Objective: To study the epidemiological characteristics and preventive methods of road traffic crashes in a mountain city in western China through sampling investigation of traffic crashes in different regions of Chon...Objective: To study the epidemiological characteristics and preventive methods of road traffic crashes in a mountain city in western China through sampling investigation of traffic crashes in different regions of Chongqing city in recent years. Methods: Two police teams of traffic management in downtown, two teams in suburb, one team in county and one freeway team were randomly selected, and road traffic crashes between 1988 and 1997 were investigated and analyzed. Results: A total of 13121 road traffic crashes with 6201 crashes with casualties were analyzed. The incidence of crashes was higher in May, June and July, and on Friday and Wednesday and at 8:00-12:00 and 14:00-18:00 within a day. Casualties were 44.0% in pedestrians and 42.5% in passengers of total casualties. The deaths and severe injuries in pedestrians were 59.1% of total deaths and 56.4% of total severe injuries. The age of drivers and passengers were mainly at 18-30 years, followed by 31-40 years. People over 60 years old accounted for 24.1% of total pedestrian casualty. Head injury was the most common reason for deaths. The main reasons for these crashes were improper driving and violating traffic laws. Violating traffic laws by pedestrian was one of the main reasons for pedestrian casualty. Conclusions: The crashes are related to the characteristics of geography, climate, society activity of people, and the sense of traffic safety, the basic traffic construction and management in Chongqing. The traffic casualty of pedestrian is a big problem in Chongqing. To prevent and decrease road traffic injuries effective methods should be worked out and propaganda on traffic safety and traffic management should be strengthened according to different characteristics of different regions. To strengthen the first aid and treatment of cranium-brain injury and chest-back injury is also helpful in decreasing traffic deaths.展开更多
Purpose： Flail chest （FC） injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being chall...Purpose： Flail chest （FC） injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being challenged by renewed interest in surgical rib fixation. This retrospective epidemiological study sets out to evaluate FC patients, and quantify the natural history of this injury by studying the injury patterns, epidemiology and mortality of patients sustaining FC injuries admitted to a major trauma centre （MTC）. Methods： A retrospective cohort analysis has been conducted at an MTC with full trauma service. All patients （age 〉 16 years） sustaining FC were included. Patient demographics, injury characteristics and inpatient stay information were extracted. Results： Two hundred and ninety-three patients were identified, with a mean injury severity score （ISS） of 28.9 （range 9-75）, average age of 56.1 years （range of 16-100）, and a male predominance （78%）. Road traffic accidents accounted for 45% （n = 132） of injuries, whilst 44% were fall or jump from height （n = 129）. Associated lung contusion was present in 133 patients （45%） while 76% of patients were found to have 5 or more ribs involved in the flail segment （n = 223） with 96% （n = 281 ） having a unilateral FC. Inpatient treatment was required 19.9 days （range 0-150 days） with 59% of patients （n = 173） requiring intensive care unit （ICU） level care for 8.4 days （range 1-63） with 61.8% requiring mechanical ventilation （n = 107） for 10.5 days （range 1-54）, and Z8g underwent rib fixation with rib plates （n = 23）. The mortality rate was found to be 14% （n = 42）. A non-significant trend towards improved outcomes in the conservative group was found when compared with the fixation group; ventilation days （6.94 vs 10.06, p = 0.18） intensive treatment unit （ITU） length of stay （LOS） （12.56 vs 15.53, p = 0.28） and hospital LOS （32.62 vs 35.24, p = 0.69）. Conclusion： This study has successfully described the natural history of flail chest injuries, and has found a nonsignificant trend towards better outcomes with conservative management. With the cohort and management challenges now defined, work on outcome improvement can be targeted. In addition the comnarahility of results to other studies makes collaboration with other MTCs a realistic vrovosal.展开更多
Inferior dislocation of the hip is the rarest type in hip dislocation. Very few cases have been reported in the anglophonic literature, most of which involved the pediatric age group. Surprisingly, we came across a 30...Inferior dislocation of the hip is the rarest type in hip dislocation. Very few cases have been reported in the anglophonic literature, most of which involved the pediatric age group. Surprisingly, we came across a 30- year-old patient with a bilateral inferior hip dislocation. He had sustained a road traffic accident and the attitude of both hip joints was flexion and abduction. The diagnosis was confirmed by radiographs which revealed the long axis of the femur at an angle of 1 l0 （right） degrees and 100 （left）degrees respectively away from the axis. Closed reduction under sedation was successfully performed. Skin traction for a period of 6 weeks was advised and the follow-up revealed an excellent result. We present the details of this case, the first of its kind along with a review of the literature, discussing the various modes and mechanisms of injury inducing inferior dislocation of the hip.展开更多
Objective： Road traffic crashes （RTCs） are considered to be the second highest cause of mortality in Iran. The purpose of this study was to describe the morbidity and mortality of RTC during 2003-2008.Methods： Dat...Objective： Road traffic crashes （RTCs） are considered to be the second highest cause of mortality in Iran. The purpose of this study was to describe the morbidity and mortality of RTC during 2003-2008.Methods： Data were got from national health sources of Iran. These data included population, the number of RTCs,consequent fatalities, cause and place of death from 2003 to 2008.Results： RTC incidence rate increased from 868.5 per 100 000 population in the year 2003 to 1 643.6 in 2008. A total of 2 565 deaths from RTC were recorded in Yazd from 2003 to 2008. RTC mortality rate increased from 46.1 per 100 000 population in 2003 to 46.9 in 2006, then declined to 38.8 in 2008. During this time period, overall traffic injury incidence per 100 000 population increased from 368.8 in 2003 to 647.9 in 2006, then declined to 527.9 in 2008. Head injuries were the most common cause of road traffic-related mortality from 2003 to 2008. Following road traffic accidents, most of the deaths occurred before arriving hospital.Conclusions： Road traffic crash-related mortality and morbidity in Yazd in the recent six years are increased, but decreased in the last two years. This decline is most probably the result of a variety of interventions, including laws,police enforcement, improvements in traffic and transport,health care resources and media and public education.展开更多
：Objective：To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan＇ an district（urban）and Jiangjin district（rural）of Chongqing,and to discuss the corresponding s...：Objective：To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan＇ an district（urban）and Jiangjin district（rural）of Chongqing,and to discuss the corresponding strategies for its prevention and cure.Methods：Records of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan＇an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries.Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared.Results：Between the year 2000 and 2006,the average annual incidence of traffic injuries and mortality rate in the aged people in Nan＇ an district were 124.62/100 000 and 13.85/100 000 respectively,higher than that in Jiangjin district（27.49/100 000,7.13/100 000,P〈0.01）.However,the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%,higher than that in Nan＇an district（10.00%,P〈0.01）.Head injury was the primary cause of death.Totally 76.58% of casualties were pedestrians.Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system.Conclusions：The traffic environment is unfavorable to the aged people.It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law,so as to provide a safe road traffic environment for the aged people.展开更多
文摘Objective: To study the epidemiological characteristics and preventive methods of road traffic crashes in a mountain city in western China through sampling investigation of traffic crashes in different regions of Chongqing city in recent years. Methods: Two police teams of traffic management in downtown, two teams in suburb, one team in county and one freeway team were randomly selected, and road traffic crashes between 1988 and 1997 were investigated and analyzed. Results: A total of 13121 road traffic crashes with 6201 crashes with casualties were analyzed. The incidence of crashes was higher in May, June and July, and on Friday and Wednesday and at 8:00-12:00 and 14:00-18:00 within a day. Casualties were 44.0% in pedestrians and 42.5% in passengers of total casualties. The deaths and severe injuries in pedestrians were 59.1% of total deaths and 56.4% of total severe injuries. The age of drivers and passengers were mainly at 18-30 years, followed by 31-40 years. People over 60 years old accounted for 24.1% of total pedestrian casualty. Head injury was the most common reason for deaths. The main reasons for these crashes were improper driving and violating traffic laws. Violating traffic laws by pedestrian was one of the main reasons for pedestrian casualty. Conclusions: The crashes are related to the characteristics of geography, climate, society activity of people, and the sense of traffic safety, the basic traffic construction and management in Chongqing. The traffic casualty of pedestrian is a big problem in Chongqing. To prevent and decrease road traffic injuries effective methods should be worked out and propaganda on traffic safety and traffic management should be strengthened according to different characteristics of different regions. To strengthen the first aid and treatment of cranium-brain injury and chest-back injury is also helpful in decreasing traffic deaths.
文摘Purpose： Flail chest （FC） injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being challenged by renewed interest in surgical rib fixation. This retrospective epidemiological study sets out to evaluate FC patients, and quantify the natural history of this injury by studying the injury patterns, epidemiology and mortality of patients sustaining FC injuries admitted to a major trauma centre （MTC）. Methods： A retrospective cohort analysis has been conducted at an MTC with full trauma service. All patients （age 〉 16 years） sustaining FC were included. Patient demographics, injury characteristics and inpatient stay information were extracted. Results： Two hundred and ninety-three patients were identified, with a mean injury severity score （ISS） of 28.9 （range 9-75）, average age of 56.1 years （range of 16-100）, and a male predominance （78%）. Road traffic accidents accounted for 45% （n = 132） of injuries, whilst 44% were fall or jump from height （n = 129）. Associated lung contusion was present in 133 patients （45%） while 76% of patients were found to have 5 or more ribs involved in the flail segment （n = 223） with 96% （n = 281 ） having a unilateral FC. Inpatient treatment was required 19.9 days （range 0-150 days） with 59% of patients （n = 173） requiring intensive care unit （ICU） level care for 8.4 days （range 1-63） with 61.8% requiring mechanical ventilation （n = 107） for 10.5 days （range 1-54）, and Z8g underwent rib fixation with rib plates （n = 23）. The mortality rate was found to be 14% （n = 42）. A non-significant trend towards improved outcomes in the conservative group was found when compared with the fixation group; ventilation days （6.94 vs 10.06, p = 0.18） intensive treatment unit （ITU） length of stay （LOS） （12.56 vs 15.53, p = 0.28） and hospital LOS （32.62 vs 35.24, p = 0.69）. Conclusion： This study has successfully described the natural history of flail chest injuries, and has found a nonsignificant trend towards better outcomes with conservative management. With the cohort and management challenges now defined, work on outcome improvement can be targeted. In addition the comnarahility of results to other studies makes collaboration with other MTCs a realistic vrovosal.
文摘Inferior dislocation of the hip is the rarest type in hip dislocation. Very few cases have been reported in the anglophonic literature, most of which involved the pediatric age group. Surprisingly, we came across a 30- year-old patient with a bilateral inferior hip dislocation. He had sustained a road traffic accident and the attitude of both hip joints was flexion and abduction. The diagnosis was confirmed by radiographs which revealed the long axis of the femur at an angle of 1 l0 （right） degrees and 100 （left）degrees respectively away from the axis. Closed reduction under sedation was successfully performed. Skin traction for a period of 6 weeks was advised and the follow-up revealed an excellent result. We present the details of this case, the first of its kind along with a review of the literature, discussing the various modes and mechanisms of injury inducing inferior dislocation of the hip.
文摘Objective： Road traffic crashes （RTCs） are considered to be the second highest cause of mortality in Iran. The purpose of this study was to describe the morbidity and mortality of RTC during 2003-2008.Methods： Data were got from national health sources of Iran. These data included population, the number of RTCs,consequent fatalities, cause and place of death from 2003 to 2008.Results： RTC incidence rate increased from 868.5 per 100 000 population in the year 2003 to 1 643.6 in 2008. A total of 2 565 deaths from RTC were recorded in Yazd from 2003 to 2008. RTC mortality rate increased from 46.1 per 100 000 population in 2003 to 46.9 in 2006, then declined to 38.8 in 2008. During this time period, overall traffic injury incidence per 100 000 population increased from 368.8 in 2003 to 647.9 in 2006, then declined to 527.9 in 2008. Head injuries were the most common cause of road traffic-related mortality from 2003 to 2008. Following road traffic accidents, most of the deaths occurred before arriving hospital.Conclusions： Road traffic crash-related mortality and morbidity in Yazd in the recent six years are increased, but decreased in the last two years. This decline is most probably the result of a variety of interventions, including laws,police enforcement, improvements in traffic and transport,health care resources and media and public education.
文摘：Objective：To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan＇ an district（urban）and Jiangjin district（rural）of Chongqing,and to discuss the corresponding strategies for its prevention and cure.Methods：Records of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan＇an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries.Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared.Results：Between the year 2000 and 2006,the average annual incidence of traffic injuries and mortality rate in the aged people in Nan＇ an district were 124.62/100 000 and 13.85/100 000 respectively,higher than that in Jiangjin district（27.49/100 000,7.13/100 000,P〈0.01）.However,the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%,higher than that in Nan＇an district（10.00%,P〈0.01）.Head injury was the primary cause of death.Totally 76.58% of casualties were pedestrians.Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system.Conclusions：The traffic environment is unfavorable to the aged people.It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law,so as to provide a safe road traffic environment for the aged people.
