Risk Factors For Fatal Injury Research Articles

Evaluating the effect of drunk driving on fatal injuries among vulnerable road users in Taiwan: a population-based study

BackgroundMost studies have focused on injuries sustained by intoxicated drivers themselves, but few have examined the effect of drunk driving on injury outcomes among VRUs (vulnerable road users) in developing countries. This study aims to evaluate the effect of drunk driving on fatal injuries among VRUs (pedestrians, cyclists, or motorcyclists).MethodsThe data were extracted from the National Taiwan Traffic Crash Dataset from January 1, 2011, to December 31, 2019. Crashes involving one motorized vehicle and one VRU were considered. This study examines the effect of drunk driving by estimating multivariate logistic regression models of fatal injuries among VRUs after controlling for other variables.ResultsAmong 1,416,168 casualties, the fatality rate of VRUs involved in drunk driving was higher than that of general road users (2.1% vs. 0.6%). Drunk driving was a significant risk factor for fatal injuries among VRUs. Other risk factors for fatal injuries among VRUs included VRU age ≥ 65 years (adjusted odds ratio [AOR]: 5.24, 95% confidence interval [CI]: 5.53–6.07), a nighttime accident (AOR: 4.52, 95% CI: 4.22–4.84), and being hit by a heavy-duty vehicle (AOR: 2.83, 95% CI: 2.26–3.55). Subgroup analyses revealed a linear relationship between driver blood alcohol concentration (BAC) and the risk of fatal injury among motorcyclists. Motorcyclists exhibited the highest fatality rate when they had a BAC ≤ 0.03% (AOR: 3.54, 95% CI: 3.08–4.08).ConclusionDrunk driving was associated with a higher risk of fatality for all VRUs. The risk of fatal injury among motorcyclists was linearly related to the BAC of the drunk drivers. Injuries were more severe for intoxicated motorcyclists, even those with BAC ≤ 0.03%, which is within the legal limit.

Characteristics and Outcomes of Shared Bicycle-Related Injuries from a Large Emergency Medical Centre in China, 2017-2021.

Objective The aim of this study is to investigate the characteristics and outcomes of shared bicycle-related injuries from a large emergency medical centre in China in five years from January 2017 to December 2021. Methods This study was conducted by reviewing the electronic medical record database of a large hospital in China for cases of shared bicycle-related injuries in five years from January 2017 to December 2021. The collected information included demographic data, injury characteristics, and outcomes. Multivariate logistic regression analysis was used to identify risk factors for fatal injury among victims. Results Most shared bicycle-related injuries occurred in male (60.50%), aged 18–35 (38.81%). Company employees (29.28%) were the majority of victims of shared bicycle-related injuries. Riding in a motor vehicle lane was the most common unsafe riding behaviour (26.52%). The lower limb was the most frequently injured body region (25.28%). Bruising (28.73%) was the most commonly diagnosed injury type. The fatality rate was 9.53%, 72.24% of victims recovered well without permanent disability, and 18.23% of victims had permanent disabilities. The length of hospital stay of most of the victims (67.54%) was less than 7 days, and the hospitalization cost of most of the victims (51.93%) was less than 20,000 Yuan. Riding in a motor vehicle lane, running red lights, and cycling against traffic flow are risk factors for fatal injury. Conclusions This study indicated that shared bicycle-related injuries make up a sizeable proportion of injuries presenting to the emergency department and with diverse injury characteristics and outcomes. The findings reflect that shared bicycle-related injury has become a public health problem. Therefore, it is necessary to establish injury prevention strategies for the safety of shared bicycle users.

Effect of Distance to Trauma Centre, Trauma Centre Level, and Trauma Centre Region on Fatal Injuries among Motorcyclists in Taiwan.

Background: Studies have suggested that trauma centre-related risk factors, such as distance to the nearest trauma hospital, are strong predictors of fatal injuries among motorists. Few studies have used a national dataset to study the effect of trauma centre-related risk factors on fatal injuries among motorists and motorcyclists in a country where traffic is dominated by motorcycles. This study investigated the effect of distance from the nearest trauma hospital on fatal injuries from two-vehicle crashes in Taiwan from 2017 to 2019. Methods: A crash dataset and hospital location dataset were combined. The crash dataset was extracted from the National Taiwan Traffic Crash Dataset from 1 January 2017 through 31 December 2019. The primary exposure in this study was distance to the nearest trauma hospital. This study performed a multiple logistic regression to calculate the adjusted odds ratios (AORs) for fatal injuries. Results: The multivariate logistic regression models indicated that motorcyclists involved in crashes located ≥5 km from the nearest trauma hospital and in Eastern Taiwan were approximately five times more likely to sustain fatal injuries (AOR = 5.26; 95% CI: 3.69–7.49). Conclusions: Distance to, level of, and region of the nearest trauma centre are critical risk factors for fatal injuries among motorcyclists but not motorists. To reduce the mortality rate of trauma cases among motorcyclists, interventions should focus on improving access to trauma hospitals.

Fatal Injuries in the Slums of Nairobi and their Risk Factors: Results from a Matched Case-Control Study

Injuries contribute significantly to the rising morbidity and mortality attributable to non-communicable diseases in the developing world. Unfortunately, active injury surveillance is lacking in many developing countries, including Kenya. This study aims to describe and identify causes of and risk factors for fatal injuries in two slums in Nairobi city using a demographic surveillance system framework. The causes of death are determined using verbal autopsies. We used a nested case-control study design with all deaths from injuries between 2003 and 2005 as cases. Two controls were randomly selected from the non-injury deaths over the same period and individually matched to each case on age and sex. We used conditional logistic regression modeling to identity individual- and community-level factors associated with fatal injuries. Intentional injuries accounted for about 51% and unintentional injuries accounted for 49% of all injuries. Homicides accounted for 91% of intentional injuries and 47% of all injury-related deaths. Firearms (23%) and road traffic crashes (22%) were the leading single causes of deaths due to injuries. About 15% of injuries were due to substance intoxication, particularly alcohol, which in this community comes from illicit brews and is at times contaminated with methanol. Results suggest that in the pervasively unsafe and insecure environment that characterizes the urban slums, ethnicity, residence, and area level factors contribute significantly to the risk of injury-related mortality.

A comparison of survival models for assessing risk of racehorse fatality

Survival analysis was used to assess risk factors for fatal injuries on UK racecourses. This allowed assessment of variation due to temporal horse-level effects, including previous racing intensity and historical distribution of race types, as well as race-level factors. Comparisons were made between measuring survival time as number of days and as number of races to injury from the first race. Two related models were presented for time as number of races to injury: a Cox regression model fitted using partial likelihood, with the Efron approximation to handling ties, and a discrete-time logit model fitted using maximum likelihood. The latter approach had the advantages of being computationally more efficient and enabling the testing of different functional forms for the dependence of hazard on time. Retrospective data were available from all race starts on the 59 courses in Britain from 1990 to the end of 1999, as analysed by Wood et al. (2000, 2001). The analysis was conducted on the data for the 47,424 horses that had started racing in the UK: 538,895 starts with 1228 fatal injuries. Horses starting racing abroad were excluded, but some included horses would have raced abroad at some stage during their racing career. The results for the selected models were broadly consistent with each other and with previously published studies. Steeplechase and hurdle races had a higher risk of fatal injury than flat races (relative hazards 1.5 and 1.7, respectively). Risk increased with the firmness of surface, age and race distance (reaching a plateau at 20 furlongs) and decreased with previous racing intensity (reaching a plateau after seven races run in the last 12 months). Horses running their first race of a new type were also found to be at higher risk (relative hazard 1.5). The main difference between the models for time as number of days and number of races concerned the role of age: age at race was identified as the more important factor in the latter model, whereas, age at first race was more significant in the former model.

Case-control study of risk factors for fatal and non-fatal injury in crashes of rotary-wing aircraft

Introduction There have been few studies of the risk factors for fatal injury in air crashes of rotary-wing aircraft, and none of risk factors for all serious injury (fatal and non-fatal) in these aircraft. The aim of the study was to identify the potentially modifiable risk factors for injury in civil rotary-wing aircraft crashes in New Zealand. Method We analyzed records from all reported civil rotary-wing aircraft crashes in New Zealand between 1988 and 1994. Air crash data from the official databases were merged with nationwide injury records and information obtained from Coroner's files. Crashes where the pilot-in-command was fatally injured were compared with crashes where the pilot-in-command was not fatally injured on 50 variables, covering pilot, aircraft, environmental, and operational characteristics. A second analysis compared crashes where the pilot-in-command was seriously injured (either fatally or non-fatally) with crashes where the pilot-in-command was not hospitalized with an injury. A series of multivariate logistic regression analyses were conducted to estimate the odds associated with each of the factors identified by the univariate analyses. Results The most significant risk factors for all serious injury were: (a) not obtaining a weather briefing, (b) off-airport location of the crash site, (c) flights carried out for air transport purposes, and (d) non-solo flights. Other risk factors, significant for fatal injury only, included post-crash fire and the nature of the crash terrain. Factors within the control of the pilot, environmental, and flight characteristics are the key determinants of the injury outcome of civil rotary-wing aircraft crashes.

Fatal occupational injuries in the New Jersey construction industry, 1983 to 1989.

Work in the construction industry involves about a threefold increased risk of fatal injury compared with all industries combined. The purpose of this study was to identify potential risk factors for fatal injury in the construction industry in New Jersey. Multiple data sources including death certificates, medical examiner reports, Occupational Safety and Health fatality files, and Workers' Compensation reports were used to identify 200 construction-related fatalities in New Jersey during the years 1983 to 1989. All deaths were in men. The death rate was 14.5 per 100,000 employed person-years over the study period. Death rates tended to diminish with increasing age after 34 until age 65 when the death rate was the highest (27.7). Death rates were higher for Hispanics (34.8) and African-Americans (24) than whites (10.6). Ironworkers and roofers had highest rates (109.0 and 56.2, respectively) among specific occupational groups within the construction industry. The leading cause of death was falls (46%). These data suggest that intervention efforts directed toward workers at heights is needed. Further research is warranted to elucidate the factors contributing to the elevated fatality rate of workers over age 65, and to Hispanic and African-American workers.