Humans ; Pilot Projects ; Singapore ; Hospitals ; Primary Health Care ; Accidents ; Emergency Service, Hospital

PURPOSE: To systematically review the risk of permanent disability related to road traffic injuries (RTIs) and to determine the implications for future research regarding permanent impairment following road traffic crashes. METHODS: We conducted this systematic review according to the preferred reporting items for systematic reviews and meta-analysis statement. An extended search of the literature was carried out in 4 major electronic databases for scientific research papers published from January 1980 to February 2020. Two teams include 2 reviewers each, screened independently the titles/abstracts, and after that, reviewed the full text of the included studies. The quality of the studies was assessed using the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. A third reviewer was assessed any discrepancy and all data of included studies were extracted. Finally, the data were systematically analyzed, and the related data were interpreted. RESULTS: Five out of 16 studies were evaluated as high-quality according to the STROBE checklist. Fifteen studies ranked the initial injuries according to the abbreviated injury scale 2005. Five studies reported the total risk of permanent medical impairment following RTIs which varied from 2% to 23% for car occupants and 2.8% to 46% for cyclists. Seven studies reported the risk of permanent medical impairment of the different body regions. Eleven studies stated the most common body region to develop permanent impairment, of which 6 studies demonstrated that injuries of the cervical spine and neck were at the highest risk of becoming permanent injured. CONCLUSION The finding of this review revealed the necessity of providing a globally validated method to evaluate permanent medical impairment following RTIs across the world. This would facilitate decision-making about traffic injuries and efficient management to reduce the financial and psychological burdens for individuals and communities.
Humans ; Accidents, Traffic ; Disabled Persons ; Abbreviated Injury Scale ; Databases, Factual ; Wounds and Injuries/etiology*

Humans ; Accidents, Traffic ; Colon, Sigmoid ; Forensic Medicine ; Autopsy ; Abdominal Injuries ; Thoracic Injuries ; Rupture

Carbon dioxide is a simple asphyxial gas, with low concentrations having an excitatory effect on the respiratory center, while high concentrations have an inhibitory effect on the respiratory center. Simple carbon dioxide poisoning is rarely seen clinically. This article reviews and analyzes the treatment process of 9 cases of acute inhalation carbon dioxide poisoning in a cargo ship carbon dioxide leakage accident in May 2019, summarizes clinical treatment experience, and provides timely and effective treatment for acute pulmonary edema caused by acute inhalation carbon dioxide poisoning. In particular, the application of hormones has a good prognosis, improving clinicians' understanding of the disease.
Humans ; Carbon Dioxide ; Ships ; Accidents ; Pulmonary Edema ; Treatment Outcome ; Poisoning ; Accidents, Occupational

PURPOSE: Spine injury is one of the leading causes of death and mortality worldwide. The objective of this study was to determine the incidence, pattern and outcome of trauma patients with spine injury referred to the largest trauma center in southern Iran during the last 3 years. METHODS: This is a cross-sectional study conducted between March 2018 and June 2021 in the largest trauma center in the southern Iran. The data collection form included the age, sex, injury location (cervical, thoracic, and lumbar), cause of injury (traffic accidents, falls, and assaults), length of hospital stay, injured segment of spine injury, severity of injury, and outcome. Statistical analyzes were performed using SPSS software version 24. RESULTS: Totally 776 cases of spine injury were identified. The spine injury rate was 17.0%, and the mortality rate was 15.5%. Cervical spine injury (20.4%) more often occulted in motorcycle accident, and thoracic spine injury (20.1%) occulted in falls. The highest and lowest rates of spine injurys were related to lumbar spine injury (30.2%) and cervical spine injury (21.5%), respectively. There was a statistically significant relationship between the mechanism of injury and the location of spine injury (p < 0.001). And patients with lumbar spine injury had the highest mortality rate (16.7%). Injury severity score (OR= 1.041, p < 0.001) and length of stay (OR = 1.018, p < 0.001) were strong predictors of mortality in trauma patients with spine injury. CONCLUSION The results of the study showed that the incidence of traumatic spine injury rate was approximately 17.0% in southern of Iran. Road traffic injury and falls are the common mechanism of injury to spine. It is important to improve the safety of roads, and passengers, as well as work environment, and improve the quality of cars. Also, paying attention to the pattern of spine injury may assist to prevent the missing diagnosis of spine injury in multiple trauma patients.
Humans ; Incidence ; Trauma Centers ; Iran/epidemiology* ; Cross-Sectional Studies ; Spinal Injuries/etiology* ; Neck Injuries ; Accidents, Traffic

Introduction: Around 1.35 million people die due to road traffic accidents yearly. In the Philippines, there is an increasing trend of mortality and morbidity caused by road crashes. Objective: The objective of the study is to show the epidemiology of transport and vehicular crash (TVC) cases in the Philippines using the Department of Health (DOH) Online National Electronic Injury Surveillance System (ONEISS) from 2010 to 2019. Methods: We used data from ONEISS, a web-based system to electronically capture injury-related data from health facilities, store data in a centralized and secure location, process and consolidate data, and transform this data into meaningful information. For Transport and Vehicular Crash cases, risk factors such as drug use, alcohol use, mobile phone use, seatbelt, and helmet use are included. There are also data on vehicle type, place of crash, and activity. Descriptive and inferential statistics were computed to explore and analyze the ONEISS dataset, particularly the epidemiology of transport and vehicular crashes (TVC). Results: There were a total of 296,760/894,989 (31%) patients admitted due to transport and vehicular crash (TVC) based on the 10-year data from ONEISS (2010–2019). There was an increasing trend in the number of transport/ vehicular crashes (TVC) during this period, with an average increase of 25.58% cases per year. Most victims were drivers (45.6%), males (72.5%), and from the younger age group (0-30 years old). Fatal crashes were observed to occur from 6:00 pm to 5:00 am while most accidents occurred during leisure activities (32.5%). The highest reported contributing factor was drunk driving (n = 25,537). There was observed low compliance on the use of vehicular safety equipment. The most common types of injuries for the TVC victims were abrasions, contusions, burns, and concussions while the vehicle most involved in TVC was the motorcycle. Motorcycle use was found to be associated with worse emergency room (ER) outcomes (p <.0001) and the highest injury types such as multiple injuries, abrasion, avulsion and burn. Alcohol use was also significantly associated with multiple injuries, abrasion, avulsion, burn, open fracture, open wound, and amputation (p < 0.05). Conclusion The trend of road traffic vehicular crashes affecting mainly the younger population has economic repercussions. Motorcycles are also most involved in crashes, hence, the need for motorcycle safety laws in the country. There is also a need to strengthen current laws and legislation governing road safety and to focus on structuring a systematic post-crash response for both the local government and hospitals throughout the Philippines.
Accidents, Traffic ; Alcoholic Intoxication

Introduction: Road traffic accidents are a growing public health burden, especially in the low- and middle-income countries (LMICs). With resource scarcity, road traffic injuries may lead to poor quality of life among survivors, or deaths at worst. Victims of crashes involving transportations are gendered; therefore, there may be differences in the trends and characteristics of injuries sustained by men and women related to road crash. Objectives: This study aimed to determine the factors related to severity of road crashes among women road users in the Philippines from 2008 to 2017. Methods: We conducted a retrospective review of clinical records of women patients involved in road crash at the Trauma Division, Department of Surgery of the Philippine General Hospital (PGH) for the ten-year period, January 1, 2008 to December 31, 2017. Data were extracted from the electronic patient records in Integrated Surgical Information System (ISIS). Results: From 2008 to 2017, 926 of the road crash victims brought to PGH were women. There was an increasing trend, with the years 2015 to 2017 accounting for half of the total cases (55.62%). The highest cases of women patient admissions were also recorded during the months of June and July (5.61%). The CALABARZON region (11.23%) and National Capital Region (8.21%) had the highest admissions. The patients were most commonly pedestrians (12.20%) and involved in collisions (13.50%) or vehicle involvement (13.17%). The most common vehicle involved was a motorcycle (9.72%) followed by car and vans (1.62%). Only a small proportion of women patients used helmets (3.33%) and seatbelts (0.12%). The median length of hospital stay of women patients was 5 days. The most commonly sustained injuries among patients were multiple (83.65%), external (43.72%), extremity (33.15%), head and neck (23.47%), and face (21.58%) injuries. Among these, injuries to the extremity had the highest average length of hospital stay (16.04 ± 31.28 days) while external and head and neck injuries had the shortest (10.81 ± 33.42 days). Multinomial regression showed that women patients who suffered from head and neck, and abdominal injuries had increased odds of dying by 4.94 times (CI: 2.158-11.302, p < 0.05), and 3.33 times (CI:1.235-9.02, p < 0.05), respectively, compared to those who did not suffer said injuries. Conclusion There is a significant number of women involved in road crashes in the Philippines, and therefore, there is a need for directed policies on female road users as vulnerable road users.
Accidents ; Women ; Motor Vehicles ; Length of Stay ; Hospitalization

OBJECTIVES: To analyze the characteristics of thoracic aorta injury in road traffic accidents, to provide data reference for forensic identification. METHODS: The data of 27 traffic accident death cases with thoracic aorta injury were analyzed according to relevant parameters including sex, age, mode of transportation, and thoracic aorta injury. RESULTS: Aortic injury in traffic accidents was significantly more in males than females, and 74.1% cases were in the age range of 31-70 years. The most common mode of transportation was the motorcycle, followed by electric bike, most of which crashed with trucks. Most cases were accompanied by rib fractures and lung injuries. Thoracic aorta injury was the most common in ascending aorta, followed by aortic arch and thoracic aorta. Ascending aorta injury was most likely to occur in the range of 0-<1.6 cm from the aortic valve, while it was rare over 2.6 cm. Taking the aortic valve as the reference, the most common locations of injury were the anterior semilunar valve, followed by the right posterior semilunar valve and the left posterior semilunar valve. Thoracic aortic rupture occurred in 63.0% cases, and intima and media lacerations only occurred in 37.0% cases. A few deceased had aortic diseases. CONCLUSIONS The proximal part of the ascending aorta is prone to be injured because of the large external force of traffic accidents. The medical examiner should carefully examine the aortic injury in traffic accident deaths, and evaluate the relationship between the injury and the disease according to the condition and degree of aortic injury.
Male ; Female ; Humans ; Adult ; Middle Aged ; Aged ; Aorta, Thoracic/injuries* ; Accidents, Traffic ; Thoracic Injuries ; Aortic Rupture/etiology* ; Rib Fractures

Humans ; Accidents, Traffic ; Cause of Death ; Technology

Humans ; Accidents, Traffic ; Automobile Driving ; Risk Factors