Non-fatal Road Traffic Accidents Research Articles

Trauma Outcomes in Pediatric Nonfatal Road Traffic Accidents.

By 2025, road traffic injuries are projected to rank third in the global burden of disease, posing a significant challenge that affects health, social well-being, and economic aspects. According to data from the Romanian Police National Statistics Center, there have been an average of 342 traffic accidents per year involving pediatric patients over the past 10 years. A retrospective research study was conducted, encompassing 358 cases of road traffic accidents identified for the study, with data collected over a span of eight years, and with the aim of analyzing the types of injury and treatment methods in relation to age and sex, while also focusing on the duration of hospitalization and the occurrence of complications. An oscillating trend is observed from 2015 to 2020, with its lowest value recorded in 2017 at around 6.8% and its peak in 2019 at 20.1%. Notably, post-pandemic (COVID-19), the cases underwent a substantial decline of approximately 60%. At least 78.7% of those who did not undergo orthopedic reduction required surgery, whereas among those who underwent orthopedic reduction, only 23.4% needed surgery. Regarding the frequency of complications 17.3% of the total cases experienced complications. According to our findings, age has a significant effect on the type of accident (p < 0.05). Complications occurred in 17.3% of patients, most commonly surgical (24 cases, 38.7%), orthopedic (17 cases, 27.4%), and neurological (15 cases, 24.2%).

A Community-based Epidemiological Study on non-fatal Road Traffic Accidents in Puducherry, South India

Introduction: Road traffic accidents are the sixth leading cause of death in India with a greater share of hospitalization, disabilities, deaths and socio-economic losses. Objective: To identify the pattern of non-fatal road traffic accidents, socio-demographic profile of accident victims and antecedent factors influencing these road traffic injuries. Method: A cross-sectional study was conducted for six months in Puducherry. From existing 27 wards of Lawspet, six wards were selected by simple random sampling technique and all the households in selected wards were included. The minimum required sample size was estimated to be 165 by considering prevalence of non-fatal road traffic accidents in Puducherry as 5.6%. Face-to-face interview with a semi-structured questionnaire was used for data collection. Data entry and analysis were performed using Epi-data manager 4.2.0. Results: Total 169 accident victims were included in the study from the households of selected wards. Mean age of the accident victims was found to be 36.2 (11.4) years. Two‑wheeler accidents accounted for 144 (85.2%) and 123 (72.7%) accident victims were drivers at the time of accident. Majority (95.1 %) of the victims did not wear helmet while driving two-wheelers and none of the four-wheel drivers/pillions wore seat belts. Majority of the accidents occurred on usual tar roads 116 (68.6%) and 42 (24.9%) on highways. 102 (60.4%) accidents occurred in bi-directional roads.Conclusion: Simple or minor injuries were high compared to serious injuries requiring hospitalization. Majority of the accidents occurred during Fridays, Saturdays and Sundays. The accidents exhibited a bimodal distribution with day and night time.

Evaluation of results of minimally invasive plating Osteosynthesis (MIPO) technique in the treatment of fractures of distal tibia

Background: Fractures are the commonest injury among the victims of non-fatal road traffic accidents, and it commonly involves the bones of the lower extremity. This can be due to the interplay of gravitational force and velocity of the vehicle at the time of accidents. Tibial fractures are the most common type of long bone fractures and are the most common open fractures. Based on the fracture location in the bone, distal tibia fractures have the second highest incidence of all tibia fractures. The relatively tenuous blood supply, subcutaneous location of the tibia, mechanism of injury, and use of certain treatment methods contribute to a relatively high incidence of post traumatic complications following tibia fractures. These complex open fractures which are produced by high energy forces, threaten to pose a challenge to orthopaedic surgeons. Considerable advances in the methods and concepts of internal fixation along with newer innovations in implants help to meet such challenging tasks.Aim: To evaluate the efficacy, functional and radiological outcome of distal third tibia fractures managed by minimally invasive plate osteosynthesis.Methods: This is a prospective study, period from December 2019 to May 2021, and a minimum of 30 cases with fractures of distal tibia were attended in the casualty and OPD and were admitted in this hospital and were evaluated clinically and radio graphically.Results: All fractures healed without the need of any secondary procedures. There was no noticeable mal- alignment or non-union. Functional outcome was good to excellent in all patients. Average time to bony union was 24 weeks.Conclusions: From our study it is further proved that the effectiveness of minimally invasive plate osteosynthesis is a good and safe technique for treatment of distal tibial fractures without intra- articular comminution providing fracture healing, rapid functional recovery, along with avoidance of major complications.

Forensic evaluation of cervical spine distortion injuries in non-fatal road traffic accidents: An observational study

Background. The study relevance is substantiated by the growing numbers of road vehicles and cervical spine traumas occurring among all spinal injuries. Currently, there is no common vision of the cervical trauma pathogenesis, diagnostic algorithm or treatment, which stipulates difficulties in the forensic evaluation of soft tissue injuries of the neck, especially combined with the head or spine traumas around neck, as well as certain diseases.Objectives. A study of the incidence of cervical spine distortion injuries and their clinical and forensic assessment for severity to human health.Methods. A retrospective selective single-stage trial and analysis of 32 forensic medical reports on road accident and physical injury administrative cases in 2017 (single year) have been conducted. Normally distributed data are presented as mean (M), standard deviation (SD) and percent shares. The significance of inter-share variation was estimated with Student’s t-test.Results. Cervical spine distortion injuries more frequently associated with traumas to drivers than passengers inside the salon (81.2%), especially in passenger vehicles, with front-seat travellers inflicted most often (60.0%). Cases of independent pathology were very rare. The most common were combinations with soft tissue injuries, combined blunt trauma to the head, torso and limbs, with craniocerebral or maxillofacial trauma. Cervical osteochondrosis was revealed in 18% cases. Primary diagnosis predominantly grounded on complaints and history (67%), with only 12% cases using a comprehensive neurological examination or instrumental methods. The severity was assessed in the context of concomitant injuries. Acute and moderate severity had equal rates of 6.2%, light severity — 37.5%, no damage — 9.3%. Non-qualified remained 39.8% cases due to a lack of full clinical and instrumental examination (66.7%) or the victim’s failure to appear (13.3%); 20% cases were expert-reported as uncertain for trauma circumstances and mechanism.Conclusion. Further research and systematisation of the data accumulated are necessary. The following clinical and forensic evaluation, as well as statistical analyses will facilitate common diagnostic and severity assessment algorithms to develop for mechanical soft tissue and ligament injuries of the cervical spine.

Trauma outcomes in nonfatal road traffic accidents: a Portuguese medico-legal approach

The objective of this study was to compare the outcomes of nonfatal road traffic accidents by the victims’ age group and sex. We used the Portuguese medico-legal rules for personal injury assessment, in the scope of the Civil Law in that country, which includes a three-dimensional methodology. This was a retrospective study including 667 victims of road traffic accidents aged 3–94 years old. Their final medico-legal reports all used the Portuguese methodology for personal injury assessment. Outcomes were analysed by the victims’ age group (children, working-age adults, and older people) and sex. Road traffic accidents were generally serious (ISS mean 9.5), with higher severity in children and older people. The most frequent body sequelae were musculoskeletal (64.8%), which were associated with functional and situational outcomes. Temporary damage resulted in an average length of impairment of daily life of 199.6 days, 171.7 days to return to work, and an average degree of quantum doloris (non-economic damage related to physical and psychological harm) of 3.7/7. The average permanent damage was 7.3/100 points for Permanent Functional Deficit, 0.43/3 for Permanent Professional Repercussion, 2/7 for Permanent Aesthetic Damage, 3.9/7 for Permanent Repercussion on Sexual Activity and 3.2/7 for Permanent Repercussion on Sport and Leisure Activities. Overall, 19% of people became permanently dependent (10.6% needed third-party assistance). The medico-legal methodology used, considering victims’ real-life situation, allows a comprehensive assessment. There were several significant differences among the three age groups but none between sexes. These differences and the impact of the more severe cases justify further detailed medico-legal studies in these specific situations on children, older people, and severely injured victims. Key points: This was a retrospective study of accident mechanisms and injury outcomes in Portugal, and considered the outcomes in the victims’ real-life situation. Lesions from road traffic accidents were generally serious, with higher severity among children and older people. The most frequent sequels were musculoskeletal, and associated with functional and situational outcomes. Both temporary and permanent outcomes had repercussions for the victims. There were significant differences between children, working-age adults and older people, but none between sexes.

Characteristics of lower limb injuries in non-fatal road traffic accidents: a retrospective analysis of forensic medical examinations

Background. Fractures of the lower limbs are one of the most common injuries in road traffic accidents, however, the frequency and localization of fractures, as well as associated trauma, are not well understood. The purpose of the study was to conduct a retrospective analysis of forensic medical examinations of victims with the road traffic injuries of the lower limbs. Results. The research material was 100 reports of forensic medical examinations of victims with fractures of the femur and/or shin bones resulting from a non-fatal road traffic accidents. The study found that the average age of the victims was 41.5 ± 18.8 years (18 - 81 years). The main contingent of those injured was pedestrians (82%). In victims, the most common injury was polytrauma; closed limb fractures were more common. Hip fractures of various localization were found in 39%, shin fractures - in 59%, ankle fractures - in 12%. Closed head injury with a concussion of the brain of a mild degree (23%), closed fractures of the ribs (3%), self-healing dislocation of the humerus (1%), diaphyseal fractures of the forearm (3%), distal radial bone fractures (7%), and fractures of styloid process of the ulna (2%) were also noted. Conclusions. The main victims of road traffic accidents are pedestrians with polytrauma. The most common localization of fractures of the lower extremities is the diaphysis of the femur and the diaphysis of the shin bones.

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.

Value of a QALY and VSI estimated with the chained approach.

The value of a quality-adjusted life-year (QALY) and the value of a statistical injury (VSI) are important measures within health economics and transport economics. Several studies have, therefore, estimated people's willingness to pay (WTP) for these estimates, but most results show scale insensitivity. The 'original' chained approach (CA) is a method developed to mitigate this problem by combining the contingent valuation (CV) with standard gamble (SG). In contrast to the version of the CA applied by the previous research of the WTP for a QALY, the original version allows the value of major health gains to be estimated without having the respondents express their WTP directly. The objective of this study was to estimate the value of a QALY and VSI in the context of non-fatal road traffic accidents using the original CA to test if the approach, applied to a wide range of health gains, is able to derive valid estimates and a constant value of a QALY which the previous research has not been able to show. Data were collected from a total of 800 individuals in the Swedish adult general population using two web-based questionnaires. The values of a QALY based on trimmed estimates were close to constant at €300,000 irrespective of the size of the QALY gain. The study shows that the original CA method may be a valid method to estimate the value of a QALY and VSI for major health losses. It also supports the use of a higher threshold value for a QALY than that which is currently applied by several health technology assessment agencies in different countries.

A Survey of Non-Fatal Road Traffic Accidents in Babol, Northern Iran

Background: Every year, millions of people die or are injured due to road traffic accidents worldwide. Investigating the epidemiology of these accidents could help reduce their frequency. Objectives: This study aimed to evaluate the epidemiological characteristics of non-fatal traffic accidents in Babol, northern Iran, over a seven-year period. Methods: Between 2010 and 2016, all of the orthopedic patients with road traffic accidents hospitalized at Shahid Beheshti hospital of Babol were enrolled in this cross-sectional study. The patients’ information, including details of the accidents and demographic characteristics, was collected using predesigned checklists. Results: The majority of 3649 subjects (2748, 75.3%) were male. The age range was from 1 to 86 years old, with an average of 30.5±15.4 years. Traffic accidents were mostly seen in the age group of 19 - 40 years (58.7%) and in those who were drivers (52.7%). The accidents were highest in 2016 (19.9%), and on interurban roads (32.9%), on sunny days (73.4%), asphalt roads (74.3%), and in the morning (42.8%). November (12.7%) was associated with the highest monthly rate, followed by August (11.9%) and March (11.2%). Fractures were observed mostly in the leg (n = 960), followed by the forearm (n = 773). Conclusions: The results showed that road traffic accidents have increased in recent years. It is recommended to improve the traffic safety with the improvement of the geometric design of the roads, especially in roads with a high probability of accident risk.

A Prospective Study of the Correlation between Non-Fatal Road Traffic Accidents and Age of Victims

A Prospective Study of the Correlation between Non-Fatal Road Traffic Accidents and Age of Victims

Risk Factors Affecting Fatal versus Non-Fatal Road Traffic Accidents: The Case of Kars Province, Turkey

The aim of this paper is to determine risk factors affecting the fatal versus non-fatal accidents in a rural region of Turkey, during 2008-2012, considering variables associated with the individual, the environment, and the motor vehicle. A retrospective study was conducted by obtaining the data from the traffic police road accident reports between 2008 and 2012. A stepwise logistic regression analysis was performed to analyze the data and critical factors that contributed significantly to fatal versus non-fatal traffic accidents. The results revealed that the driver’s age (OR = 1.09; 90% CI = 1.05 – 1.14), clear weather (OR = 0.11; 90% CI = 0.02 – 0.65), winter season (OR = 0.16; 90% CI = 0.03 – 0.75), straight (OR = 0.22; 90% CI = 0.05 – 0.91) or slight road curve/bend (OR = 0.17; 90% CI = 0.04 – 0.83), the driver’s education (OR = 0.18; 90% CI = 0.04 – 0.85) and the purpose of the vehicle (OR = 0.20; 90% CI = 0.04 – 0.94) were the significant factors affecting road traffic accidents over the sample period.

Road Traffic Injuries Involving Illegal Blood Alcohol Levels and Psychoactive Drug Use in Côte d’Ivoire: A Hospital-based Study

In Côte d’Ivoire alcohol and drugs consumption in the general population is a serious issue. However, their role in Road Traffic Accidents (RTAs) has never been investigated. Our study aimed to estimate the prevalence of alcohol-impaired road users at the time of the RTA and report psychoactive drug use, in various categories of casualties, and in various circumstances of the crash. We conducted a cross-sectional study including 893 casualties involved in fatal or non-fatal RTAs and admitted at the Emergency Room or the Forensic Institute from March to September 2012. Blood alcohol dosage (BAC) and urine drug screening were carried out, and results were linked with hospital and police crash report data. The mean BAC in positive cases indicated heavy drinking before the crash: drivers (1.9 g/L), pedestrians (2.1 g/L), passengers (1.5 g/L). The prevalence of alcohol-impairment was significantly higher in drivers (41%) and riders (27%) compared to pedestrians (17%) and passengers (13%). Over 75% of casualties that tested positive for alcohol had a BAC largely above the legal limit. Psychoactive drug use was twice more prevalent in alcohol-impaired drivers than in sober drivers (20% vs 10%). Binge drinking is an emerging issue in African countries, which should be taken into account in the management or prevention of road traffic injuries.

Profile of non-fatal injuries due to road traffic accidents from a industrial town in India

Background:India has one of the highest road traffic accident rates in the world. To lessen this burden, information on the contributing factors is necessary.Materials and Methods:We studied a series of cases of non-fatal road traffic accidents in two tertiary care hospitals in Pimpri, Pune, India. A total of 212 non-fatal road traffic accidents admitted over a period of one year in these two hospitals constituted the study sample. The study variables were, the gender of the accident victims, mode of accident, days of week on which the accident took place, time of day when the injury was sustained, part of the body injured, nature of injury, and self-reported reasons for the accident.Statistical Analysis:data were summarized using percentages. The Chi-square test for goodness of fit was applied, to see whether there was any association between the different weekdays or time of day and the accidents.Results:Male : female ratio was almost 5 : 1, which was statistically significant (Chi-Square for goodness of fit = 95.11, df = 1, P < 0.0001). The maximum accidents occurred on Sundays and Mondays and the least around midweek (Wednesday). This pattern was also statistically significant (Chi-square for goodness of fit = 30.09, df = 6, P < 0.001). Pedestrians were the most vulnerable group, followed by drivers and pillions of two wheelers. These categories of road users contributed to almost 80% of the cases of Road Traffic Injuries (RTIs). Accidents were more likely in the time zone of 8 pm to midnight, followed by 4 pm to 8 pm (Chi-square for goodness of fit = 89.58, df = 5, P < 0.0001). A majority of the patients sustained multiple injuries followed by injuries to the lower limbs. A majority reported impaired visibility and fatigue as the cause of accident. Almost half (46.22%) of the injured admitted to drinking alcohol on a regular basis.Conclusion:Wide pavements and safe zebra crossings should be provided for pedestrians, as the highest casualty in this study were pedestrians. More accidents occurred on Sundays and Mondays and in the late evenings. Extra supervision by traffic police may be considered on Sundays / Holidays and the day following. Roads should be well lit to improve visibility after sunset.

Alcohol, psychoactive substances and non-fatal road traffic accidents - a case-control study

BackgroundThe prevalence of alcohol and other psychoactive substances is high in biological specimens from injured drivers, while the prevalence of these psychoactive substances in samples from drivers in normal traffic is low. The aim of this study was to compare the prevalence of alcohol and psychoactive substances in drivers admitted to hospital for treatment of injuries after road traffic accidents with that in drivers in normal traffic, and calculate risk estimates for the substances, and combinations of substances found in both groups.MethodsInjured drivers were recruited in the hospital emergency department and drivers in normal conditions were taken from the hospital catchment area in roadside tests of moving traffic. Substances found in blood samples from injured drivers and oral fluid samples from drivers in moving traffic were compared using equivalent cut off concentrations, and risk estimates were calculated using logistic regression analyses.ResultsIn 21.9% of the injured drivers, substances were found: most commonly alcohol (11.5%) and stimulants eg. cocaine or amphetamines (9.4%). This compares to 3.2% of drivers in normal traffic where the most commonly found substances were z-hypnotics (0.9%) and benzodiazepines (0.8%). The greatest increase in risk of being injured was for alcohol combined with any other substance (OR: 231.9, 95% CI: 33.3- 1615.4, p < 0.001), for more than three psychoactive substances (OR: 38.9, 95% CI: 8.2- 185.0, p < 0.001) and for alcohol alone (OR: 36.1, 95% CI: 13.2- 98.6, p < 0.001). Single use of non-alcohol substances was not associated with increased accident risk.ConclusionThe prevalence of psychoactive substances was higher among injured drivers than drivers in normal moving traffic. The risk of accident is greatly increased among drivers who tested positive for alcohol, in particular, those who had also ingested one or more psychoactive substances. Various preventive measures should be considered to curb the prevalence of driving under the influence of psychoactive substances as these drivers constitute a significant risk for other road users as well as themselves.

Injury pattern among non-fatal road traffic accident cases: A cross-sectional study in Central India

What is the pattern of injuries among non-fatal cases of road traffic accidents? To study the pattern of injuries among non-fatal cases of road traffic accidents. Cross-sectional study. Nagpur, a city in central India. 423 non-fatal cases of road traffic accidents reporting for treatment to Indira Gandhi Medical College, Nagpur during 1999-2000. Demographic characteristics, accident characteristics. Percentages, proportions, Chi-square test. Out of total 423 subjects, 363 (85.8%) were male while only 60 (14.2%) were female subjects. Majority of the victims (75%) were in the age group 18- 37 years. Sideways collision was the most common type of accident seen in 269 (63.59%) cases. Two wheelers and LMV were the common vehicle being involved in accidents (69.97%) and these accidents were almost equally distributed in both half of the day. Fracture of the bones was the common injury afflicted to the victims followed by multiple injuries like blunt injury, abrasions and lacerations. Lower extremity was involved in 192 (45.39%) cases while multiple sites were affected in 114 (26.95%) cases. In the present study, the fractures were the commonest injury among the victims of non-fatal road traffic accidents.

P1. Non-fatal road traffic accidents in Brescia: comparison of 1988 and 1993

P1. Non-fatal road traffic accidents in Brescia: comparison of 1988 and 1993