PURPOSE: Injury is a leading cause of morbidity and mortality for children. As an injury prevention measure, the differences in external causes of severe pediatric injuries based on ICECI were analyzed according to age groups. METHODS: A retrospective study was performed for pediatric patients under 15 years of age, who had been admitted to the emergency department with severe injuries from January 1998 to December 2004. The external causes of injury were investigated according to the ICECI: intent, mechanisms, places of occurrence, objects/substances producing injury, and related activities. The patients were divided into four groups based on age: infant (< 0 year), toddler (1~4 years), preschool age (5~8 years), and school age (9~15 years). RESULTS: The injury mechanisms, the places of occurrence and the related objects/substances vary with the age groups. The most common subtype of traffic accidents was pedestrian injury in pre-school age group. Falls most frequently occurred in the toddler group. But falls from a height of less than l meter height (6 patients) occurred only in the infant group. The most common place of occurrence in the infant group was the home, and that of other groups was the road. The related objects/substances for falls, for example, household furnitures and playground equipment depended on the age group. CONCLUSION: The age-group specific characteristics of severe pediatric injury were analyzed successfully through the ICECI. Therefore, when establishing a plan for the prevention of pediatric injury, consideration must be given to the differences in the external causes of injuries according to age group.
Accident Prevention ; Accidents, Traffic ; Child ; Emergency Service, Hospital ; Family Characteristics ; Humans ; Infant ; Mortality ; Retrospective Studies

Accidents, Traffic ; mortality ; prevention & control ; statistics & numerical data ; China ; epidemiology ; Humans ; Prevalence ; Survival Rate

Accidents, Traffic ; mortality ; prevention & control ; China ; epidemiology ; Global Health ; Humans ; Wounds and Injuries ; epidemiology

PURPOSE: The environment of traffic accident sites could affect the outcomes of injured patients during emergency care. The goal of this investigation is to assess the association between the road type during motor vehicle collision and mortality or disability of severe trauma patients. METHODS: We used an emergency medical service based on severe trauma database operated by the Korean Center for Disease Control and Prevention. The database collected information on injured patients with abnormal prehospital revised trauma score transported by fire department during 2012 in 6 provinces of South Korea. Among the cases collected, we distinguished between drivers and passengers of motor vehicle collision. We divided the road types into two categories: highway and non-highway. We collected the demographics, injury related information, prehospital indicator, and clinical outcome. Primary outcome was in-hospital mortality and secondary outcome was disability. We assessed the association using a multivariate logistic regression. RESULTS: During the study period, 1,122 cases with 131 highway types and 991 non-highway types were analyzed. Patients in the highway type showed delayed time of arrival at the scene from EMS activation and delayed hospital arrival from departing the scene. Hospital mortality was higher in the highway group (43.5% vs 31.6%, p<0.05). According to multiple logistic regression, the highway group showed higher mortality (OR 1.86, 95% CI 1.26-2.75). Higher proportion of disability was also associated with the highway group (OR 1.53, CI 1.04-2.25). CONCLUSION: We assessed the association of road type and clinical outcome of patients injured due to traffic accident. Cases associated with the highway type were showed 1.86 times higher mortality and 1.53 times higher disability compared with the non-highway type.
Accidents, Traffic* ; Ambulances* ; Centers for Disease Control and Prevention (U.S.) ; Demography ; Disability Evaluation ; Emergency Medical Services ; Fires* ; Hospital Mortality ; Humans ; Korea ; Logistic Models ; Mortality* ; Motor Vehicles*

OBJECTIVETo develop the forecasting models for fatal road traffic injuries and to provide evidence for predicting the future trends on road traffic injuries.

METHODSData on the mortality of road traffic injury including factors as gender and age in different countries, were obtained from the World Health Organization Mortality Database. Other information on GDP per capita, urbanization, motorization and education were collected from online resources of World Bank, WHO, the United Nations Population Division and other agencies. We fitted logarithmic models of road traffic injury mortality by gender and age group, including predictors of GDP per capita, urbanization, motorization and education. Sex- and age-specific forecasting models developed by WHO that including GDP per capita, education and time etc. were also fitted. Coefficient of determination(R(2)) was used to compare the performance between our modes and WHO models.

RESULTS2 626 sets of data were collected from 153 countries/regions for both genders, between 1965 and 2010. The forecasting models of road traffic injury mortality based on GDP per capita, motorization, urbanization and education appeared to be statistically significant(P < 0.001), and the coefficients of determination for males at the age groups of 0-4, 5-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65+ were 22.7% , 31.1%, 51.8%, 52.3%, 44.9%, 41.8%, 40.1%, 25.5%, respectively while the coefficients for these age groups in women were 22.9%, 32.6%, 51.1%, 49.3%, 41.3%, 35.9%, 30.7%, 20.1%, respectively. The WHO models that were based on the GDP per capita, education and time variables were statistically significant (P < 0.001)and the coefficients of determination were 14.9% , 22.0%, 31.5%, 33.1% , 30.7%, 28.5%, 27.7% and 17.8% for males, but 14.1%, 20.6%, 30.4%, 31.8%, 26.7%, 24.3%, 17.3% and 8.8% for females, respectively.

CONCLUSIONThe forecasting models that we developed seemed to be better than those developed by WHO.

Accidents, Traffic ; mortality ; prevention & control ; trends ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Forecasting ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Models, Statistical

PURPOSE: By studying the economic data related to road traffic accidents in recent 10 years, this paper explores the impact of various economic factors on the number of casualties in traffic accidents in China, and puts forward related prevention and management measures. METHODS: Based on five economic factors including the number of new health institutions, health investment, transportation investment and disposable income per capita, this paper collects the data of traffic accidents in 31 provinces and municipalities of China from 2004 to 2016 and estimates the parameters using fixed effect model. RESULTS: The number of health institutions, health investment, transportation investment and disposable income per capita are negatively correlated with the number of traffic accident casualties; the number of new health institutions is positively correlated with the number of traffic accident casualties; health investment and transportation investment have a great impact on the number of road traffic accident casualties. CONCLUSION Economic development has a positive impact on improving traffic conditions, but the increase in the number of new health institutions does not reduce the number of casualties in accidents. The irrational layout of health institutions and imperfect road traffic management mechanism should be taken into account.
Accidents, Traffic ; mortality ; prevention & control ; statistics & numerical data ; China ; epidemiology ; Economics ; Health ; economics ; Health Facilities ; statistics & numerical data ; Humans ; Income ; Time Factors ; Transportation ; economics ; Wounds and Injuries ; epidemiology

PURPOSE: Injury continues to be an important cause of morbidity and mortality in both developed and developing countries. Globally, it is responsible for approximately 5.8 million deaths per year and 91% of these deaths occur in developing countries. Road traffic collision, suicides and homicides are the leading cause of traumatic deaths. Despite the fact that traumatic chest injury is being responsible for 10% of all trauma-related hospital admissions and 25% of trauma-related deaths across the world including in Ethiopia, only few published studies showed the burden of traumatic chest injury in Ethiopia. So, this study aims at assessing the characteristics and outcome of traumatic chest injury patients visited Tikur Anbesa Specialized Hospital (TASH) over one year period. METHODS: A single center based retrospective study was done. We collected data from patients' records to assess characteristics and outcome of traumatic chest injury at TASH over one year period. All patients diagnosed with traumatic chest injury and received treatment at the hospital from January 1 to December 31, 2016 regardless of its types and severity levels were included in the study. Patients with incomplete medical records for at least 20% of the study variables and without detailed medical history, or patients died before receiving any health care were excluded from the study. The collected data were cleaned and entered into Epidata version 3.1 and exported to SPSS Version 21.0 for analysis. Bivariate and multivariate logistic regression models were used to examine factors associated with outcome of traumatic chest injury patients. RESULTS: A total of 192 chest injury patients were included in the study and about one-fourth of chest injury victims were died during treatment period in TASH. Road traffic collision (RTC) was the leading cause of morbidity and mortality among traumatic chest injury victims. Age of the victims (adjusted odds ratio (AOR) 8.9, 95% confidence interval (CI) 1.51-53.24), time elapsed between the occurrence of traumatic chest injury and admission to health care facilities (AOR 4.6, 95% CI 1.19-18.00), length of stay in hospital (AOR 0.12, 95% CI 0.02-0.58), presence of multiple extra-thoracic injury (AOR 25, 95% CI 4.18-150.02) and development of complications (AOR 23, 95% CI 10-550) were factors associated with death among traumatic chest injury patients in this study. CONCLUSION RTC contributed for a considerable number of traumatic chest injuries in this study. Old age, delay in delivering the victim to health care facilities, length of stay in hospital, and development of atelectasis and pneumonia were associated with death among traumatic chest injury patients. Road safety interventions, establishment of organized pre-hospital services, and early recognition and prompt management of traumatic chest injury related complications are urgently needed to overcome the underlying problems in the study setting.
Accidents, Traffic ; prevention & control ; Adult ; Age Factors ; Ethiopia ; epidemiology ; Female ; Hospitals, Special ; statistics & numerical data ; Humans ; Length of Stay ; Male ; Middle Aged ; Pneumonia ; etiology ; mortality ; Pulmonary Atelectasis ; etiology ; mortality ; Retrospective Studies ; Thoracic Injuries ; complications ; epidemiology ; mortality ; Time Factors ; Transportation of Patients

Accidents, Traffic ; mortality ; Adult ; Aged ; Cause of Death ; China ; epidemiology ; Coronary Disease ; mortality ; Databases, Factual ; Female ; Humans ; Hypertension ; prevention & control ; Male ; Middle Aged ; Risk Factors ; Smoking ; adverse effects ; Stroke ; mortality

Proper seat belt use saves lives; however, the use rate decreased in Korea. This study aimed to measure the magnitude of the preventive effect of seat belt on case-fatality across drivers and passengers. We used the Emergency Department based Injury In-depth Surveillance (EDIIS) database from 17 EDs between 2011 and 2012. All of adult injured patients from road traffic injuries (RTI) in-vehicle of less than 10-seat van were eligible, excluding cases with unknown seat belt use and outcomes. Primary and secondary endpoints were in-hospital mortality and intracranial injury. We calculated adjusted odds ratios (AORs) of seat belt use and driving status for study outcomes adjusting for potential confounders. Among 23,698 eligible patients, 15,304 (64.6%) wore seat belts. Driver, middle aged (30-44 yr), male, daytime injured patients were more likely to use seat belts (all P < 0.001). In terms of clinical outcome, no seat belt group had higher proportions of case-fatality and intracranial injury compared to seat belt group (both P < 0.001). Compared to seat belt group, AORs (95% CIs) of no seat belt group were 10.43 (7.75-14.04) for case-fatality and 2.68 (2.25-3.19) for intracranial injury respectively. In the interaction model, AORs (95% CIs) of no seat belt use for case-fatality were 11.71 (8.45-16.22) in drivers and 5.52 (2.83-14.76) in non-driving passengers, respectively. Wearing seat belt has significantly preventive effects on case-fatality and intracranial injury. Public health efforts to increase seat belt use are needed to reduce health burden from RTIs.
Accidents, Traffic/mortality/*prevention & control ; Adult ; Aged ; Craniocerebral Trauma/prevention & control ; Databases, Factual ; Emergency Service, Hospital ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Motor Vehicles ; Odds Ratio ; Republic of Korea/epidemiology ; Seat Belts/*utilization ; Young Adult

PURPOSE: Traffic accidents are one of the main causes of death and disability, causing annual deaths of 1.23 million and tens of millions injured people worldwide. Meanwhile, a significant proportion of the deaths and injuries caused by traffic accidents occur among motorcyclists. According to the world health organization's 2015 report, about 25% of deaths from traffic accidents occur in motorists. In Iran, a significant proportion of deaths and injuries result from traffic accidents among motorcyclists, especially in passages within the cities. According to traffic police, about 25% of deaths and 50% of injuries in traffic accidents of Tehran are reported among motorcyclists. Therefore, due to the importance of this issue, the spatial factors influencing the incidence of motorcycle-related accidents in Tehran were investigated using the geographic information system. METHODS: The present work was a cross-sectional and descriptive analysis study. The data necessary for the study were extracted from Tehran traffic police as well as municipality databases. Zoning maps were used to display the distribution of events. In the analytical investigation, Moran index was used to determine the distribution pattern of the events, while Getis-Ord G * statistics were applied to analyze hot spots. To investigate the role of regional and environmental factors in the frequency of traffic accidents related to motorcyclists in geographic units (Tehran 22 districts), Poisson regression and negative binomial models were used. The geographically weighted regression (GWR) model was used to analyze the relationship between environmental factors and the location of these events. Statistical analyses were performed using SPSS, STATA, ARC-GIS and GWR software. RESULTS: The southern and eastern margins of Tehran are the most vulnerable areas in terms of deaths related to traffic accidents of motorcyclists. Highways are considered the location of most traffic accidents which lead to death of motorcyclists. Getis-Ord General G * (p < 0.04) indicates that the distribution of high-risk points is statistically significant. The final model showed that in Tehran, the association of different variables including demographic characteristics, pathways network and type of land use with the number of accidents in geographic units was statistically significant. The spatial distribution of traffic accidents leading to deaths of motorcyclists in the center of Tehran varies considerably with changes in population density, length of highways, volume of traffic, and land use in different parts. CONCLUSION Most of the traffic accidents leading to deaths of motorcyclists occur in highways. Various environmental variables play a role in determining the distribution pattern of these types of events. Through proper traffic management, controlling environmental risk factors and training people the safety of motorcyclists in Tehran can be improved.
Accidents, Traffic ; prevention & control ; statistics & numerical data ; Automobile Driving ; statistics & numerical data ; Cross-Sectional Studies ; Environment ; Geographic Information Systems ; Geography ; Humans ; Incidence ; Iran ; epidemiology ; Motorcycles ; statistics & numerical data ; Regression Analysis ; Risk Factors ; Wounds and Injuries ; epidemiology ; etiology ; mortality ; prevention & control