Objective： To compare fatalities and injuries in road traffic crashes （RTC） in Iran with other countries. Methods： Data were obtained from national health sources of Iran. These data included population number, r...Objective： To compare fatalities and injuries in road traffic crashes （RTC） in Iran with other countries. Methods： Data were obtained from national health sources of Iran. These data included population number, registered motor-vehicles number, number of RTCs and consequent fatalities and injuries from 1997 to 2006. Results： RTC fatality and injury rates increased from 1997 to 2005, but decreased in 2006. The overall men/women ratio in the RTC fatalities was 4.2：1. High RTC fatality rate of 39 per 100 000 population in Iran was almost the same as some other developing countries. In Iran, RTC fatalities in recent years were almost twice as much as the highest rate among the European countries. Conclusions： This investigation shows that in spite of reduction of RTC fatality in Iran in 2006, it is still one of the highest in the world. Moreover, this paper describes the state of RTC-related parameters in a developing country in comparison with the developed countries.展开更多
The 7th of April is always appointed to be ”World Health Day” by World Health O rganization (WHO), to celebrate the anniversary of its founding in 1946. World Health Day (WHD) 2004 focuses on road traffic injuries a...The 7th of April is always appointed to be ”World Health Day” by World Health O rganization (WHO), to celebrate the anniversary of its founding in 1946. World Health Day (WHD) 2004 focuses on road traffic injuries and measures to pre vent them, and the slogan for the WHD 2004 is ”Road Safety is No Accident”. 1 W HO calls all people to be concerned with road safety on WHD 2004 and beyond. In fact, almost everybody is related with road traffic, and everybody may be consid ered as a road user. Occurrence of road traffic injury (RTI) It is estimated that in 2002 road crashes killed 1.18 million people and inj ured about 20 to 50 million more. Millions were hospitalized for days, weeks or months. Perhaps 5 million were disabled for life. Every day as many as 140 000 people are injured because of road crashes. More than 3 000 die and about 15 000 are disabled for life. It is predicted that by the year 2020, the an nual number of deaths and disabilities from road traffic injuries will increase by 60% or more, and could take third place in the rank order of disease burden ( DALYs) by the year 2000 as compared with the ninth in 1990. 2展开更多
Objective： To describe mortality pattern and to determine undiagnosed fatal injuries according to autopsy findings among road traffic accident victims in Yazd, Iran. Methods： In this retrospective study, 251 victims...Objective： To describe mortality pattern and to determine undiagnosed fatal injuries according to autopsy findings among road traffic accident victims in Yazd, Iran. Methods： In this retrospective study, 251 victims of road traffic accidents who were admitted to a tertiary trauma hospital over a two-year period （2006 and 2007） and received medical cares were included. Hospital records were reviewed to gather demographic characteristics, road user type, and medical data. Autopsy records were also reviewed to determine actual causes of death and possible undiagnosed injuries occurred in the initial assessment of the emergency unit or during hospitalization. Results： There were 202 males （80.5%） and 49 females （19.5%）. The mean （＋SD） age of fatalities was 34.1 （＋21.5） years. Pedestrian-vehicle accidents were the most common cause of trauma （100 cases, 39.8%）. The most common cause of death was central nervous system injury （146 cases, 58.1%）. The other causes were skull base fractures （10%）, internalbleeding （8%）, lower limb hemorrhage （8%）, skull vault fractures （4%）, cervical spinal cord injury （3.6%）, airway compromise （3.2%）, and multifactor cases （5.1%）, respectively. Thirty-six fatal injuries in 30 victims （12%） mainly contributed to death according to autopsy, but were not diagnosed in initial assessments. The head （72.2%） and cervical spine （13.8%） regions were the two most common sites for undi- agnosed injuries. Conclusion： Training courses for emergency unit medical staff with regard to interpreting radiological findings of head and neck and high clinical suspicion for cervical spine injuries are essential to improve the quality of early hospital care and reduce the mortality and morbidity of traffic accident patients.展开更多
Objective： Injury is a major neglected health problem in developing countries. The first step in dealing with injury problem is to identify the injury patterns and characteristics. Therefore, we aimed to demonstrate ...Objective： Injury is a major neglected health problem in developing countries. The first step in dealing with injury problem is to identify the injury patterns and characteristics. Therefore, we aimed to demonstrate the current status of trauma admissions to hospitals in Shiraz, as a major city of Iran. Methods： A hospital-based study was conducted in 2002. All injured patients admitted during 6 months in emergency departments of two general hospitals of Shiraz, Nemazi and Chamran were included. Results： A total of 1 765 injured patients were registered during the study period, with mean age of 33 years. Manual workers were the most vulnerable group among occupational categories. Inner-city roads were the most common place of injury and traffic accident was the major cause of injury. Overally, falling injury was the second common cause of injury in males and the first cause in females （ especially at the age of over 60）. Conclusion： As other studies conducted in our society, traffic accidents are the major cause of morbidity and mortality and this can emphasize on the obligation to take legislative action in the field of driving and road safety, directing resources and educating the public and raising the awareness of the community in prevention of this iceberg-like problem.展开更多
Objective ： To analyze the data of patients with spinal cord injury （SCI） induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designi...Objective ： To analyze the data of patients with spinal cord injury （SCI） induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designing health system planning. Methods ： In this historical cohort study, the patients who had been transferred to Level I trauma center in southeastern Iran due to road traffic accidents with radiographic documented SCI were evaluated. Results： Among 64 patients with SCI, 38 patients （59.4 %, 36 males and 2 females, aged 27.42 years ± 9.44 years on average） were injured by road traffic accidents. Car and motorcycle accidents were responsible for 26 cases （68.4%） and 12 cases （31.6%）, respectively. And 31patients （81. 6%） had complete SCI. Conus medularis （T12-L2 ） was the most affected level. Conclusions： Results are discussed in terms of preventive measures, specifically those concerning the use of restraint and helmet and driving behavior. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and the characteristics for low occurrence of SCI can be more precisely identified.展开更多
Objective： Trauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. Th...Objective： Trauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. The aim of the study was to assess the various epidemiological parameters that influence the cause of injury in the patients admitted to a major trauma centre in northem India. Methods： An observational study of 748 patients chosen by random assortment was carried out over a peri- od of 1 year （August 2008 to July 2009）. Age, sex, injury type and pattern were noted. Injury mode of upper and lower limbs was also noted. Results： Injuries occur predominately in the age group of 15-30 years. Males incurred more injury with male to female ratio of 6：1. The most vulnerable group was motorcycle users. Among the injured, farmers were the most commonly involved. Blunt injuries （94.92%） were much more common than penetrating injuries. Among patients with head injury, two wheelers related accidents were the most common （40.3%）. Most spinal cord injuries were caused by falls from height （51.09%）. Most lower limb fractures were simple type. Compound fractures of the lower limb were more common than up- per limb fractures. Conclusion： Strict enforcement of traffic rules, combined with improved infrastructure and behavior change can decrease the burden of road traffic accidents in India and other developing countries. This study could assist in raising the profile of road traffic accidents as a public health problem which needs to be addressed as a preventable cause of mortality and morbidity, and plan- ning appropriate interventions for this major challenge. Preventive strategies should be made on the basis of these epidemiological trends.展开更多
Purpose： As trauma is a public health problem, different programs have been designed to prevent in- juries. The aim of this study was to evaluate the effectiveness of an educational model that measures the adolescent...Purpose： As trauma is a public health problem, different programs have been designed to prevent in- juries. The aim of this study was to evaluate the effectiveness of an educational model that measures the adolescents＇ attitudes towards the rules of road safety, alcohol and road accidents in Colombia. Methods： A pedagogical model evaluating the effect of road safety education and adolescents＇ attitudes towards and experiences of alcohol and road accidents in Colombia was created. After the education concluded, this educational process is analyzed by its impact on adolescents＇ behavior. The educational program included 160 adolescents with the mean age being 1Z5 years. Results： The test results indicated that before the educational program 80g of adolescents did not use a safety element when driving, while after the educational program the percentage of no helmet use among adolescents decreased from 72.5% to 24.3% （p = 0.0001 ） and driving a vehicle under the state of drunkenness from 49.3% to 8.1% （p = 0.0001）. Conclusion： An educational model aimed at preventing injuries caused by traffic accidents is shown to be effective in generating changes in adolescents＇ customs of and attitudes towards alcohol and road safety standards in Colombia.展开更多
Purpose： The epidemiology of pediatric trauma is different in different parts of the world. Some researchers suggest falls as the most common mechanism, whereas others report road traffic accidents （RTAs） as the mo...Purpose： The epidemiology of pediatric trauma is different in different parts of the world. Some researchers suggest falls as the most common mechanism, whereas others report road traffic accidents （RTAs） as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India. Methods： Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21. Results： We had 300 patients over a 33 month period. Among them, 236 （78.6%） were males and 64 （21.3%） females. Overall the predominant cause was RTAs in 132 （43%） patients. On subgroup analysis of up to 12 years age group （n - 147）, the most common cause was found to be RTAs again. However, falls showed an incremental upward trend （36.05% in up to 12 age group versus 27% overall）, catching up with RTAs （44.89%）. Pediatric Trauma Score （PTS） ranged from 0 to 12 with a mean of 8.12 _＋ 2.022. 223 （74.33%） patients experienced trauma limited to one anatomic region only, whereas 77 （25.66%） patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days （range 1-182）. Conclusion： Pediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs （43%） as compared to falls from height （27%）; however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatric trauma and local injury patterns must be taken into account when formulating policies to address this unique challenge.展开更多
文摘Objective： To compare fatalities and injuries in road traffic crashes （RTC） in Iran with other countries. Methods： Data were obtained from national health sources of Iran. These data included population number, registered motor-vehicles number, number of RTCs and consequent fatalities and injuries from 1997 to 2006. Results： RTC fatality and injury rates increased from 1997 to 2005, but decreased in 2006. The overall men/women ratio in the RTC fatalities was 4.2：1. High RTC fatality rate of 39 per 100 000 population in Iran was almost the same as some other developing countries. In Iran, RTC fatalities in recent years were almost twice as much as the highest rate among the European countries. Conclusions： This investigation shows that in spite of reduction of RTC fatality in Iran in 2006, it is still one of the highest in the world. Moreover, this paper describes the state of RTC-related parameters in a developing country in comparison with the developed countries.
文摘The 7th of April is always appointed to be ”World Health Day” by World Health O rganization (WHO), to celebrate the anniversary of its founding in 1946. World Health Day (WHD) 2004 focuses on road traffic injuries and measures to pre vent them, and the slogan for the WHD 2004 is ”Road Safety is No Accident”. 1 W HO calls all people to be concerned with road safety on WHD 2004 and beyond. In fact, almost everybody is related with road traffic, and everybody may be consid ered as a road user. Occurrence of road traffic injury (RTI) It is estimated that in 2002 road crashes killed 1.18 million people and inj ured about 20 to 50 million more. Millions were hospitalized for days, weeks or months. Perhaps 5 million were disabled for life. Every day as many as 140 000 people are injured because of road crashes. More than 3 000 die and about 15 000 are disabled for life. It is predicted that by the year 2020, the an nual number of deaths and disabilities from road traffic injuries will increase by 60% or more, and could take third place in the rank order of disease burden ( DALYs) by the year 2000 as compared with the ninth in 1990. 2
文摘Objective： To describe mortality pattern and to determine undiagnosed fatal injuries according to autopsy findings among road traffic accident victims in Yazd, Iran. Methods： In this retrospective study, 251 victims of road traffic accidents who were admitted to a tertiary trauma hospital over a two-year period （2006 and 2007） and received medical cares were included. Hospital records were reviewed to gather demographic characteristics, road user type, and medical data. Autopsy records were also reviewed to determine actual causes of death and possible undiagnosed injuries occurred in the initial assessment of the emergency unit or during hospitalization. Results： There were 202 males （80.5%） and 49 females （19.5%）. The mean （＋SD） age of fatalities was 34.1 （＋21.5） years. Pedestrian-vehicle accidents were the most common cause of trauma （100 cases, 39.8%）. The most common cause of death was central nervous system injury （146 cases, 58.1%）. The other causes were skull base fractures （10%）, internalbleeding （8%）, lower limb hemorrhage （8%）, skull vault fractures （4%）, cervical spinal cord injury （3.6%）, airway compromise （3.2%）, and multifactor cases （5.1%）, respectively. Thirty-six fatal injuries in 30 victims （12%） mainly contributed to death according to autopsy, but were not diagnosed in initial assessments. The head （72.2%） and cervical spine （13.8%） regions were the two most common sites for undi- agnosed injuries. Conclusion： Training courses for emergency unit medical staff with regard to interpreting radiological findings of head and neck and high clinical suspicion for cervical spine injuries are essential to improve the quality of early hospital care and reduce the mortality and morbidity of traffic accident patients.
文摘Objective： Injury is a major neglected health problem in developing countries. The first step in dealing with injury problem is to identify the injury patterns and characteristics. Therefore, we aimed to demonstrate the current status of trauma admissions to hospitals in Shiraz, as a major city of Iran. Methods： A hospital-based study was conducted in 2002. All injured patients admitted during 6 months in emergency departments of two general hospitals of Shiraz, Nemazi and Chamran were included. Results： A total of 1 765 injured patients were registered during the study period, with mean age of 33 years. Manual workers were the most vulnerable group among occupational categories. Inner-city roads were the most common place of injury and traffic accident was the major cause of injury. Overally, falling injury was the second common cause of injury in males and the first cause in females （ especially at the age of over 60）. Conclusion： As other studies conducted in our society, traffic accidents are the major cause of morbidity and mortality and this can emphasize on the obligation to take legislative action in the field of driving and road safety, directing resources and educating the public and raising the awareness of the community in prevention of this iceberg-like problem.
文摘Objective ： To analyze the data of patients with spinal cord injury （SCI） induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designing health system planning. Methods ： In this historical cohort study, the patients who had been transferred to Level I trauma center in southeastern Iran due to road traffic accidents with radiographic documented SCI were evaluated. Results： Among 64 patients with SCI, 38 patients （59.4 %, 36 males and 2 females, aged 27.42 years ± 9.44 years on average） were injured by road traffic accidents. Car and motorcycle accidents were responsible for 26 cases （68.4%） and 12 cases （31.6%）, respectively. And 31patients （81. 6%） had complete SCI. Conus medularis （T12-L2 ） was the most affected level. Conclusions： Results are discussed in terms of preventive measures, specifically those concerning the use of restraint and helmet and driving behavior. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and the characteristics for low occurrence of SCI can be more precisely identified.
文摘Objective： Trauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. The aim of the study was to assess the various epidemiological parameters that influence the cause of injury in the patients admitted to a major trauma centre in northem India. Methods： An observational study of 748 patients chosen by random assortment was carried out over a peri- od of 1 year （August 2008 to July 2009）. Age, sex, injury type and pattern were noted. Injury mode of upper and lower limbs was also noted. Results： Injuries occur predominately in the age group of 15-30 years. Males incurred more injury with male to female ratio of 6：1. The most vulnerable group was motorcycle users. Among the injured, farmers were the most commonly involved. Blunt injuries （94.92%） were much more common than penetrating injuries. Among patients with head injury, two wheelers related accidents were the most common （40.3%）. Most spinal cord injuries were caused by falls from height （51.09%）. Most lower limb fractures were simple type. Compound fractures of the lower limb were more common than up- per limb fractures. Conclusion： Strict enforcement of traffic rules, combined with improved infrastructure and behavior change can decrease the burden of road traffic accidents in India and other developing countries. This study could assist in raising the profile of road traffic accidents as a public health problem which needs to be addressed as a preventable cause of mortality and morbidity, and plan- ning appropriate interventions for this major challenge. Preventive strategies should be made on the basis of these epidemiological trends.
文摘Purpose： As trauma is a public health problem, different programs have been designed to prevent in- juries. The aim of this study was to evaluate the effectiveness of an educational model that measures the adolescents＇ attitudes towards the rules of road safety, alcohol and road accidents in Colombia. Methods： A pedagogical model evaluating the effect of road safety education and adolescents＇ attitudes towards and experiences of alcohol and road accidents in Colombia was created. After the education concluded, this educational process is analyzed by its impact on adolescents＇ behavior. The educational program included 160 adolescents with the mean age being 1Z5 years. Results： The test results indicated that before the educational program 80g of adolescents did not use a safety element when driving, while after the educational program the percentage of no helmet use among adolescents decreased from 72.5% to 24.3% （p = 0.0001 ） and driving a vehicle under the state of drunkenness from 49.3% to 8.1% （p = 0.0001）. Conclusion： An educational model aimed at preventing injuries caused by traffic accidents is shown to be effective in generating changes in adolescents＇ customs of and attitudes towards alcohol and road safety standards in Colombia.
文摘Purpose： The epidemiology of pediatric trauma is different in different parts of the world. Some researchers suggest falls as the most common mechanism, whereas others report road traffic accidents （RTAs） as the most common cause. The aim of this study is to find out the leading cause of pediatric admissions in Trauma Surgery in New Delhi, India. Methods： Inpatient data from January 2012 to September 2014 was searched retrospectively in Jai Prakash Narayan Apex Trauma Centre Trauma Registry. All patients aged 18 years or less on index presentation admitted to surgical ward/ICU or later taken transfer by the Department of Trauma Surgery were included. Data were retrieved in predesigned proformas. Information thus compiled was coded in unique alphanumeric codes for each variable and subjected to statistical analysis using SPSS version 21. Results： We had 300 patients over a 33 month period. Among them, 236 （78.6%） were males and 64 （21.3%） females. Overall the predominant cause was RTAs in 132 （43%） patients. On subgroup analysis of up to 12 years age group （n - 147）, the most common cause was found to be RTAs again. However, falls showed an incremental upward trend （36.05% in up to 12 age group versus 27% overall）, catching up with RTAs （44.89%）. Pediatric Trauma Score （PTS） ranged from 0 to 12 with a mean of 8.12 _＋ 2.022. 223 （74.33%） patients experienced trauma limited to one anatomic region only, whereas 77 （25.66%） patients suffered polytrauma. 288 patients were discharged to home care. Overall, 12 patients expired in the cohort. Median hospital stay was 6 days （range 1-182）. Conclusion： Pediatric trauma is becoming a cause of increasing concern, especially in the developing countries. The leading cause of admissions in Trauma Surgery is RTAs （43%） as compared to falls from height （27%）; however, falls from height are showing an increasing trend as we move to younger age groups. Enhancing road safety alone may not be a lasting solution for prevention of pediatric trauma and local injury patterns must be taken into account when formulating policies to address this unique challenge.
