Non-fatal Accidents Research Articles

New approaches for predicting outcomes in patients with atrial fibrillation

Aim:we aimed to assess the capabilities of “machine learning” methods in predicting remote outcomes in patients with non-valvular atrial fi brillation (AF).Methods.From 2015 to 2016 234 patients with non-valvular AF were included in the study (median age 72 (65; 79) years; 50.0% men). During the median follow-up of 2.9 (2.7; 3.2) years 42 patients died, 9 patients had non-fatal acute cerebral circulatory disorders and 3 patients had non-fatal myocardial infarction (MI). These events in 52 subjects (22.2% from all patients included) were combined into a combined endpoint (death and a nonfatal cardiovascular accident at the stage of remote observation). The first 184 patients comprised a “training” group. The next 50 patients formed the “test” group. The following methods of «machine learning» were used in the analysis: classifi cation trees, linear discriminant analysis, the k-nearest neighbor method, support vectors method, neural network.Results.Long-term outcomes were influenced by age, known traditional risk factors for cardiovascular diseases, the presence of these diseases, changes in intracardiac hemodynamics and heart chambers as evaluated by echocardiography, the presence of concomitant anemia, advanced stages of chronic kidney disease, and the administration of drugs associated with a more severe cardiovascular disease progression (amiodarone, digoxin). The best prognosis was created using the model of linear discriminant analysis, the complex neural network model, and the support vector machine.Conclusion.Modern methods aimed at prognosis estimation seem to be of importance in cardiology. These methods include big data analysis and machine learning technologies. The methods require further evaluation and confirmation, and in the future they may allow correcting cardiovascular risks, using data from real clinical practice and evidence-based medicine at the same time.

Abstract 16664: Aortic Valve Calcification is Prognostic for Mild Cognitive Impairment

Introduction: While an association between vascular disease and dementia has been identified, few studies have assessed the longitudinal relationship between aortic valve calcification (AVC) and mild cognitive impairment (MCI). We recently found AVC to be associated with increased atherosclerotic events, and we sought to determine the prognostic value of AVC derived from low dose, lung cancer screening computed tomography (LCSCT) for MCI in a moderate-to-high atherosclerotic risk cohort. Methods: This was a single site, retrospective analysis of 1401 U.S. veterans (65 years [IQI: 61, 68] years; 97% male), who underwent quantification of AVC from LCSCT indicated for smoking history. Exclusion criteria included lung cancer, prior aortic valve replacement and prior MCI diagnosis. The primary outcome was new diagnosis of MCI identified by objective testing (Mini-Mental Status Exam or Montreal Cognitive Assessment) or by ICD coding. Secondary outcome was nonfatal cerebrovascular accident (CVA). Time-to-event analysis was carried out using AVC as a continuous and a categorical variable, and multivariate adjustment included age, diabetes mellitus, glomerular filtration rate <60 mL/min, coronary artery disease, and prior CVA. Results: Over a 5-year follow up, 110 patients (8%) were newly diagnosed with MCI and 45 patients (3%) had CVA. By Cox regression, AVC was predictive of MCI (HR: 1.15 [1.07 -1.24], p<0.001) and the association remained significant after multivariate adjustment (HR: 1.09 [1.01-1.18], p=0.026). Non-zero AVC tertiles were: 0.1-115; 116-427; and ≥428 Agatston Units. AVC was associated with MCI at increasing tertiles, and after multivariate analysis, the association remained significant (HR: 1.89 [1.09-3.28], p=0.024 and HR: 1.80 [1.01-3.20], p=0.047; tertiles 2 and 3, respectively). AVC was also associated with CVA (HR: 1.17 [1.05-1.32], p=0.006); however, the association lost significance after multivariate adjustment (HR: 1.12 [0.99-1.26], p=0.080). Conclusions: To our knowledge, this is the first study demonstrating that quantification of AVC from LCSCT is predictive of MCI. The association may be in part due to atherosclerotic thromboembolic events as there was a trend toward increasing nonfatal CVA in this population.

A Logistic Regression model of Road Traffic Fatalities in Benue State: Implication to Public Health

Road accident fatalities remain one of the major causes of deaths in Nigeria. These accidents sometimes appear to occur at some flashpoints where there are sharp bends or curves, Potholes due to bad roads, and bad sections of the highways. The study aimed to model road traffic fatalities in Benue State with implications for public health. The data used for the study was sourced from the department of the rescue unit, Federal Road Safety Corps, Benue State Command from July 2011-December 2019. To better comprehend the impact of sex on successfully having a non-fatal accident, we employed a logistic regression analysis. The results indicated that for the 3,545 RTAs used in the model, the model correctly predicted whether or not someone will have a fatal accident 81.7% of the time. The results further showed that females have .970 times the odds of not having a fatal accident compared to males with statistically significant value (P =.015, 95% C.I .652, .956). The results also stated that males demonstrated a greater likelihood to be involved in a fatal accident than the female with statistically significant difference (P =.015, 95% C.I .652, .956). The study, therefore concluded that sex or gender is an influential predictor and as such, has a significant effect on the status of an accident. The implication of the results to public health is that people are likely to spend more money on hospital bills with an increased number of disabilities caused as a result of these accidents which may result to a reduction in physical activity in the next decade if the rate of accidents is not controlled.

Accidents during mountain hiking and alpine skiing – epidemiological data from the Austrian Alps

This article presents epidemiological data on traumatic accidents during mountain hiking in the summer season and recreational alpine skiing in the Austrian Alps. In mountain hiking, the absolute number of fatalities remained stable from 2006-2014 (32 to 46 victims per year), whereas the number of non-fatal accidents increased by about 5% per year implying a decreasing mortality index. About 75% of all falls happened during the descent and 70% of the victims who sustained a fall-related injury showed defective vision. Mountain hikers should pay attention to sufficient regeneration before and breaks during descending. Additionally, a regular check of visual aids (glasses, contact lenses) can be recommended. In recreational alpine skiing, the injury rate is estimated to be less than 1 injury per 1000 skier days and the traumatic fatality rate amounts to 0.36 traumatic deaths per million skier days. A tear of the anterior cruciate ligament is the most common diagnosis with about 15-21% of all injuries and the risk is 3 times higher in women than in men. Protective equipment and an appropriate skiing speed, depending on skill level, represent preventive measures to reduce injuries and traumatic deaths. Key Words: Traumatic Accidents,Falls, Injuries, Anterior Cruciate Ligament

Quality of Life in Road Traffic Accident Survivors.

IntroductionThe loss of quality of life is the major consequence following a non-fatal road traffic accident (RTA). Previous research regarding quality of life did not include uninjured RTA survivors. The research aim was thus to evaluate the quality of life of the RTA survivors regardless of whether or not they sustained injures, and to identify factors associated with decreased quality of life after the RTA.MethodsA cohort of 200 RTA survivors with and without injuries was followed after experiencing an RTA. The quality of life and mental health outcomes were assessed 1 month following RTA. A vast range of sociodemographic, pre-RTA health-related, RTA related, RTA injury-related, compensation-related factors and mental health outcomes were investigated.ResultsDecreased quality of life following an RTA showed an association with the low socioeconomic status of the RTA victims, poor pre-RTA health, injury-related factors, compensation-related factors and psychological disorders after the RTA.ConclusionsIdentifying predictors of decreased quality of life following an RTA will enable planning interventions targeting the most important factors that influence recovery of RTA victims. Assessing and recording of self-reported quality of life should be a part of the routine protocol in RTA survivors’ health-care.

Social, cultural and working conditions determinants of fatal and non-fatal occupational accidents in Europe

SUMMARY: The determinants of occupational accidents from a social, cultural and a working condi-tions combined perspective are unveiled considering the level of analysis of the European nation. Fatal and non-fatal work accidents in 2014, collected and provided by Eurostat, are correlated with country by country results of the 7th European Social Survey (ESS) (2014 data). This informs on social deter-minants of work accidents. National Dimensions of Culture proposed by Gert Hofstede are correlated with country by country results of the ESS informing on cultural determinants of the European Social Dimensions reported on the ESS. Moreover, considering data from the 6th European Working Condi-tions Survey (2015 data), working conditions, on a country by country basis as well, are further consid-ered and analyzed from the perspective of fatal and non-fatal accidents and from the perspective of social and cultural dimensions. This multiple pronged study of association unveils interesting associa-tions between fatal and non-fatal work accidents and working conditions, as well as between fatal and non-fatal work accidents and social and cultural dimensions, and, between social and cultural dimen-sions and working conditions, taking the European country as a unit of analysis. The findings shed light on the interconnectedness of the distinct domains under study, as well as informing policy development towards creating tailor made approaches suiting each country reality within the countries encompassed in the analysis.

Burden of Disease Caused by Road Traffic Accidents in the City of Mashhad

Background: Mashhad is the second-largest Iranian megacity with a population of roughly 3 million and receiving around 25 million tourists a year, wherein road traffic accidents (RTAs) have become the leading cause of death and injuries. Objectives: The main purpose of this study was to calculate the burden of disease caused by RTAs in the city of Mashhad. Methods: In this applied research using a descriptive cross-sectional method, data associated with RTAs in the city of Mashhad in March 2016 - March 2017 were collected based on a complete enumeration of RTA-induced fatalities and disabilities from the Organization for Cemetery Management (Ferdows Organization) affiliated to Mashhad Municipality and the database of the Ministry of Health of Iran (MOH). Following verification, the years of life lost (YLL), the number of years lost due to disability (YLD), and the disability-adjusted life years (DALYs) were measured through the method proposed by the World Health Organization (WHO). Results: The total number of RTA deaths was 677 cases (men = 494 (73%) and women = 183 (27%)) and the number of DALYs was 29155 years (men = 21219.3 (72.8%) and women = 7935.1 (27.2%)). Of the total DALYs, 96% of them were associated with YLL, and 4% were related to YLD. Conclusions: Mortality data are recorded with relatively high accuracy in Iran. Given low YLD in DALYs in comparison with the findings of similar studies in developed countries, there are possible defects in data quality, in particular in terms of non-fatal accidents and injuries. These findings can be thus exploited for optimal allocation of resources in Razavi Khorasan Province and across Iran.

Aortic valve calcification predicts all-cause mortality independent of coronary calcification and severe stenosis

Background and aimsCalcific aortic valve disease is highly prevalent in patients with significant smoking history and is a marker of atherosclerosis. The aim of this study was to define the prognostic value of aortic valve calcification (AVC) derived from low dose, lung cancer screening computed tomography (LCSCT) for all-cause mortality in this higher risk population. MethodsThis is a single site, retrospective analysis of 1529 moderate-to-high atherosclerotic cardiovascular risk U.S. veterans (65 years [IQI: 61, 68] years; 96% male), who underwent clinically indicated LCSCT. CTs were scored for aortic valve calcification (AVC) and coronary artery calcification (CAC). The primary endpoint was all-cause mortality and secondary endpoints were nonfatal myocardial infarction (MI) and nonfatal cerebrovascular accident (CVA). ResultsOver 4-year follow-up, 227 patients (15%) died, 112 patients (7%) had nonfatal MI, and 52 patients (3%) had nonfatal CVA. AVC was predictive of all-cause mortality (HR per 100: 1.041 [1.030–1.052], p < 0.001), and this association remained significant after multivariate adjustment for traditional atherosclerotic risk factors, including CAC (1.021 [1.007–1.036], p = 0.003). After excluding patients with severe aortic stenosis (AS) or severe AVC (≥1274 AU in women and ≥2065 AU in men), in a subset of 765 patients who had echocardiograms, this association remained significant after multivariate analysis (HR per 100: 1.052 [1.010–1.095], p = 0.014). Despite controlling for CAC in the models, AVC was still associated with MI (HR per 100: 1.021 [1.004–1.039], p = 0.017) and with CVA (HR per 100: 1.027 [1.002–1.051], p = 0.032). ConclusionsScoring AVC derived from LCSCT is predictive of mortality, nonfatal MI, and nonfatal CVA in patients at known risk for cardiovascular disease, independent of coronary calcification or severe aortic valve stenosis.

The Relationship between General Aviation Pilot Age and Accident Rate

The purpose of this study is to assess the relationship between the number of accidents and pilot’s age. The pilot considered for this study is General Aviation Pilot. Normal distribution of the accidents shows the mean pilot’s age &lt;MEAN age&gt; = 54.60 with S. Dage = 14.38. There is a non-linear relationship between pilot’s age and accident rate and there is a significant difference in accidents across the age intervals F(19, 234) = 9.3116, p &lt; 0.0001. There is no statistical difference in the number of accidents between the interval 40-70 age group. Also, there is statistical difference in the number of accidents above and below 60-year age with respect to event severity and cause of accident (Wiki’s lemma= 0.36, F(26, 160) = 4.00, p &lt; 0.0001). The follow up shows that the number of fatal and non-fatal accidents were statistically different for both above F(2, 92) = 4.58, p &lt; 0.0127 and for below F(2,129) = 7.2, p &lt; 0.0011 while the number of accidents with respect to its causes above 60 are not statistically different but there is statistical difference (F = (5, 126) = 8.74, p &lt; 0.0001) in the number of accidents caused by pilot and caused by technical fault or weather/wind in the age group below 60.

Analysis of Run-Off-Road Accidents by Association Rule Mining and Geographic Information System Techniques on Imbalanced Datasets

Run-off-road (ROR) accidents cause a large proportion of fatalities on roads. Exploring key factors is an effective method to reduce fatalities and improve safety sustainability. However, some limitations exist in current studies: (1) Datasets of ROR accidents have imbalance problems, in which the samples of fatal accidents (FA) are much less than non-fatal accidents (NFA). Data mining methods on such imbalanced datasets make the results biased. (2) Few studies conducted spatial analysis of ROR accidents in visualization. Therefore, this study proposes an association rule mining (ARM)-based framework to analyze ROR accidents on imbalanced datasets. A novel method is proposed to address the imbalance problem and ARM is applied to analyze accident severity. Geographic information system (GIS) is adopted for spatial analysis of ROR accidents. The proposed framework is applied to ROR accidents in Victoria, Australia. Six FA factors and seven NFA factors are identified from two-item rules. The results of three-item rules indicate factors acting interactively increase the likelihood of FA or NFA. Hot spots of ROR accidents are presented by GIS maps. Effective measures are accordingly proposed to improve road safety. Compared with traditional data-balancing methods, the proposed framework has been validated to provide more robust and reliable results on imbalanced datasets.

Developing Concentration Index of Industrial and Occupational Accidents: The Case of European Countries.

BackgroundFrom only frequency rate of industrial accidents, it is difficult to define the industry composition of accident statistics in a nation. This study aims to propose and develop a new index for measuring the degree of concentration of industrial accidents using the concept of the Herfindahl-Hirschman Index in the case of European countries.MethodsUsing the concept of the Herfindahl-Hirschman Index, the concentration index of accidents in the country is developed, and the conditions of European countries are compared using indexes of frequency rate and concentration ratio.ResultsThe frequency rate and concentration ratio of fatal and nonfatal accidents in European countries are compared. According to the economic condition and geographical position, different patterns of accidents concentration are presented in terms of frequency rate and concentration ratio.ConclusionWe develop the concentration index of industrial and occupational accidents that identifies the industrial ratio of accident occurrence, and the differentiated strategy can be formulated such as approaches to reducing frequency and prioritizing target industries.

Circumstances and causes of death of hikers at different altitudes: A retrospective analysis of hiking fatalities from 2003–2018

IntroductionThe number of hikers and the popularity of hiking in the Alpine region is great. Inevitably linked to this, natural deaths as well as fatal and non-fatal accidents occur. Nevertheless, there is little data available on hiking accidents in particular. This study examines the circumstances of accidents and the causes of death of hikers who have suffered fatal accidents. MethodsRetrospectively, the police files and forensic medical reports of hiking fatalities in the Canton of Berne (Switzerland) from 2003 to 2018 were analyzed. In this process 25 predefined parameters were collected (e.g. manner of death, causes of death, height of fall). Subsequently, all fatal hiking accidents were evaluated and compared by altitude (<1800 m vs. >1800 m). Results77 fatal hiking accidents were recorded in the given period, all of which were caused by a fall. Over 1800 m significantly more traumatic brain injuries occurred than under 1800 m (85 vs. 62.2 %, p = 0.022). Besides, significantly more accidents occurred during descent in the group above 1800 m than below 1800 m (60.9 vs. 84.8 %, p = 0.041). A large share of accidents occurred off official hiking trails (45.9 vs. 32.5 %). Significantly more equipment shortages were found in the group below 1800 m (32.4 vs. 12.5 %, p = 0.035). The accident victims with equipment shortages were on average 10.35 years younger. ConclusionCauses and circumstances of death of hikers differ in some points significantly at different altitudes. Prevention in the form of education about the dangers of hiking off the official hiking trails and equipment shortages could prevent deaths in the future. The education should primarily be aimed at foreign, young and inexperienced hikers.

Fatal injury by air gun: a case report

BackgroundThe popularity of air weapons is increasing. They are often viewed as toys, rather than potentially lethal weapons. Regulations on purchase and ownership of air weapons differ from country to country. The majority of fatal and non-fatal air gun accidents involve children less than 16 years of age.Case presentationIn this report, we present a fatal case resulting from an accident involving an air gun. An accident happened between two brothers aged 9 and 7 and was initially considered to be a traumatic wound inflicted by falling on a scooter handle. Upon the arrival of an experienced police inspector, the cause of child’s death was called into question and it was discovered that unlicensed, loaded air gun was left unattended in a backyard shed. It was later established that the cause of death was a fatal gunshot wound to the chest and a pointed lead pellet was found in the boy’s liver.ConclusionsThe public and governments should be advised that air guns can be dangerous weapons which may cause serious injuries and even death. We believe that air guns should be regulated by the same laws that apply to firearms.

Characteristics of Victims of Fall-Related Accidents during Mountain Hiking.

The study evaluated characteristics of non-fatal mountain hiking accidents caused by falls. Questionnaires were sent to mountain hikers who suffered a fall-related accident in Tyrol (Austria) during a 3-year period. The questionnaire included details of socio-demographic data, physical activity, medication intake, defective vision, breaks, fluid intake, level of fatigue, muscle soreness, use of backpacks, use of hiking sticks, and type of shoes. Data of 405 individuals (57% females and 43% males) were included in the analyses. Victims were 56 ± 15 years of age, had a body mass index of 24.8 ± 3.5, and indicated 4.2 ± 3.9 h/week regular physical activity. A defective vision was reported by 70% of the victims, breaks were frequent (in 80%), and alcohol intake was rare (4%) among the interviewed hikers. Subjective level of fatigue was low and only 5% reported muscle soreness. A backpack was carried by 83% of the victims and the average weight was higher in males compared to females. The majority (61%) of the victims wore ankle-height hiking shoes with a profiled sole. Victims of non-fatal falls in mountain hiking are older than the general population of mountain hikers and are often afflicted with defective vision.

The implications of ridehailing for risky driving and road accident injuries and fatalities.

The nature of transportation has fundamentally transformed in recent years with the rise of ridehailing providers such as Uber. Yet, few studies have examined whether there is an association between ridehailing and rates of road accident injuries, and virtually all of the existing studies focus on the exceptional case of the United States. In this study, we exploit differences in the timing of the deployment of Uber across Britain to test the association between the advent of Uber's ridehailing services and rates of fatal and non-fatal road accidents. We find that the deployment of Uber in Great Britain is associated with a marginally significant reduction in the number of serious road accident injuries (e.g., fractures and internal injuries), although not the number of serious accidents. Slight injuries (e.g., sprains and bruises) declined outside of London after the rollout of Uber, but increased within London. We do not observe a statistically significant association between Uber and traffic fatalities. One interpretation for the decline in serious road injuries is that Uber may be a substitute form of transportation for risky drivers, including drink-drivers. However, ridehailing is also a substitute for public transit, particularly buses. The increase in the number of cars on the road may explain why slight injuries increased in London following Uber's rollout.

Evaluation of pile driving accidents in geotechnical engineering

Pile driving accidents that occurred between 1984 and 2018 were selected from the Occupational Safety and Health Administration database, producing 84 cases. To evaluate the causes of accidents, pile driving stages were presented and the potential hazards were discussed. Two models were necessary to link the accidents with workers’ behavior. An accident type model and a workers’ behavior model were developed. The accident type model was related to physical factors leading to accidents, and the workers’ behavior model determined the occupational behavior under the act of the incident. Among fatal accidents, unsafe site conditions had the highest frequency at 26.9%. Among non-fatal accidents, both poor attitudes toward safety and unsafe methods had the highest frequency at 28.1%. Furthermore, a map presenting work-specific accident frequencies in pile driving operations was created. Consequently, project-specific countermeasures should be taken regarding the root causes of accidents, leading to vigorous strategies to develop safety measures.

A cross-sectional study of epidemiological factors related to road traffic accidents in a metropolitan city.

Background:Traffic injuries are one of the major causes of morbidity in India. It involves human sufferings in terms of physical, emotional, and financial losses to the individual, family, and the country. A better insight into the epidemiological determinants will help prevent such injuries.Objectives:To estimate the proportion of fatal and nonfatal accidents and to determine the epidemiological factors related to nonfatal accidents.Methods:It was a cross-sectional study carried out in a tertiary care hospital over a period of 6 months. A simple random sampling technique was used for the selection of sample size of 476. Nonfatal accident victims were interviewed.Results:The proportion of nonfatal to fatal accidents was found to be 1.8:1. Around 72.9% of drivers did not use any safety measure while driving. Two-wheelers (39%) and light motor vehicles (28.3%) were mostly involved, 45% of drivers had speed more than 60 km/h. Obstacles in the road (41%), defective roads (36.5%), and poor street lighting (11.4%) were reported as contributing factors of the accident. Lower extremities and head neck and face were involved in 47.2% and 27.1% of cases, respectively. Around 40.4% of cases had a single-site fracture.Conclusion:Traffic injuries result from the interaction between agent, host, and environmental factors. Preventing these interactions is very well possible with little extra care given towards road safety and traffic behavior of individuals.

The age and gender distribution of patients admitted following nonfatal road traffic accidents in Riyadh: A cross-sectional study.

Introduction:Road traffic accidents (RTAs) are the leading cause of mortality and disability nationally and globally. There is a need to identify the age and gender distribution of individuals involved in nonfatal RTAs.Methods:This was a cross-section study using electronic trauma registry data from King Abdulaziz Medical City. We included all trauma registry patients older than 14 years, who were involved in a nonfatal RTA from 2015 to 2017. The data collected included patient demographic information (age and gender), injury mechanism, injury type, and severity.Results:In total, 1314 patients were included in the analysis. The majority of the sample (88%) was male, with a median age of 25 (interquartile range: 21–35) years. A higher proportion of the male group had severe injury scores. Gender was equally distributed in terms of head-and-neck injuries. The majority (66%) of the sample was admitted in a ward. The female group had a higher proportion (17%) of chest injuries. In terms of age, the 65-year and older group had more severe injuries to the head, neck, and chest.Conclusions:The findings of this study provide updated evidence regarding the age group most frequently involved in nonfatal RTAs. The evidence from this study supports the urgent need for developing prevention programs such as early awareness and education for young drivers and passengers of both genders.

Examination the Influence of Human Factors in Indian Building Construction Sites

This research intends to explore the human factors which lead to non-fatal accidents (i.e. first aid case, near miss, lost time injury) and assessing safety supervision factors in building construction sites. A total of hundred non – fatal accident data is collected for the analysis. Human factors such as age, experience, language, education level and competency of the worker are explored using data analysis method. The root causes for the accidents are also determined and it is found that 22% of the construction site accidents are due to improper supervision. Furthermore a questionnaire survey is conducted among the Safety Engineers, Site Engineers, Supervisors and Workers to elicit the actual happenings about the safety supervision in the site. The questionnaire mainly focused on safety supervision factors and Relative Importance Index (RII) is used to rank the safety factors. As a result, monitoring hoist operation (0.73), moving vehicle (0.72) and checking the stability of scaffolds (0.69) shows higher level of disagreement which means that these factors have been given least priority. In order to measure the strength of relationship between the respondents, Spearman’s Rank Correlation is done. Through the Spearman’s correlation it is known that Safety Engineers vs Supervisors (0.83) and Safety Engineers vs Site Engineers (0.81) has high correlation values which indicates that these respondents have provided similar rankings.

Differentiating between fatal and non-fatal mining accidents using artificial intelligence techniques

ABSTRACT Using statistical methods for categorical data analysis, namely multiple correspondence analysis and Artificial Intelligence through Bayesian networks, we analysed a database of occupational mining accidents for Spain for the period 2004–2017 to identify the factors most associated with the occurrence of fatal and non-fatal accidents. The results obtained allow to shed light on the hidden patterns present in different work situations where accidents can have fatal consequences. In addition, this study exemplifies the application of statistical techniques suitable for Big Data and data-driven decision making in the mining sector.