 9.8 per 100,000 in 1992 to 6.1 in 2002, representing an overall reduction of 38% (relative risk = 0.62), particularly in expanding employment industries (–4.4%), women (–7.6%) and permanent employment (–4.3%). In 2002 the incidence was 8.5 after adjusting by economic activity in 1992 (adjusted relative risk = 0.87). Conclusions The decreasing trend observed in fatal occupational injuries is similar to that observed in other developed countries. At least two thirds of this decrease can be explained by changes in productive structures. The results indicate the areas in which preventive activities should be concentrated.

The Epidemiology of Serious and Fatal Injury in San Diego County Over an 11-Year Period

Analysis of the mechanism and severity of injury over time may permit a more focused planning of acute care and trauma prevention programs. A retrospective, population-based study examining severe traumatic injury in a single county was undertaken. Three overlapping data sets were used to form a composite injury data set. There were 55,664 patients included in the study. A total of 40,897 (73.5%) patients survived and 14,767 (26.5%) died. Of those patients who died, 8,910 (60.3%) died in the field and were not transported to a trauma center. There was an increase in the mean age of all trauma victims (3 years) and an increase of 5 years in fatally injured patients. The mean Injury Severity Score decreased from 14.7 to 11.6 (p < 0.01); however, Injury Severity Score for fatal patients remained constant (39.7). The overall injury rate remained unchanged (195 per 10(5)), whereas the fatal injury rate decreased by 22% (45.9 per 10(5)) over the 11-year study period. The leading cause of injury was motor vehicle crash, followed by assault. The leading cause of fatal injury was suicide, followed by homicide. A combination of three independent injury data sources generated a composite data set of serious and fatal injury. This regional injury analysis was the most comprehensive overview of injury in our region. Important observations included the following: there has been no change in the overall incidence of severe injury within our county; the incidence of fatal traumatic injury has significantly decreased; the leading causes of nonfatal injury do not correlate with the rank order of fatal injury; intentional injury was the leading cause of injury deaths; and scene fatalities represent a poorly studied group of patients who may benefit from primary prevention and injury control research.

The CT appearance of aortic transection.

Aortic transection is a frequently fatal traumatic injury. Patients who survive the initial event require rapid diagnosis and treatment. To this end, enhanced CT of the chest has been used to detect both mediastinal hematoma and direct vessel injury [1-6]. This essay shows the CT features associated with aortic transection, particularly the direct signs.