Objective To study factors influencing injury severity of expressway traffic acci- dents. Methods Data of expressway traffic accidents involving casualties in areas around Hangzhou during 2005-2006 were collected and analyzed by non-conditional simple and multiple logistic regression analysis. Results (1) During 2005-2006, there were 220 traffic crashes involving 327 eases, of which there were 64 deaths (19.6%), 121 severe injuries (37.0%, ISS≥16 points) and 142 slight and mod- erate injuries (43.4%, 1 point≤ ISS≤15 points). (2) Non-conditional simple logistic regression analy- sis showed that risk factors significantly influencing the injury outcomes of traffic accidents included gen- der, weekday, weather, type of collision, vehicle type, driver category, purpose of vehicle use, purpose of travel and crash responsibility. (3) Non-conditional multiple logistic regression analysis manifested that influential factors were gender, type of collision, driver category and crash respensibihty. Conclu- sion Analysis of expressway traffic accidents data helps identify factors influencing injury severity of ex- pressway traffic accidents may provide suggestions for prevention or decrease of expressway traffic acci- dents.

Objective To study the positive influence of a standard trauma system on the care of severely injured patients.Methods The severely injured patients (NISS≥16 points)were divided into study group ( in 2006-2008,after the establishment of trauma center in our hospital) and control group (in 2001-2005,before the establishment of trauma center),which was bound by the establishment of the trauma center in our hospital in January 2006.The injury severity,care and outcomes were recorded by using China Trauma Database and changes in efficiency and quality of injury care were compared.Results The study group (66 patients) and control group (260 patients) with NISS of (20.59 ±4.63)points and (20.57 ± 5.38 ) points respectively,were similar in the distribution of severity ( P ＞ 0.05 ).The emergency care time was (0.33 ± 0.03) hour in the study group,which was significantly shortened compared with (0.57 ±0.35 ) hours in the control group (P ＜ 0.01 ).The length of hospital stay was (27.64 ±29.01 ) days in the study group,which was shorter than (30.84 ± 32.87 ) days in the control group (P ＞ 0.05 ),while the length of ICU stay was (2.98 ± 5.77 ) days in the study group,longer than (2.65 ± 7.00) days in the control group (P ＞ 0.05 ).The recovery rate was significantly increased from 76.5％ to 87.9％ (P ＜0.05) and mortality was significantly decreased from 20.8％ to 9.1％ (P ＜0.05).Conclusion The study indicates that the standard first aid model can notably improve the trauma care in our hospital.

Objective To study the postoperative survival rate of elderly patients with hip fracture at different time and its related factors.Methods We conducted the follow-up studies of 255 elderly hip fracture patients from June 2008 to June 2011 in our hospital.The survival rates of patients at 6 months,1,2 and 3 years after operation and their related factors were studied.Results The survival rate was 96.5％,89.8％,78.0％ and 69.4％ at 6 months,1,2 and 3 years after operation respectively in 255 elderly hip fracture patients.Survival analysis showed that many kinds of preoperative comorbidities,low albumin level,old age and severe anemia were the risk factors for survival.Good activity of daily living before injury was a protective factor for survival.Gender,fracture type,the American Society of Anesthesiologists (ASA) classification,time from injury to surgery,anesthesia type,surgical approach,operative time,blood loss and hospital stay periods had no effect on survival after operation.Conclusions The survival rate in elderly patients with hip fracture after surgery is affected by many factors.Preoperative comorbidities,anemia and hypoalbuminemia should be actively treated,the activity of daily living should be improved by the directed therapy and rehabilitation,in order to improve the survival rate in elderly patients with hip fracture.

Objective To study the incidence, character and related risk factors of post trauma stress disorders (PTSD) after road traffic accidents. Methods Inpatients after road traffic accidents from January 2001 to January 2005 were surveyed with self-made questionnaire. The incidence, clinical symptoms and related factors of PTSD were analyzed. Results 156 cases (7.53％) were diagnosed as PTSD among all subjects and their major clinical manifestation including difficulty of falling or staying asleep, compulsion of re-experience traumatic process and excessive startled reactions. The related factors of PTSD including the personality, the degree of education, family harmony and compensation. Conclusion PTSD is common in patients injured in road traffic accidents. Early psychological intervention for susceptible may be needed.