OBJECTIVETo investigate the application of percutaneous endoscopic gastrostomy (PEG) to patients with severe craniocerebral injury for the purpose of nutritional support therapy and pulmonary infection prevention.

METHODSA total of 43 patients with severe craniocerebral injury admitted to our department from January 2008 to December 2012 received PEG followed by nutritional therapy. There were other 82 patients who were prescribed nasal-feeding nutrition. Nutrition status was evaluated by comparing serum albumin levels, and the incidence of pulmonary infection 1 week before and 2 weeks after operation was identified and compared.

RESULTSBoth PEG and nasal-feeding nutrition therapies have significantly elevated serum albumin levels (P<0.05). Serum albumin levels before and after nutritional therapies showed no significant difference between the two groups (P>0.05). The incidence of pulmonary infection in PEG group was significantly decreased compared with that in nasal-feeding nutrition group (P<0.05).

CONCLUSIONPEG is an effective method for severe craniocerebral injury patients. It can not only provide enteral nutrition but also prevent pulmonary infection induced by esophageal reflux.

Craniocerebral Trauma ; therapy ; Gastroesophageal Reflux ; prevention & control ; Gastroscopy ; Gastrostomy ; methods ; Humans ; Lung Diseases ; prevention & control ; Nutritional Support ; Serum Albumin ; analysis

PURPOSE: The purpose of this study is to suggest methods for construction of a database for in-depth analysis of the relationship between occupant injury and vehicle damage in domestic motor vehicle crash accidents through analysis of real examples of real motor vehicle crash accidents. METHODS: Among patients who visited the emergency room of three domestic hospitals due to motor vehicle crash accidents from January 2011 to September 2011, we collected data on patients with an ISS (Injury Severity Score) over 16. In addition, we surveyed the cause of the accident, information on vehicles involved in the accident, the type and amount of damage inflicted on the vehicle, and the severity of injury of the patient. Damage to the vehicle was presented using the CDC (Collision Deformation Classification) code by evaluation of photo-images of the damaged vehicle, and a trauma score was used for evaluation of the severity of the patient's injury. RESULTS: Of 76 cases of motor vehicle accidents, the number of subjects was 87, with an average age of 43.2+/-17.9. Of these, 68(78.2%) subjects were males, 65(74.7%) subjects were drivers, 35(42.2%) subjects had fastened their seat belts, and, in 15(19.7%) cases, the airbag was deployed in the accident. Averages of ISS and RTS (Revised Trauma Score) were 32.3 and 6.6, respectively. Among 45 cases of frontal collision, chest injury was the most common (30,66.7%), and average AIS (Abbreviated Injury Scale) of chest injury was the highest (3.1+/-0.7). Severity of head injury (AIS 1) and mean ISS by PDoF (Principal Direction of Force) showed a significant difference (p<0.001, p=0.003, respectively), and mean ISS between seat belt users and non-users also differed (23.8 vs. 37.5, p=0.002). In addition, the occupant's mean ISS in vehicles whose airbag was deployed was lower (23.7 vs. 33.9), however, no statistically significant difference was observed (p=0.123). CONCLUSION: For analysis of the relationship between occupant injury and vehicle damage in domestic motor vehicle crash accidents, construction of an in-depth database through the national surveillance system for motor vehicle traffic accidents is necessary.
Accidents, Traffic ; Air Bags ; Centers for Disease Control and Prevention (U.S.) ; Craniocerebral Trauma ; Emergencies ; Humans ; Injury Severity Score ; Male ; Motor Vehicles ; Pilot Projects ; Seat Belts ; Thoracic Injuries

BACKGROUND: Helmet use reduces the risk and severity of head injury and death due to road traffic crash among motorcyclists. The protective efficacy of different types of helmets varies. Wearing firmly fastened full-face helmet termed as effective helmet use provides greatest protection. This study estimates the prevalence and factors associated with effective helmet use among motorcyclists in Mysuru, a tier II city in Southern India. METHODS: Cross-sectional road side observational study of 3499 motorcyclists (2134 motorcycle riders and 1365 pillion riders) at four traffic intersections was done followed by interview of random sample of 129 of the above riders. Effective helmet use proportion and effective helmet use per 100 person-minute of observation was calculated. Multivariate logistic regression analysis was done to identify factors associated with effective helmet use. RESULTS: Prevalence of effective helmet use was 28 per 100 riders and 19.5 per 100 person-minute of observation in traffic intersections. Prevalence rates of effective helmet use was higher among riders (34.5% vs pillion riders 18.1%), female riders (51.3% vs male riders 26.8%), and male pillion riders (30.5% vs female pillion riders 13.7%). Riders commuting for work and school and those ever stopped by the police in the past 3 months had significantly higher odds of effective helmet use. CONCLUSION Despite helmet use being compulsory by law for motorcyclists, the effective helmet use was low in Mysore. Strict enforcement and frequent checks by the police are necessary to increase the effective helmet use.
Adult ; Cities ; Craniocerebral Trauma ; prevention & control ; Cross-Sectional Studies ; Female ; Head Protective Devices ; statistics & numerical data ; Humans ; India ; Male ; Middle Aged ; Motorcycles ; statistics & numerical data ; Transportation ; Young Adult

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

OBJECTIVE: By summarize the characteristics of death cases caused by road traffic accident, to provide information and data for prevention of traffic accident. METHODS: To retrospectively analyze 4148 death cases caused by road traffic accident in Shenzhen. The characteristics studied include the age and sex of the dead, the cause of death, time and place of the accidents and vehicle types, etc. RESULTS: The death was mainly male and the proportion of male to female is 2.45:1; the accidents mainly occured in 6:00-8:00 and 18:00-2:00; 72% of the accidents took place on the main suburban roads. The proportions for each traffic modes of the death were: 44% of walking, 19% of bike, 15% of motorbike. Most traffic accidents were induced by truck, 83.2% of the death causations were severe head injury and 13.3% were complex injuries. CONCLUSION The death cases of road-traffic accident in Shenzhen has obvious characteristic and maybe is preventible.
Accidents, Traffic/prevention & control* ; Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Cause of Death ; Child ; Child, Preschool ; China/epidemiology* ; Craniocerebral Trauma/epidemiology* ; Female ; Humans ; Infant ; Male ; Middle Aged ; Retrospective Studies ; Sex Factors ; Young Adult

BACKGROUND AND OBJECTIVES: A fall refers to a sudden fall accident resulting in injury and hurt of the human body. In the hospital, fall accidents occur mainly in dizzy patients or elderly people, but can also occur even in young people who fail to adapt to the unfamiliar hospital environment. This study analyzed the incidence of fall accidents and its pattern in dizzy patients in a tertiary hospital in South Korea. SUBJECTS AND METHOD: This study was conducted using 477 fall accidents that occurred in a tertiary hospital in Korea from 2011 to 2015. Extensively investigated were related fall risk factors such as patient's sex, age, medical department, diagnosis, first witness, mental status, physical activity, patient risk factors, walking aids, medication use and treatment. RESULTS: Dizziness induced falls consisted of 20.5% of the total fall accidents. Sedative medications were frequently used in patients of dizziness induced falls (42.9%). Fall acidents were mainly detected by nurses 33%. The frequente sites of fall were the bed rooms (55%), the corridor (15%) or the bath rooms (8%). Types of physical damage were no damage (47%), abrasion or bruising (20%), laceration (10%), bath rooms (8%), fracture (3%), and head trauma (1%). In 532 treatments, observation was recommended for 68%, sterilization 15.2%, suture 4.7%, cast 1%, and surgery 1%. CONCLUSION: The study finds that the fall risk screening test and Multifactorial Fall Prevention Program should be performed for all high-risk patients of fall. About 20% of falls were associated with otologic dizziness, and otolaryngology doctors should pay attention to the fall problem and the medication related to dizziness, which may potentially increase the risk of falls.
Accident Prevention ; Accidental Falls ; Aged ; Baths ; Craniocerebral Trauma ; Diagnosis ; Dizziness ; Education ; Human Body ; Humans ; Incidence ; Korea* ; Lacerations ; Mass Screening ; Methods ; Motor Activity ; Otolaryngology ; Risk Factors ; Sterilization ; Sutures ; Tertiary Care Centers* ; Walking