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

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: Personal mobility devices (PMDs), such as electronic scooters or motorised bicycles, are efficient modes of transportation. Their recent popularity has also resulted in an increase in PMD-related injuries. We aimed to characterise and compare the nature of injuries sustained by PMD users and bicycle riders. METHODS: This retrospective study compared injury patterns among PMD and bicycle users. 140 patients were admitted between November 2013 and September 2018. Parameters studied included patients' demographics (e.g. age, gender and body mass index), type of PMD, nature of injury, surgical intervention required, duration of hospitalisation and time off work. RESULTS: Of 140 patients, 46 (32.9%) patients required treatment at the department of orthopaedic surgery. 19 patients were PMD users while 27 were bicycle riders. 16 (84.2%) patients with PMD-related injuries were men. PMD users were significantly younger (mean age 45 ± 15 years) when compared to bicycle riders (mean age 56 ± 17 years; P <0.05). A quarter (n = 5, 26.3%) of PMD users sustained open fractures and over half (n = 10, 52.6%) required surgical intervention. Among 27 bicycle users, 7.4% (n = 2) of patients sustained open fractures and 70.4% (n = 19) required surgical intervention. Both groups had comparable inpatient stay duration and time off work. CONCLUSION PMD-related orthopaedic traumas are high-energy injuries, with higher rates of open fractures, when compared to bicycle injuries. In addition, PMD users are significantly younger and of economically viable age. Prolonged hospitalisation and time off work have socioeconomic implications. Caution should be exercised when using PMDs.
Male ; Humans ; Adult ; Middle Aged ; Aged ; Female ; Bicycling/injuries* ; Retrospective Studies ; Fractures, Open ; Orthopedics ; Hospitalization ; 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

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

Objective: To analyze the trajectory of drowning and road traffic injury mortality among children aged 5-14 years in China from 2008 to 2019. Methods: Mortality data of unintentional injuries were from the Mortality Surveillance Data Set of National Disease Surveillance System from 2009 to 2018 and grouped by regions, urban and rural areas, genders, and age groups. The trajectory model was used to analyze the trend of drowning and road traffic injury mortality with years. Results: The mortality of drowning and road traffic injury showed a similar trend. In the trajectory model of drowning mortality, east, middle and west rural boys and western urban boys of all ages belonged to the high mortality group. The moderate mortality group included eastern urban boys and western girls aged 5-9 years and also contained eastern and middle urban boys and western urban girls aged 10-14 years. The other combinations belonged to the low mortality group. In the trajectory model of road traffic injury mortality, western urban boys, all rural boys and western rural girls aged 5-9 years, middle and western rural boys and western urban boys aged 10-14 years belonged to the high mortality group. Eastern urban girls aged 5-9 years and 10-14 years belonged to the low mortality group. The other combinations belonged to the moderate mortality group. Conclusion: There are different groups in the trajectory model of drowning and road traffic injury mortality among children in China. Identifying the trajectory of injury mortality is helpful to carry out more targeted prevention in China.
Accidental Injuries ; Accidents, Traffic ; Child ; China/epidemiology* ; Drowning ; Female ; Humans ; Male ; Rural Population ; Urban Population ; Wounds and Injuries

Objective: To analyze the mortality level and tendency of road traffic injury in Shandong province from 2012 to 2020. Methods: Based on the data of road traffic deaths from the cause of death registration system in Shandong province from 2012 to 2020, the mortality rates of road traffic injury were calculated by sex, age, area, and injury type. The mortality was standardized based on the age structure of the Chinese population in the sixth Population Census in 2010. The annual percent change (APC) and average annual percent change (AAPC) of the mortalities and the standarized mortalities were calculated by using Joinpoint regression model, and the trends were also examined. Results: In 2020, the crude mortality of road traffic injury in Shandong Province was 15.58/100 000, and the standardized mortality was 12.90/100 000. From 2012 to 2020, the standardized mortality of road traffic injury in Shandong province showed a downward trend with AAPC of -5.4%. The standardized mortality of middle-south mountain areas, male and children aged 0-14 years in Shandong showed a significantly decreasing trend with AAPC of -6.8%, -6.1% and -6.0%, respectively. The standardized mortality of people aged 65 years and over did not decrease significantly, but the number of deaths increased significantly by 50.96% in 2020 (5 780 cases), compared with those in 2012 (3 829 cases). The standardized mortality of pedestrian and motorcyclists decreased significantly with AAPC of -7.5% and -6.7%, respectively. There was no significant change in the standardized mortality among people who rode motor vehicles or bicycles. Conclusion: From 2012 to 2020, the standardized mortality of road traffic injury in Shandong Province showed an obvious downward trend, but the standardized mortality of people aged 65 years and over did not decrease significantly. In the future, it is still necessary to take government-led, multi-sectoral collaboration, with a focus on comprehensive preventive measures, to further reduce road traffic injury mortality.
Accidents, Traffic ; Asian People ; Child ; Government ; Humans ; Male ; Mortality ; Motor Vehicles