Road Traffic Accident Victims Research Articles

Brachial artery injuries - the impact of the anatomical site of injury on postoperative outcomes

The start of the armed conflicts in Libyan society in 2011 led to a dramatic increase in the incidences of unusual types of brachial artery injuries, which were previously uncommon. In this study, the postoperative outcomes have been compared prospectively between patients who have had injuries at the proximal anatomical half of the brachial artery with those who suffered injuries at the distal anatomical half.A cohort study was undertaken to compare patients who had an injury at the proximal anatomical half of the brachial artery (considered as the first group) and patients who had an injury at the distal anatomical half of the brachial artery (considered as the second group). This was undertaken to analyse the influence of the anatomical site of injury on the postoperative outcomes in patients who underwent urgent surgical repair procedures at the hospital from February 2011 to December 2016.Out of fifty-one patients, 31 (60.8%) patients had gunshot injuries, 12 (23.5%) had explosive injuries, four (7.8%) had stab wounds and four (7.8%) were victims of road traffic accidents. There were 13 (25.5%) patients in the first group and 38 (74.5%) patients in the second group. Three patients (5.9%) had postoperative arterial occlusion due to thrombosis, while two (3.9%) had postoperative graft occlusion due to thrombosis; the other two (3.9%) had compartment syndrome.Based on the anatomical background, critical limb ischaemia and postoperative ischaemic complications, as well as delayed limb amputation, are more associated with the injuries to the proximal anatomical half of the brachial artery due to poor collateral circulation at this level.

Об опыте организации работы трассовых медико-спасательных пунктов для оказания экстренной медицинской помощи при дорожно-транспортных происшествиях

The paper presents a comparative analysis of three similar forms of emergency medical care on remote routes (experience of Denmark, Russia and Kazakhstan). Expediency of creating and placing medical stations on routes, which include not only provision of emergency medical care, but also conducting of emergency rescue operations, is noted.Organization of emergency medical care to victims of road traffic accidents lies in timeliness and integrated approach. Staff structure and staff of teams of rescue service of the route medical station, assignment of the “area of responsibility” of reaction and procedure for notifying an accident are also important.

Socio-demographic profiles of victims of road traffic accidents in Kumaon Region of Uttarakhand

Socio-demographic profiles of victims of road traffic accidents in Kumaon Region of Uttarakhand

A record based study of death due to road traffic accident brought for postmortem examination at Tertiary Care Center Bhavnagar

Road traffic accidents happen to be a leading cause of death among young people and cause considerable economic losses to victims and their families and the nation at large. This is a retrospective autopsy-based study consisting of 120 medico-legal autopsies performed at the mortuary complex of the tertiary care center Bhavnagar during the period from 1st September 2019 to 31st August 2020. Out of the 914 medico-legal autopsies performed during the study period, 120 (13.12%) were due to fatal RTA. There were 103 (85.83%) males and 17 (14.17%) females. 11 to 20 years age group showed the highest number of victims of 24 (20%). The maximum of road traffic deaths of 18 (15%) was shown in March 2020 and a minimum of 2 (1.66%) in April 2020. The highest number of injuries were head injuries of 92 (76.66%), followed by thoracic injury of 30 (25%) and abdominal injury of 21 (17.5%). Road traffic accidents are increasing at an alarming rate in rural and urban areas. Most of them are caused by human errors and they can be prevented by providing road safety education to all. In conclusion, most of the victims of road traffic accidents were young males and the productive age group.

The pattern ofthoracic injuries in victims of road traffic accidents: Anautopsy based cross- sectional study

The pattern ofthoracic injuries in victims of road traffic accidents: Anautopsy based cross- sectional study

Assessing the quality of life among nonfatal road traffic accident victims by using WHO-QOL-BREF

Background/Objectives: Road traffic accident affects people more in terms of disability with prolonged treatment than premature death. More people suffer from nonfatal injuries, with many incurring a disability as a result of their injury. The study aims to report the quality of life among nonfatal road traffic accident victims of Karnataka state, India. Methodology: Consecutive data of 6 years (2013–2018) on road traffic injuries of the state of Karnataka were collected from the States Crimes Records Bureau of Karnataka. The contact details of victims categorized as nonfatal were traced out. Finally, 286 nonfatal cases were selected as respondents. Data were collected using WHO-QOL-BREF questionnaire to measure the quality of life. Results: The better quality of life in all the four domains, that is, physical health, psychological health, social relationships, and environmental health, was found among the less injured category of victims. There was a statistically significant difference (P < 0.05) among the different categories of accidents as well as the types of postaccident occupation of the respondents for all the four domains. A significant variation was found across different age groups for the physical health domain. Respondents of below 18 years were found with the better mean score for all the domains. Similar differences are observed for education for all the domains, except the social relation domain. The Mann–Whitney U-test revealed a significant difference between those who received the compensation and those who did not receive the compensation for the psychological domain. Conclusions: The study warrants policy-related measures with ease of compensation procedures by simplifying the insurance processes and counseling. Indeed, rehabilitation measures need to be taken seriously by the government as the support system is vital for the improvement for quality of life among road traffic accident victims.

Epidemiology of mass casualty incidents in a tertiary care trauma center in eastern India: A retrospective observational study.

OBJECTIVES:Disasters and mass casualty incidents (MCIs) that cause substantial mortality and morbidity have been increasing worldwide. The emergency department (ED) services manage MCIs by optimizing triage and providing health care with required resources. The present study attempted to describe the epidemiological characteristics and outcomes of MCIs presenting to the ED.METHODS:The present retrospective observational study was conducted at the ED of a tertiary care hospital on patients of MCI for 4 years from 2017 to 2021. The data were extracted from the ED disaster records and other paper-based patient records. Information on patient demography, date and time of arrival, mode of transport, method of arrival (direct or referral), type and mechanism of MCI, ED management, and outcome were recorded. Statistical analysis was performed using R, version 4.1.0.RESULTS:Analysis of 21 MCIs was conducted. Road traffic accidents (RTAs) were the predominant cause of MCIs. The majority of MCI victims, except for those of blast injuries, were men. The victims in medical emergencies were significantly younger than those in other MCI groups (P < 0.001). The majority of patients were brought to ED through ambulance services (n = 120 [47.1%]), followed by private vehicles (n = 112 [44.2%]). Most of the MCI victims (n = 143 [56.2%]) were brought to the ED during evening hours (4 pm–8 pm). The majority of victims belonged to the “Red” triage category (n = 110 [43.3%]). The injury severity score was significantly higher (P = 0.014) in the disaster group than in other trauma MCI groups (20 vs. 17). Autorickshaw occupants were the most common victims of mass casualty RTAs (n = 38 [40%]). Suturing (n = 97 [50%]) and dressing (n = 167 [88%]) were the most common ED procedures required by the victims of trauma MCIs. Of the total, 167 (66%) patients were discharged from the ED, 47 (19%) patients were admitted to wards, 13 (5%) patients were admitted to intensive care units, and 24 (9%) patients got referred to other centers. In addition, two patients died in the ED during treatment, whereas one patient was brought dead.CONCLUSIONS:RTAs dominate the MCIs and are affecting the young producative male population. The present study exhibited the severity of the cases in MCIs and their impact in the health-care setting, therefore signifying the importance of standardized MCI management protocols.

The burden of road traffic accident-related trauma to orthopaedic healthcare and resource utilisation at a South African tertiary hospital: a cost analysis study

BACKGROUND: Road traffic accidents (RTAs), the second commonest cause of trauma in South Africa (SA), are on the rise. It is therefore important to study and understand the burden of RTA-related injuries on our orthopaedic healthcare and healthcare in general, in order to devise new prevention strategies to minimise the number of RTAs METHODS: A retrospective analysis of data from orthopaedic trauma intake records was done for patients admitted with RTA-related injuries to the orthopaedic department at a South African tertiary hospital between February 2019 and January 2020. Hospital records and the PAC (picture archiving and communication) system were analysed for radiological studies done. The Uniform Patient Fee Schedule (UPFS) was analysed for individual costing of all variables being studied RESULTS: There were 642 patients seen and managed with RTA-related injuries included in this study. Seventy-one per cent of them were males, with an average age of 35 years. The majority (76.2%) were motor vehicle occupants, whereas 17% were pedestrians. Seventeen per cent of them had polytrauma. Four hundred and sixty-two (76%) patients required some form of surgical intervention and spent an average of 171 minutes in theatre per procedure. Ten per cent of these patients required ICU/HCU admission for an average of 13 days. The total length of hospital stay was an average of 21.8 days. The majority of patients (67%) had some form of orthopaedic implant inserted, with an average of 1.3 implants per patient. The average cost per patient was R92 737.39. The major cost drivers were hospital stay, ICU/HCU stay, implant cost, radiological studies and theatre utilisation, respectively CONCLUSION: Management of RTA-related trauma puts a significant burden on orthopaedic healthcare management and resource utilisation. While we may not be able to directly influence other contributing factors to high costs, reducing the use of temporary external fixators may help reduce the cost of managing RTA victims These findings provide scientific data which will help support the implementation of preventative measures aimed at minimising the numbers of RTAs we see on our roads, thereby minimising the burden this puts on our healthcare system. Level of evidence: Level 3

Forensic Evaluation of the patterns of fatal injuries among pedestrians in road traffic accidents in Hyderabad, Pakistan.

Introduction: Road traffic accidents (RTAs) preventable yet responsible for a large number fatalities among children and adults. It is estimated that RTA causes approximately 1.35 million deaths (27.5 deaths per 100,000 population) through out the world.Objective: To evaluate the patterns of fatal injuries among pedestrians due to road traffic accidents brought in emergency unit of Liaquat University, hospital, Hyderabad.Methodology: This cross-sectional study conducted between Jan 2019 to Dec 2019 and all victims of road traffic accidents brought in the emergency due to fatal injuries belongs to either sex or age-group were included. Data collected includes demographic details; type, site, impact, intensity of inju-ries and different types of vehicles involved in the accidents were recorded from history/ autopsy findings of medico-legal officer. Collected data was entered and analyzed in SPSS ver. 23.Results: Motorcars were more involved (31.0%) in road traffic accidents followed by trucks/loaders (29.0%). Males (87.5%) outnumber female. Head and neck region (26.0%) affected most, while abdomen/pelvis were the least(16.0%) affected. Contusions occurred in predominantly (51.0%) while most (60.5%) pedestrians were found dead when received in the emergen-cy unit. Most common cause of death was head injury induced complica-tions.Conclusion: Injuries to head, neck and facial regions are more common while contusions are the predominant type of injuries occur in the pedestri-ans. Skull bone is most commonly fractured bone among the victimsKeywords: Pattern of injuries, Pedestrians, Road traffic accidents .

Mortality Prediction of Victims in Road Traffic Accidents (RTAs) in India using Opposite Population SGO-DE based Prediction Model

Getting immediate and appropriate care for the victims of Road Traffic Accidents (RTAs) in countries like India with huge population is a challenging job. In this paper a new hybridized evolutionary algorithm has been proposed for hyper-parameter tuning of the hyper-parameters of the prediction models using which mortality prediction of victims of RTAs in India have been performed. The proposed methodology Opp-SGO-DE has been used for parameter tuning in prediction algorithms like Random Forest (RF) and Support Vector Machine (SVM) and promising results were found from the experimentation. In RF, accuracy was increased from 0.75 to 0.82 and F1-score was increased from 0.66 to 0.77 in dataset-1 and accuracy was increased from 0.66 to 0.75 and F1-score was increased from 0.62 to 0.65 in dataset-2. In SVM, accuracy was increased from 0.63 to 0.74 and F1-score was increased from 0.58 to 0.67 in dataset-1 and accuracy was increased from 0.56 to 0.62 and F1-score was increased from 0.54 to 0.575 in dataset-2.

Assessment of Mortality Pattern Based on Autopsy in Victims of Road Traffic Accident

Background: The Trauma and road accident is considered as major cause mortality in the young adults’ populations around the world. The understanding the importance of forensic investigation of un-natural deaths, accidental injuries and suicidal cases is required by medical staff and patients’ family members. Objective: To asses of mortality pattern based on autopsy in victims of road traffic accident Study Design: Retrospective study Place and Duration of the Study: Medicolegal Section of Liaquat University Hospital Hyderabad, Pakistan from 1st January 2018 to 31st December 2019. Methodology: Six hundred and twenty nine autopsies were included. Deaths due to road traffic accident were included. Results: There were 472 males and 157 females between 31 to 50 years. Two hundred and forty nine patients were admitted in ICU. Two hundred and fourteen patients had affected head region followed by face 104 injuries. While 74 had affected neck, 67 affected thorax, 63 affected abdominal region, 52 affected spine and 55 had affected lower extremities.173 were died due to damage of central nervous system. The damages were due to car accident was 62, motorbike 73, rickshaw 22 and other reasons 14. One hundred and forty patients were died due to fracture of skull. Conclusion: The mortalities rates are under reported in majority of accidental cases due to lacking of autopsies procedures. Keywords: Autopsy, Assessment, Mortality pattern, Road traffic accident

Alar cartilage hematoma of the nose secondary to facial trauma.

&lt;p&gt;A 27 years old male patient victim of road traffic accident presented to emergency department by ambulance team with ankle swelling and decrease range of motion, seen by orthopedic team and admitted as case of right ankle fracture for surgical intervention. Patient then referred to otolaryngology regarding on and off nasal bleeding and right nasal swelling arising from inner surface of right lower lateral cartilage of the nose 6 hour after the facial trauma, we present this case of hematoma of lower lateral cartilage which consider as one of the unique and rare condition following nasal and facial trauma. Early recognition of this condition is important, also differentiation between alar hematoma and septal cartilage hematoma is not easy for non-otolaryngology doctor, so increase awareness of this condition as one of possible sequel of fecal trauma and early referral to otolaryngology services is crucial. We present here a case of right sided alar cartilage hematoma, including the approach, management and follow up of the patient. We recommend early surgical drainage to optimize aesthetic out come after trauma.&lt;/p&gt;

Epidemiology and patterns of road traffic fatalities in India pre- and post-motor vehicle (Amendment) act 2019

Background:Road traffic accidents (RTAs) are a preventable cause of death. The government of India enacted the motor vehicle amendment (MVA) act on September 01, 2019, to curtail the alarming trend of RTAs and their associated fatality. The study objective was to compare the epidemiology and pattern of fatal RTAs before and after the MVA Act 2019 of India.Methods:An autopsy-based cross-sectional study was conducted at the Department of Forensic Medicine and Toxicology (FMT) of a tertiary-care hospital from March 2019 to February 2020. The sample comprised 75 fatal RTA victims who underwent postmortem at FMT. Patients were studied in two groups: One pre-MVA group (n = 47) and one Post-MVA group (n = 28). The data were obtained from medical records and inquest reports with autopsy correlation. Data pertaining to sociodemographic profile, mechanism, injury profile including injury-severity-score (ISS) and survival-time was recorded.Results:There was a 40.4% decline in mortality among RTA victims (P = 0.057) in the post-MVA group. The case fatality rate also declined during post-MVA implementation months compared to pre-MVA months (1.61 vs. 1.96). A significant correlation was noted between the ISS and survival-time of victims (P < 0.001, r = −0.522). The mean age of patients was 39.87 ± 17.44 years. Heavy motor vehicles along with motorized two-wheeler were the most common offending-vehicle. The median ISS of all victims was 41 (33–57). Head injury was the most common cause of death (60%).Conclusion:Study results signal-toward early triumph of the new MVA act, probably due to enhanced adherence to safety gears and constructive behavioral change.

Neurocognitive deficits among adult road traffic accident victims at the University Teaching Hospital, Lusaka, Zambia

Introduction: Road traffic accidents (RTAs) are of growing public health importance worldwide contributing significantly to the global disease burden thus public health experts worldwide concede that there is a global epidemic of RTAs. Exposure to RTAs may be associated with changes in brain functioning and cognitive performance. Objective: This study sought to contribute to the understanding of the neurocognitive deficits among adult victims of RTAs. Methodology: It is a cross-sectional study (descriptive in nature). Cognitive profiles of the affected participants were assessed by selected tests from the International Neurobehavioral test battery. The quality of life was assessed by application of the World Health Organisation Quality of Life (WHOQOL) questionnaire. The primary data obtained was analyzed using descriptive and inferential statistics using SPSS. Results: Twenty-seven (27) RTA victims out of Thirty (30) had executive functioning impairment with a Domain Deficit Score (DDS) of ≥ 0.5 and all the RTA victims in the study had speed of information processing impairment with a Domain Deficit Score (DDS) of ≥ 0.5. There was no significant statistical gender difference in neurocognitive functioning (Executive functioning F=0.85, P=0.36; Speed of information processing F=0.98, P=0.33). Compromised quality of life among adult victims of road traffic accidents was confirmed (P=0.005). Conclusion: This study shows an association between RTA and neurocognitive functioning in adult victims. Findings of this study show the presence of neuropsychological impairments in the two domains assessed (executive functioning and speed of information processing). The study indicates that RTA significantly compromises the quality of life.

Neurocognitive deficits among adult road traffic accident victims at the University Teaching Hospital, Lusaka, Zambia

Neurocognitive deficits among adult road traffic accident victims at the University Teaching Hospital, Lusaka, Zambia

IN ROAD TRAFFIC ACCIDENTS, ARE THE PATTERN, SEVERITY, AND OUTCOME OF DRIVERS’ INJURIES AFFECTED BY MARIJUANA ABUSE?

Introduction: Road traffic accidents (RTAs) represent a leading contributor to the global disease burden. Drivers involved in some RTAs were found to be under the influence of different drugs. Marijuana effects on driving risks are not thoroughly understood. The study aimed to compare the pattern, severity, and clinical outcome of injuries between marijuana-smoking drivers and non-drugged drivers in RTAs. Patients and Methods: This prospective, comparative study was carried out on 78 drivers admitted to the emergency department, Tanta University Emergency Hospital during the period from the start of January to the end of December 2018. All drivers were subjected to history taking, clinical examination, assessment of injury severity score (ISS) and revised trauma score (RTS), and detection of tetrahydrocannabinol (THC) in urine. Results: Thirty-six drivers tested positive for THC with a median level of 314.6 ng/ml. There was a lack of significant association between marijuana smoking and the site of injuries. The marijuana-positive group had a significantly higher frequency of skull fractures, ruptured spleen, intraperitoneal hemorrhage, and abrasions on the body surface when compared to the marijuana-negative group. The median ISS was non-significantly higher, and the mortality was significantly higher in the marijuana-positive group. The THC level correlated significantly and strongly with both ISS and RTS. A significantly higher median THC level was detected in non-survivors compared to survivors. Conclusion: It could be concluded that Marijuana smoking is associated with an increased mortality rate in victims of RTAs. There are strong correlations between THC level and both ISS and RTS, suggesting a dose-dependent effect of marijuana smoking.

Trends of Road Traffic Accidents: Patterns of Injuries in Road Traffic Accidents Victims: A study from Lady Reading Hospital MTI, Peshawar KPK

Background This study reflects the pattern of road traffic accidents and road traffic injuries sustained by RTA victims reporting to LRH MTI. Traffic volume, single and narrow roads is a big problem, traffic rules violation is another demon, lack of awareness, reluctance for the use of safety gears, underage vehicle drivers or rider with questionable driving/ riding skills and no license has worsen the injury pattern and more severe crashes here, putting pedestrians and biker at high risk. Aim: To know the different trends of road traffic accidents, most common victims and different patterns of injuries Methods This is hospital based analytical comparative study, which was conducted in the trauma section of Accident Emergency lady reading hospital MTI Peshawar KPK, during the tenure from May 2020 to November 2020. In this study 298 victims of road traffic accidents were assessed and analyzed from both genders and of all age groups. Results 298 victims of RTAs evaluated in our study. Most common mechanism involved pedestrian verses vehicle 40.3% followed by vehicle versus vehicle 28.6%, curiously in 5.3% of RTAs mechanism was unknown. Most of victims were males when compared with females, Males 86.3% and females 13.6%. children age group 0 -10 years makes 12.6%. Most common vehicle involved was a bike in 48%, followed by car 30% and then 3-wheelers (auto ricksha and Qing chi) 15.3% followed by crashes involving unknown vehicle 8% which is significantly high with all the victims severely wounded or unknown category. Most common victims were vulnerable road users (pedestrian and bike riders) 35% pedestrians and 31.6% bike riders. 11.3% of victims were passengers. Most common injury sustained was head injury38.5%(n=115), followed by lower limb injuries(n=105) 35.2% and polytrauma victims with chilling percentage of 9.3%. Conclusion There is a rising toll of road traffic injuries in and around Peshawar and majority being reported to emergency department LRH, MTI and it is major public health concern. Not only Pedestrians and bike rider are at threat but children of age group under 10 as well with high pedestrian mortality. If proper preventive steps not taken this will continue to rise causing significant death and disabilities. Keywords: Road traffic injuries, road traffic accidents, safety gears road traffic injury victims

Traumatic injuries due to road traffic accidents (RTA) involving motorized tricycles in Morocco

Road Traffic Accident (RTA) are a major health problem in Morocco. Those involving rear cargo tricycles for passenger transport or mixed transport use require special attention. An 18-month continuous retrospective study was performed. It included all victims of RTA involving at least one tricycle, admitted to emergency department with a documented traumatic injury. The data collected was analyzed by statistical software (SPSS v18.0). The aim of this study was to assess the epidemiological, lesional and therapeutic characteristics of stroke’s victims involving tricycles in the region of Grand Casablanca in Morocco. It also highlights the frequency and severity of injuries related to motorized tricycles accidents and the interest of regulatory enforcement to reduce the incidence of these accidents.

A DRAFT OF THE FEDERAL REGISTRY OF MEDICAL CONSEQUENCES OF ROAD TRAFFIC ACCIDENTS

Background: Medical registries are important sources of information that allow timely processing of statistical information for evidence-based decisions in healthcare. The Federal Register of Medical Consequences of Road Traffic Accidents (RTA) with a possibility to be adapted for regional circumstances can serve as a tool for better medical care to the victims of RTA. Aim: To justify the need for and provide a draft of the Federal Registry of Medical Consequences of RTA. Methods: We performed a systematic review of regulatory documents and scientific articles on the organizational issues related to provision of medical care to the victims of RTA in the pre-hospital and hospital periods as well as on the development and implementation of information technologies in healthcare. Results: A justification of the need for a Federal Registry of Medical Consequences of RTA has been provided. The aims of the registry, the list of variables and standard operation procedures for running the registry and the use of the data have been developed. Conclusions: Implementation of the Federal Registry of Medical Consequences of RTA in Russia will allow qualitative estimation of health consequences of RTA providing federal and regional health authorities with reliable and measurable information required for development of preventive measures to reduce the burden of RTA and their consequences in Russia.

Geospatial analysis of severe road traffic accidents in Singapore in 2013-2014.

Injury is a significant cause of mortality and morbidity. We aimed to investigate which areas in Singapore have a significantly higher incidence of road traffic accidents (RTA) resulting in severe injuries (Tier 1), which is defined as an Injury Severity Score (ISS) greater than 15, and to develop a spatiotemporal model. Data was obtained from the National Trauma Registry. The RTA locations were geomapped onto the Singapore map, and spatial statistical techniques were used to identify hotspots with the Getis-Ord Gi* algorithm. From 1 January 2013 to 31 December 2014, there were 35,673 people who were injured as a result of RTAs and 976 Tier 1 RTA victims. A total of 920 people were included in the geospatial analysis. Another 56 were involved in RTAs that did not occur within Singapore or had missing location data and thus were not included. 745 (81.0%) were discharged alive, whereas 175 (19.0%) did not survive to discharge (median ISS 38.00, interquartile range 30.00-48.00). Most of the Tier 1 RTA victims were motorcycle riders (50.1%, n = 461), pedestrians (21.8%, n = 201) and cyclists (9.9%, n = 91). The majority were male and aged 20-40 years, and there was a peak occurrence at 0600-0759 hours. Nine hotspots were identified (p < 0.01). Information from studying hotspots of RTAs, especially those resulting in severe injuries, can be used by multiple agencies to direct resources efficiently.