Road Traffic Accident Patients Research Articles

Magnitude and outcome of road traffic accidents among patients admitted in dessie town governmental hospitals, Northeast Amhara, Ethiopia, 2022

BackgroundRoad traffic accidents(RTA) are a major public health problem worldwide, accounting for almost 1.24 million deaths per year and it is the number one cause of death among those aged group 15–29 years. Even though there are great benefits from access to road transportation there also poses a great challenge in the individual’s daily activities ranging from minor injury to death.ObjectiveThis study aimed to assess the magnitude and outcome of road traffic accidents among patients admitted in Dessie Town Governmental Hospitals, Northeast Amhara, Ethiopia, 2022.MethodsA five-year hospital-based retrospective descriptive cross-sectional study design was conducted among 377 road traffic accident patients admitted to Dessie Town Governmental hospitals. Data were collected by simple random methods based on patient chart reviews from June 7/, 2022 to May 23/ 2017 using a checklist adapted from the WHO standard hospital-based road traffic accident questionnaires after obtaining consent from the concerned authority. EPI-Data software version 7.2 for data entry and SPSS version 25 for statistical analysis were used. Descriptive and inferential statistics were used. Statistical significance was declared at a p-value of < 0.05 with an adjusted odds ratio (AOR) and a 95% confidence interval (CI) in the final multinomial logistic regression model.ResultsThe magnitude of road traffic accidents was 59%, using of logistic multi nominal logistic regression we found results such that, road traffic victims who had unstable vital signs at admission (AOR = 6.4,95% CI; 2.5–16.6), didn’t get prehospital treatment (AOR = 9.3,95% CI; 4–20), and severe injury (AOR = 9, 95% CI;7-15.4), had a Glasgow coma scale of 3–5 (AOR = 5.2,95% CI; 1.4–20) were found predictors for death were as unstable vital signs at admission (AOR = 3.79,95%CI;2.1–6.8), Doesn’t get prehospital treatment (AOR = 2.8, 95% CI; 1.4–5.7), Hospital stay for one to two months duration (AOR = 6,95% CI;2.3–15), and greater than two months duration (AOR = 6.5,95%CI;2.5–17) were found predictors for disability among road traffic victims.Conclusions and recommendationsRoad traffic accidents constitute a major public health problem in our setting and contribute significantly to excessively high morbidity and mortality. Unstable vital signs at admission, Client doesn’t get prehospital treatment, severely injured client, and had a Glasgow coma scale of 3–5 were found predictors for death were as an unstable vital sign at admission, Client doesn’t get pre-hospital treatment, Hospital stays for one to two months duration, and greater than two months duration were found predictors for disability among road traffic victims.

Associated factors with intensive care unit (ICU) admission and mortality among road traffic accident victims in southern Iran: results from a trauma registry

Objective: Road traffic crashes are a significant health problem worldwide, causing injury, disability, and death. This study aims to identify associated factors with intensive care unit (ICU) admission and mortality among road traffic accident victims using data from a trauma registry.&#x0D; &#x0D; Methods: This descriptive study examined 368 road traffic accident patients in the national trauma registry system from March 2021 to March 2023. Following the objectives of the study, a checklist was created that included information on age, gender, marital status, level of education, injury severity score (ISS), Glasgow coma scale (GCS), and abbreviated injury scale (AIS). The factors associated with ICU admission and mortality among road traffic accident victims were found significant according to univariate and multivariable logistic regression analyses results.&#x0D; Results: 87.8% of the 368 patients included in this study were men, with a mean age of 33.54±18.95 years. Ten patients (2.71%) of total died, and 46 (12.5%) needed to be admitted to the ICU. In-hospital mortality and gender were not significantly associated (P=0.081). However, univariate logistic regression revealed several factors significantly associated with in-hospital mortality, including GCS&lt;8 (OR: 60.05, 95% CI: 11.67,309), ISS&gt;16 (OR: 11.39, 95% CI: 2.67,48.55), ICU admission (OR: 5,01, 95% CI: 1.36,18.50), underwent surgery (OR: 0.055, 95% CI: 0.014,0.223), respiratory rate (OR: 0.726, 95% CI: 0.630,0.836), O2 saturation (OR: 0.906, 95% CI: 00.852,0.963), systolic blood pressure (OR: 0.910, 95% CI:0.865,0.957) and temperature (OR: 0.932, 95% CI: 00.891,0.975). Furthermore, the odds of ICU admission was found to be increased with an ISS&gt;16 (OR: 2072.12, 95% CI: 17.29,50644.09), being a pedestrian (OR: 366.53, 95% CI: 31.44,389.85), GCS&lt;8 on admission (OR: 87.64, 95% CI: 29.04,264.43), smoking (OR: 11.92, 95% CI: 1.45,97.64), drug usage before the accident (OR: 11.47, 95% CI: 7.09,18.56), being a motorcyclist (OR: 5.72, 95% CI: 1.06,29.22), age (OR: 1.19, 95% CI: 1.05,1.34) and the time duration between the event and admission (OR: 1.01, 95% CI: 1.003,1.02).&#x0D; &#x0D; Conclusion: This study underscores the critical role of timely and effective medical interventions, including surgical procedures, in improving the outcomes of road accident victims. It also highlights the need for targeted preventive measures and interventions for high-risk groups pedestrians and motorcyclists.

Driving Under the Influence of Alcohol among Road Traffic Accident Patients Presenting to a Tertiary Care Centre.

Driving under the influence is one of the most significant risk factors for road traffic accidents, leading to severe and multiple orthopaedic injuries. The aim of this study was to find out the prevalence of driving under the influence of alcohol among road traffic accident patients presenting to a tertiary care centre. A descriptive cross-sectional study was conducted on patients involved in road traffic accidents presenting to a tertiary care centre. Data from 10 January 2020 to 9 December 2021 were collected between 22 July 2023 to 22 August 2023 from the hospital records after receiving ethical approval from the Institutional Review Committee. Patients who had road traffic accidents and were diagnosed with fractures were included in the study. Patients with incomplete hospital records were excluded from the study. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Among 2,519 patients, 307 (12.19%) (10.91-13.47, 95% Confidence Interval) were driving under the influence of alcohol when involved in a road traffic accident. Out of 307 patients, 305 (99.35%) accidents involved two-wheelers. A total of 118 (38.44%) patients suffered soft tissue injuries, while 47 (15.31%) sustained head injuries, and 28 (9.12%) sustained facial injuries. The prevalence of driving under the influence of alcohol among road traffic accident patients presenting to a tertiary care centre was similar to other studies done in similar settings. accidents; alcohol consumption; bone; Nepal; trauma.

Factors associated with ocular injuries among adult road traffic accident patients presenting at Mulago National Referral Hospital, Uganda.

Ocular trauma is the leading cause of unilateral blindness globally. Road traffic accidents are among the top risk factors for ocular trauma. This study aimed to evaluate factors associated with ocular injuries among adult road traffic accident patients at Mulago Hospital, Uganda. A cross-sectional study was conducted among adult road traffic accident patients. History taking and ophthalmological examination were performed on consenting participants. Data was analysed using STATA version 14.0. Overall, 428 road traffic accident cases were enrolled, of which majority (84.3%) were male. Age 30-39years (aOR = 0.58, 0.36 - 0.94, p = 0.027), being male (aOR = 2.64, 1.21 - 5.13, p = 0.004) and being a passenger of motor vehicle/cycle (aOR = 3.85, 1.49 - 9.93, p = 0.005) were the factors associated with ocular injuries among the participants. Age 30-39 years, male gender and being a passenger of motor vehicle/cycle were the factors associated with ocular injuries among the adult road traffic accident patients. Ocular injuries were more common among the road users who did not use safety measures. Use of safety measure by passengers of motor vehicles and cycles is recommended.

24 h mortality and its predictors among road traffic accident victims in a resource limited setting; a multicenter cohort study

IntroductionThe incidence of road traffic accidents (RTAs) is on the rise contributing to the global burden of mortality as a major global health threat. It has been estimated that 93% of RTAs and more than 90% of the resulting deaths occur in low and middle income countries. Though death due to RTAs has been occurring at an alarming rate, there is paucity of data relating to incidence and predictors of early mortality. This study was aimed at determining the 24 h mortality and its predictors among RTA patients attending selected hospitals in western Uganda.MethodsThis was a prospective cohort that consecutively enrolled 211 RTA victims admitted and managed in emergency units of 6 hospitals in western Uganda. All patients who presented with a history of trauma were managed according to the advanced trauma life support protocol (ATLS). The outcome regarding death was documented at 24 h from injury. Data was analyzed using SPSS version 22 for windows.ResultsMajority of the participants were male (85.8%) aged 15–45 years (76.3%). The most common road user category was motorcyclists (48.8%). The 24 h mortality was 14.69%. At multivariate analysis, it was observed that a motorcyclist was 5.917 times more likely to die compared to a pedestrian (P = 0.016). It was also observed that a patient with severe injury was 15.625 times more likely to die compared to one with a moderate injury (P < 0.001).ConclusionThe incidence of 24 h mortality among road traffic accident victims was high. Being motorcycle rider and severity of injury according to Kampala trauma score II predicted mortality. Motorcyclists should be reminded to be more careful while using the road. Trauma patients should be assessed for severity, and the findings used to guide management since severity predicted mortality.

Determinants of post-traumatic stress disorder among survivors of road traffic accidents in dessie comprehensive specialized hospital North-East Ethiopia

BackgroundPost-traumatic stress disorder is the most common mental disorder occurring among survivors of road traffic accidents. However, it remains under-explored and is not taken into account in the health policies of Ethiopia. Therefore, this study aimed to identify determinant factors of post-traumatic stress disorder among survivors of road traffic accident patients in Dessie Comprehensive Specialized Hospital, North-East Ethiopia.MethodsA facility-based unmatched case–control study design was employed from February 15 to April 25, 2021, in Dessie Comprehensive Specialized Hospital, with a total sample size of 139 cases and 280 controls selected by using a simple random sampling technique. Data were collected by pretested, interview with a structured questionnaire. The data were entered using Epi-Info, then exported and analyzed using STATA. The bi-variable and multivariable binary logistic regression model was used to identify determinant factors of post-traumatic stress disorder among survivors of road traffic accident. Adjusted odds ratio with a 95% confidence level was used as a measure of association. Variables with a p-value less than 0.05 were considered as statistically significant.ResultA total of 135 cases and 270 controls participated in this study, with a response rate of 97% and 96%, respectively. In the final multivariable analysis, being male [AOR = 0.43, 95% CI: 0.32–0.99], primary educational status [AOR = 3.4, 95% CI: 1.04–11], presence of personal psychiatric history [AOR = 2.12, 95% CI: 1.17–3.92], presence of fracture [AOR = 2.41, 95% CI: 1.2–4.8], witness of death [AOR = 2.25, 95% CI: 1.26–4.30], presence of comorbidity [AOR = 2.29, 95% CI: 1.28–4], good social support [AOR = 0.71, 95% CI: 0.12–0.68] were significantly associated with post-traumatic stress disorder among survivors of road traffic accident patients.ConclusionPTSD following road traffic accidents is common. A multi-disciplinary approach was therefore essential in the management of road traffic accident survivors at the orthopedic and trauma clinics. Patients with poor social support, bone fracture, witnessed death, comorbidity, and females should be routinely screened for post-traumatic stress disorder in all road traffic accident survivors.

Assessment of Post Traumatic Stress Disorder and the Associated Socio Demographic Parameters of Road Traffic Accident Victims

Background: Road traffic accident (RTA) is a global trauma which can produce a traumatic stress with tremendous physical, social and psychological impairments to the victims. Post traumatic stress disorder (PTSD) is the most common mental disorders among the RTA victims. Objectives : To assess the PTSD among the RTA victims and the relationship between the socio demographic parameters of RTA victims with PTSD. Methods: This cross sectional study conducted among 202 RTA patients attended in the inpatient dept. of a specialized hospital in Dhaka city for one year duration. Data collected from these patients using a semi structured interview administered questionnaire and PTSD assessed by using Diagnostic and Statistical Manual-IV DSM-IV(PCL-S). The collected data were analyzed by using SPSS software (Version 21) and p &lt; 0.05 considered as significant. Results: The mean age of RTA victims found 37.6 (±13.2) years, majority 57.4% belongs to 18-30 years age group. Out of 202 RTA patients 41.1% developed PTSD having e”51 score in Diagnostic and Statistical Manual-IV DSM-IV (PCL-S) checklist. Among the socio demographic parameters age and occupation were significantly associated with the PTSD; whereas education, family income, sex were not associated significantly with PTSD. Conclusion: This study found a high magnitude of PTSD among RTA victims. J Bangladesh Coll Phys Surg 2023; 41: 22-26

Predictors of the selective use of chestcomputed tomography in road traffic accident patients with none clinically evident chest trauma

Predictors of the selective use of chestcomputed tomography in road traffic accident patients with none clinically evident chest trauma

Post traumatic stress disorder and the associated factors among the survivors of road traffic accident attending in a specialized hospital in Dhaka

Background: Post traumatic stress disorder (PTSD) is the most common mental disorder occurring among survivors of road traffic accidents (RTA). It could result in long-term adverse consequences if left untreated, mainly leading to social and functional impairments of RTA survivors, which finally results in a poor quality of life. Objectives: To assess the prevalence of PTSD among the RTA survivors and the associated factors of it. Materials &amp; methods: An institution-based cross-sectional study was carried out among 202 admitted RTA patients in the inpatient department of a specialized hospital in Dhaka city for one year duration. Data were collected from these patients using a semi structured interview administered questionnaire where the Diagnostic and Statistical Manual-IV DSM-IV(PCL-S) checklist used to assess PTSD. The collected data were analyzed by using SPSS software (Version 21) and p &lt; 0.05 considered as significant. Results: A total 202 RTA patients were included in the study and the prevalence of probable PTSD among RTA survivors was 41.1% according to DSM-IV(PCL-S) checklist. The mean age of RTA survivors found 37.6 (±13.2) years, majority 57.4% belongs to 18-30 years age group. The mean PTSD score found was 44.1(±8.2), 9.2% RTA survivors had previous history of known depressive symptoms. Among the socio-demographic attributes, age and occupation were significantly associated with the PTSD; other accident related factors like time since accident and type of accident were strongly associated with the PTSD. Conclusion: This study found a high prevalence of PTSD among RTA survivors with some associated significant sociodemographic and accident-related factors. The findings suggest a need for early screening for PTSD among the survivors of RTA. Update Dent. Coll. j: 2022; 12(2): 14-18

Effect of Lockdown on Neurosurgery Trauma Patients in a Tertiary Care Hospital in India

Abstract Background With an increasing number of cases of COVID-19 disease, the Indian government announced a complete lockdown on March 24, 2020, and the country remained under complete lockdown in April 2020. After ramping up health infrastructure and although cases were on the rise, the lockdown was ordered to gradually lift in May 2020. Methodology It was a retrospective cross-sectional study of all patients admitted to our medical college trauma center in April 2020 and who were compared with April 2019. We studied the prevalence and outcome of road traffic accidents (RTA), assault, and fall from height (FFH) victims admitted to our trauma center. Data were collected using an Excel sheet, and statistical analysis was done using the latest available SSPS software. Results Our study groups included 124 trauma patients from April 2020 as compared with 322 trauma patients from April 2019. The intense lockdown resulted in a decrease in the number of RTA (−72%), FFH (–29%), and assault patients (–7%). There was no statistically significant change in patients' care and management at our center in terms of mortality and morbidity. No Covid-19-positive neurosurgery trauma patients were admitted in April 2020 to our center. Conclusion During the stringent lockdown period of April 2020, there was a significant decrease in the number of trauma victims, especially RTAs. The intense lockdown resulted in a significant decrease in the proportion of trauma victims under the influence of alcohol, head injuries, fractures, and dislocations along with a decrease in the number of cases of assaults and FFH as compared with the unlock period.

Efficacy Of Conservative Management Of Early Post Traumatic Cerebrospinal Fluid Rhinorrhoea.

The incidence of Post-traumatic Cerebrospinal Fluid Rhinorrhoea (PCSFR) has been decreased due to advanced therapeutic measures. The current investigative study has been arranged to assess the efficacy of conservative management of early PCSFR. This cross-sectional study was conducted at departmental of Neurosurgery, Ayub Medical Institute, Abbottabad. Patients with traumatic brain injury having Cerebrospinal fluid rhinorrhoea with either gender having age 5-50 year and presenting within seven days of traumatic brain injury were included. Moreover, those with nasal fractures, penetrating head injuries having fever and neck stiffness were also included in the study. A total number of 120 patients having male dominancy, i.e., 86 (72%) were included in the study with the mean age of 27 years ± 8.741 in which 77 (92%) patients were in the age range of 2nd to 4th decades. The commonest cause was trauma due to Road Traffic Accidents (RTA) having 65 (54%) patients. Conservative treatment was effective in 62 (52%) patients predominantly in the patients of 3rd decade, i.e., 31 (50%), in which the effectiveness in male gender was revealed to be 52.32% (45) and effectiveness in RTA patients was recorded to be 54.83%. Similarly, the Chi-Square value was calculated for the PCSFR patients for four groups of patients (5-20, 21-30, 31-40, 41-50) to be 48.27 having critical value of 7.81 with the p-value of 1.87e-10, which completely rejects the Null-hypothesis for the patients of various ages. Based on the current investigative study, it may be concluded that PCSFR is common in middle age population with slight male dominancy. It may also be inferred that RTA is the leading cause of PCSFR in our set up and majority of the patients shows improvement after conservative management. Moreover, the effectiveness of conservative management of PCSFR could be predominantly observed in the patients of 3rd decade.

Pattern of Road Traffic Accident Cases Attending in the Emergency Department of Khwaja Yunus Ali Medical College and Hospital, Bangladesh.

Objective: To evaluate the pattern of Road Traffic Accident cases attending the Emergency Department of Khwaja Yunus Ali Medical College &amp; Hospital (KYAMCH), Enayetpur, Sirajganj. Materials and Methods: This cross-sectional study was carried out at the emergency department of Khwaja Yunus Ali Medical College and hospital (KYAMCH), Enayetpur, Sirajganj from January’21 to June’21. Total 148 Road Traffic Accident (RTA) cases were collected by using a pre-designed format from the Emergency register/ records book, for the study. Results: During the study majority of the cases (73.65 %) were male and 58 (39.19%) of the patients belong to above 40 years of age, In the above 40 age group (29.73%) were male and (9.45%) were female. The majority (29.05%) had only soft tissue injury (Abrasion/Bruise/Laceration), followed by (27.02%) had only lower limb fracture and dislocation, (17.58%) of patient had only upper limb Fracture and dislocation,( 19.59%) had head injury,( 4.05%) had both upper and lower limb fracture, only (1.35%) had spinal cord injury and (1.35%) had another injury. During the accident common vehicle for the accident was Compressed Natural Gas (CNG) Auto-rickshaw (28.38%) followed by Motorcycle were (22.97%), 15.54% cases were due to Auto rickshaw/ van, 8.78% were due to Bi-cycle, 9.46% others. Besides that, management was given according to requirements where surgical intervention required in most of the cases, 64.87%, whereas Intensive care unit (ICU) support was required only 6.08 % cases, referred cases 8.11%, Patient refused to take treatment 10.13% cases. Conclusion: From our study we can say that, soft tissue injury (Abrasion/ Bruise/ Laceration) was a common injury found in road traffic accident patients, where CNG Auto-rickshaw and Motorcycle was the prominent source of road accident at this area, may be due to these are the main transportation in this rural area. Moreover, the recommendations from the world report on road traffic injury prevention should be considered and promptly implemented. The awareness among both users of road and administrators about road travel discipline should be very high in order to curb the ever-rising epidemic of road traffic accidents. KYAMC Journal Vol. 13, No. 01, April 2022: 41-44

In-patient Service Management of Road Traffic Accident Patients in a Specialized Hospital

Background: Road Traffic Accidents (RTA) is a major threat to life in our country which are increasing exponentially day by day all over the world. The major consequences of road traffic accidents are associated with multiple traumatic injuries and are the leading cause of death both in developed and developing countries. The death rate would be reduced with a properly organized system of trauma care. Prompt, effective, and efficient healthcare services save a significant amount of lives and also reduce the suffering and duration of illness. RTA patients require immediate attention and treatment as well as long-term comprehensive healthcare under the direct supervision of a medical team. The study aimed to assess the In-patient service management for Road Traffic Accident patients in a specialized hospital in Bangladesh. Methods: A cross-sectional study was conducted among 120 respondents (74.20% male, mean age = 24.6 ± 1.62 years) In-patient department of the National Institute of traumatology and orthopedic rehabilitation Centre (NITOR) in Bangladesh through purposive sampling technique. Data were collected from February 2019 to February 2020 via face-to-face interviews using a semi-structured questionnaire. Results: The relationship between the residence of the respondents and the satisfaction level of IPD service was significantly found. (P = 0.002). The relationship between the level of education and satisfaction regarding IPD service was also significantly found (P = 0.026). Conclusions: Skilled manpower should be increased and out of pocket expenditure should be reduced for the provision of better treatment care. All facilities-related services should be enriched, modernized, and ensure the availability of these services.

Emergency Service Management for Road Traffic Accident Patients in a Specialized Public Hospital in Dhaka

Introduction: Road traffic accident (RTA) imposes an enormous public health burden and are a major threat to society nowadays. Emergency service has gained tremendous importance because of increasing RTA. Emergency medical service (EMS) can reduce the extent of death and disability. Method: This cross-sectional study aimed to assess the management of emergency service for RTA patients which covers both service receivers and service RTA patients as service receivers 50 doctors, nurses, and supporting staff as service providers were interviewed with a semi-structured questionnaire based on different variables related to emergency service management. Data were analyzed by SPSS software. Through an observational checklist, almost all the facilities in the emergency department were found available and functional according to Standard Operating Procedure (SOP) in spite of having a high doctor-patient and nurse-patient ratio. Result: The study revealed that out of 250 RTA patients majority 84.0% were male, the mean age was 34.8 (± 10.6 ) years, and the majority (84.0%) suffered from multiple injuries. It was also observed more than half (58.8%) of RTA patients waited to get emergency treatment for 2-5 minutes; where 38.4% waited for more than 5-10 minutes to get emergency treatment, almost three fourth (78.4%) got emergency medicines and the majority (83.6%) got the urgent investigation facilities from the hospital, almost all the emergency patients (89.2%) attended by a doctor within 5 minutes according to ­receivers found highly satisfied on overall emergency service management. Conclusion: Some important suggestions made by the service providers to improve the emergency service for RTA patients need to consider with proper attention by the authority. Update Dent. Coll. j: 2022; 12(1): 8-11

The burden of road traffic accidents in trauma in low-resource settings: a retrospective cohort analysis of patient admissions to 2 Médecins Sans Frontières trauma facilities

Introduction: Medecins Sans Frontieres (MSF) is known for its work providing surgical care for victims of violent trauma (VT) in conflict zones. However, the trauma centers also deal with road traffic accidents (RTAs) which may require different staffing, facilities and supplies as compared with those required for VT. This study aimed to compare differences in types of injuries, clinical outcomes, and resources needed to properly operate trauma centers in low and middle-income countries. Material and methods: This was a retrospective analysis of routine program data of &gt;70,000 patient presentations in the emergency, in-patient, and operating departments of 2 of MSF’s major trauma centers, in Kunduz (Afghanistan) and Bujumbura (Burundi), using data from 2011 to 2018. Results: RTAs comprised a significant proportion of overall presentations to these centers (23% in Kunduz and 56% in Bujumbura). RTA patients presented with different patterns of injury, with higher rates of fractures, extremity injuries, and traumatic brain injury. RTA patients were 2.3 times more likely to have a peripheral injury (extremities and head) as VT patients, and 12.5 times more likely to undergo an orthopedic procedure. VT patients had higher rates of abdominal injury. However, there was no statistically significant difference in overall mortality and length of stay between the 2 groups. Conclusion: This study demonstrates that trauma centers, even in zones of conflict, need to be prepared and resourced to manage RTA cases. Policy-makers in such centers should be aware of the different injury patterns associated with this patient group and have appropriate, sustainable capacity to manage RTA trauma, particularly in terms of management of orthopedic injuries.

Outcomes of Traffic Accident Patients Transferred by Air and Ground Ambulance: Propensity Score Matching

Background: The main task of the emergency medical system is to provide primary care and transfer the patients to hospital. Studies have been conducted to investigate the outcome of air and ground ambulance patients, but they show different results. These different results may be due to the type of study, statistical methods, differences in prehospital emergency systems, and insufficient control of confounding variables. Thus, it is difficult to compare and generalize the results. This study aimed to investigate the outcomes of injured people transported by air and ground ambulance in road traffic accidents in Qom Province, Iran, during 2015-2019. Materials and Methods: In this retrospective analytical descriptive study, we used the numerical method and examined all road traffic accident patients transferred through ground or air to Qom Shahid Beheshti Hospital by the prehospital emergency from 2015 to 2019. The collected information included the type of transfer, age, sex, type of trauma, distance from the accident site to the hospital, initial vital signs, duration of the mission, and day of the accident. To control the confounding factors, we used propensity score matching. Outcomes studied included length of hospital stay, length of stay in the intensive care unit, duration of mechanical ventilation, and the need for immediate surgery. Logistic regression was used to analyze the need for immediate surgery and a generalized linear model for other consequences. Results: After matching, the number of patients in each group transferred by ground ambulances and helicopter was 566. Trauma to the head (P=0.028) and back (P=0.002) were more common in helicopter-transported patients. The patients transported by helicopter had a longer time to reach the scene (7.70 ±5.18 min) (P&lt;0.001), a shorter duration of presence on the scene (12.17±8.33 min) (P=0.041), and a shorter duration of transfer (13.12±4.75 min) (P&lt;0.001) than the ground ambulance. There was no significant difference between the patients who transferred by ground and helicopter ambulance regarding the length of hospital stay in the intensive care unit (P=0.718), mechanical ventilation (P=0.507), and hospitalization (P=0.089). The need for immediate surgery in helicopter-transported patients was 84.8% higher than ground ambulance patients (95%CI: 0.086-0.267; P&lt;0.001). Conclusion: The patients transported by helicopter were not significantly different from ground ambulances transported patients regarding staying in the intensive care unit, mechanical ventilation, and hospitalization, but they more needed immediate surgery. If the patients are triaged adequately according to the type of injury and the level of consciousness at the scene and transferred to the appropriate hospital by ground or air, they can enjoy the benefits of the type of transfer.

The impact of lockdown on incidence of neurosurgery trauma patients in India

Objective: Covid19 pandemic challenged the global healthcare system and both developed and developing countries responded with their might to fight this global pandemic. Road traffic accidents are a major cause of morbidity and mortality in India and we studied the impact of lockdown on neurosurgery trauma patients in a tertiary care centre in India. Methods: Indian government announced complete lockdown on 25th march 2020 and India remained in complete lockdown till 31st May 2020. We included the patients admitted from 1st January 2020 to 24th March 2020 in pre lockdown period and25th march to In this cross-sectional study we divided the patients into two groups of pre lockdown and lockdown period and incidence of neurosurgery trauma patients was assessed for Road Traffic Accident, assault, hit by animal and fall from height. Result: In our study 491 patients were admitted in pre lockdown and 369 patients were admitted in lockdown period. Road traffic accident patients were more in pre lockdown 39.5% (n=194) as compared to lockdown period 31.2% (n=115). However, cases of assaults were more in the lockdown period (14.6%, n=54) as compared to pre lockdown (3.9%, n=19). The death rate in neurosurgery trauma patients reduced significantly in lockdown (7.3%, n=27) as compared to pre lockdown (21.8%, n=107). Conclusion: The COVID19 pandemic induced lockdown resulted in a decrease in motor vehicle movements which further decreased the incidence of RTA and related trauma however incidence of assault-related trauma and cases increased significantly in this period. The overall outcome of such patients improved probably due to better utilization of available health care facilities.

Pattern and Burden of Road Traffic Accidents in Tertiary Care Public Hospital, District Central, Karachi from 2016 to 2018

Objective: To assess the burden of trauma during the last three years (2016-18) caused by road traffic accidents presenting to the trauma centre of tertiary care public hospital in district central, Karachi.Methods: All the accident cases presenting in the trauma center of the hospital in last three years who were defined as accidents occurring on a public road and involving at least one moving vehicle were included in the study. Those with incomplete medical records were excluded. This was a crosssectional study where records of a total of 2857 individuals were retrospectively collected and their socio-demographic information, history of road traffic crashes, clinical history and examination was noted. Data was analyzed through SPSS while descriptive statistical analysis of continuous and categorical variables was performed.Results: The mean age of patients admitted to the trauma centre was 29.3 ± 16.7 years with no significant difference between both gender. Out of 2857 patients with road traffic accident injuries, around 80.9% were males. The most prevalent age group was 16-30 years of age, which was over 40.2%, followedby subjects of 31 - 45 years age group which was 21%. The study results further showed that over 51.3% of the road traffic accident patients were discharged normally, followed by 46.7% subjects who left against medical advice. Overall death rate was 2% (n=57).Conclusion: This study helps to identify the latest accident burden and pattern of injuries to develop plans aimed at prevention of road traffic accidents. Looking at the burden, the most affected was the younger subjects (16-30 years) highlighting the need for targeting this population for educational programsand policies about safe driving. Among the road traffic accidents cases the subjects who left against medical advice cases was gradually decreasing from 2016 to 2018 suggesting better healthcare facilities at the tertiary care hospital and corresponding increasing patient's confidence in them.

Prevalence of Motorcycle Accidents and Its Associated Factors Among Road Traffic Accident Patients in Hawassa University Comprehensive Specialized Hospital, 2019.

BackgroundRoad traffic damages were amongst the central causes of passing away, hospitalization, disability, and low socioeconomic status. About 1.3 million lethal road traffic damages and 20–50 million nonfatal damages happened consequently of road traffic accidents every year globally. Motorcycles are a small subsection of all motor vehicles significantly over-represented in total motor vehicle accidents and lead to a great rate of deaths and disabilities.ObjectiveThe study aimed to assess the prevalence of motorcycle accident and associated factors among road traffic accident patients in Hawassa University Comprehensive Specialized Hospital, Hawassa city, Ethiopia in 2019.Methods and MaterialsThe health institution/hospital-based retrospective cross-sectional study design was applied and a systematic random sampling technique was implemented to select the sample size of 274 patient’s cards from January 2018 to January 2019. The data were entered and analyzed on SPSS 20.ResultsFrom 274 patients’ medical records reviewed in the study period, 151 (55.1%) injuries were due to motorcycle accident. In a multiple logistic regression analysis, age, sex, high speed, and types of roads showed significant association with motorcycle accidents.ConclusionThe prevalence of motorcycle accidents was the main cause of injuries among others, which was 55.1%. Motorcycle accidents occurred mainly in males and in people with the age category of 20–29 years. Age, sex, high speed, and type of road were significantly associated with a motorcycle accident.

A Study Of Spectrum Of Findings Of Magnetic Resonance Imaging In Ankle Joint Pathologies

Aims & Objectives: This study is being carried out to describe various MRI features in the pathologies of ankle joint. Trauma to the ankle joint is a significant cause of morbidity in the young & active individuals especially amongst labourer’s, road traffic accident patients and athletes. A correct diagnosis regarding traumatic/ non traumatic ankle joint pathologies is essential for early operative as well as non-operative treatment. Magnetic resonance imaging (MRI) has now been accepted as the best modality for non-invasive evaluation of ankle pathologies. This study was undertaken to study different pathologies of ankle joint and its incidence by MR imaging.MATERIALS AND METHODS:A total of 50 cases of clinically suspected & diagnosed of having any pathology of ankle joint by MR imaging of the ankle, at the department of Radiodiagnosis, AMC MET Medical college, L.G hospital, Maninagar, Ahmedabad. Study was performed between December 2018 to December 2019. MRI was carried out on SIEMENS 1.5 T MAGNETOM_ESSENZA machineResults:Of the total50 patients evaluated, most common pathology of ankle joint being anterior talofibular ligament tear & tenosynovitis,20(40%) cases of each, followed by stress fractures 17(34%) & contusions 16(32%). Associated findings include joint collection, marrow edema &soft tissue changes.Interpretation and Conclusions:From these observations, it is found that MRI is an excellent, noninvasive, radiation free imaging modality with multiplanar capabilities and better soft tissue delineation. It can accurately detect, localize and characterize various ligamentous, tendinous, bony & soft tissue pathologies related to ankle joint and thereby guiding in further management of the patient.