Improving hospital-based trauma care for road traffic injuries in Malawi

BACKGROUND: The mortality rate from road traffic injuries has increased in sub-Saharan Africa as the number of motor vehicles increase. This study examined the capacity of hospitals along Malawi's main north-south highway to provide emergency trauma care.METHODS: Structured interviews and checklists were used to evaluate the infrastructure, personnel, supplies, and equipment at all four of Malawi's central hospitals, ten district hospitals, and one mission hospital in 2014. Most of these facilities are along the main north-south highway that spans the country.RESULTS: Between July 2013 and March 2014, more than 9 200 road traffic injuries(RTIs) and 100 RTI deaths were recorded by the participating hospitals. All of the hospitals reported staff shortages, especially during nights and weekends. Few clinicians had completed formal training in emergency trauma management, and healthcare workers reported gaps in knowledge and skills, especially at district hospitals. Most central hospitals had access to the critical supplies and medications necessary for trauma care, but district hospitals lacked some of the supplies and equipment needed for diagnosis, treatment, and personal protection.CONCLUSION: The mortality and disability burden from road traffi c injuries in Malawi(and other low-income countries in sub-Saharan Africa) can be reduced by ensuring that every central and district hospital has a dedicated trauma unit with qualified staff who have completed primary trauma care courses and have access to the equipment necessary to save lives.

Comparison of risk factors associated with sepsis between road traffic injuries and non-road traffic injuries in ICU patients with severe trauma

Objective:To estimate the incidence and related risk factors of sepsis between road traffic injuries (RTIs) and non-RTIs.Methods:Clinical data of 339 patients with severe trauma who were admitted into ICU in both Third Affiliated Hospital of Army Military Medical University and ChongGang General Hospital from January 2012 to December 2015 were retrospectively analyzed.Twenty items of potential risk factors affecting sepsis were evaluated by univariate and multivariate Logistic Analysis with the purpose of drawing a comparison between RTI patients and non-RTI patients.Results:There were 154 cases of RTI and 185 cases of nonRTI entering the study period.The significant independent risk factor of sepsis in RTIs was SOFA 11 (0R=4.821;95% CI=1.901-12.226;P=0.001).The significant independent risk factors of sepsis in non-RTIs were SOFA 11 (OR=12.410;95% CI=2.559-60.185;P=0.002),trachcal intubation (OR=8.913;95% CI=2.322-34.206;P=-0.001),APACHE Ⅱ 15 (0R=3.684;95% CI=1.750-7.753;P=0.001).Conclusions:The clinical medical personnel should not give equal treatment to RTI patients and non-RTI patients admitted in ICU in that factors predicting sepsis within above two groups are different.The sample volume should be increased and validated in further prospective research.

Factors and Pattern of Injuries Associated with Road Traffic Accidents in Hilly District of Nepal

Introduction: In 21st century, road traffic accidents (RTA) are considered as increasing epidemic of non-communicable disease which is abandoned and needs special attention to prevent them. The aim of this study was to assess the factors and pattern of injuries associated with road traffic accidents. Methods: A cross sectional study was conducted among 112 RTA victims and 56 drivers in Palpa District of Nepal. The association of factors and pattern of injuries with exposure to accidents was assessed using Fisher’s exact test. Bivariate logistic regression examined the association between driving and socio-demographics factors and exposure to road accidents. Results: Of 112 RTA victims, 50% were in the age group of 21 to 40 years and 71.4% were male. Drivers who were in the age less than or equal to 30 years were more likely (OR: 3.6;95% CI: 1.0, 14.3) to expose to an accident than those who were above 30 years. Similarly, those having driving speed less than 40 km/hr were less likely to expose to an accident than those with speed 40 - 60 km/hr (OR: 6.0;95% CI: 0.8, 73.5) and those with speed more than 60 km/hr (OR 7.8;95% CI: 1.0, 100.1). Moreover, the driving experience was also found positively associated (OR: 5.6;95% CI: 1.1, 35.5) with the exposure to an accident. Conclusion: Being in younger age group, male gender, morning time, the driving speed, driving experiences, and driving hours on the road were positively associated with RTA. The efforts should be made to enforce laws in control of speed targeting experienced drivers and those with younger age groups.

Prediction of the burden of road traffic injuries in Iran by 2030: Prevalence, death,and disability-adjusted life years

Purpose:Road traffic accidents pose a global challenge with substantial human and economic costs.Iranexperiences a high incidence of road traffic injuries,leading to a significant burden on society.This studyaims to predict the future burden of road traffic injuries in Iran until 2030,providing valuable insights forpolicy-making and interventions to improve road safety and reduce the associated human and economiccosts.Methods:This analytical study utilized time series models,specifically autoregressive integrated movingaverage(ARIMA)and artificial neural networks(ANNs),to predict the burden of road traffic accidents byanalyzing past data to identify patterns and trends in Iran until 2030.The required data related toprevalence,death,and disability-adjusted life years(DALYs)rates were collected from the Institute forHealth Metrics and Evaluation database and analyzed using R software and relevant modeling andstatistical analysis packages.Results:Both prediction models,ARIMA and ANNs indicate that the prevalence rates(per 100,000)of allroad traffic injuries,except for motorcyclist road injuries which have an almost flat trend,remaining ataround 430,increase by 2030.Based on estimations of both models,the rates of death and DALYs due tomotor vehicle and pedestrian road traffic injuries decrease.For motor vehicle road injuries,estimatedtrends decrease to approximately 520 DALYs and 10 deaths.Also,for pedestrian road injuries these ratesreached approximately 300 DALYs and 6 deaths,according to the models.For cyclists and other roadtraffic injuries,the predicted DALY rates by the ANN model increase to almost 50 and 8,while predictionsconducted by the ARIMA model show a static trend,remaining at 40 and approximately 6.5.Moreover,these rates for the prediction of death rate by the ANN model increased to 0.6 and 0.1,while predictionsconducted by the ARIMA model show a static trend,remaining at 0.43 and 0.07.According to the ANNmodel,the predicted rates of DALY and death for motorcyclists decrease to 100 and approximately 2.7,respectively.On the other hand,predictions made by the ARIMA model show a static trend,with ratesremaining at 200 and approximately 3.2,respectively.Conclusion:The prevalence of road traffic injuries is predicted to increase,while the death and DALYrates of road traffic injuries show different patterns.Effective intervention programs and safety measuresare necessary to prevent and reduce road traffic accidents.Different interventions should be designedand implemented specifically for different groups of pedestrians,cyclists,motorcyclists,and motorvehicle drivers.

Analysis of Thorax Injuries in 112 Death Cases Caused by Traffic Accidents

Objective: To explore the characteristics and mechanisms of serious injuries of chest caused by road traffic accidents. Methods: Totally 112 autopsy cases with chest injuries in the urban of Jingzhou road traffic accidents were collected. Systematic review and analysis of the general information, postmortem examinations and assessments of chest injury had carried out from Feb. 2016 to Mar. 2018. Results: Average age of the victims was 52.2 years and the ratio of male to female deaths was 2.39:1. The proportion of motor-cyclists and pedestrians increased significantly. The overwhelming majority of accident vehicles were motorcycles and bicycles. Fractures of ribs and pulmonary contusion were the most common injuries. Craniocerebral and abdominal injuries were the most common associated injuries. Conclusion: Fractures of ribs and pulmonary contusion were the most common features of fatal road traffic injuries, often associated with vitreoretinal damage and serious multiple damages. These features reflect the characteristics of great violence in traffic accidents, which provides the evidence of identification of violent injuries.

Injury Pattern among Road Traffic Accidents’ Victims in Najran City, Saudi Arabia

Traffic accidents constitute the substantial cause of disability and mortality in the young Saudi individuals reaching horrible figures. The aim of this study was to review and identify the pattern of injury among road traffic accident (RTA) victims as well as the peak time of accidents and their implications. This retrospective hospital-based cross-sectional study was carried out in the period between April 2016 to March 2017 in King Khalid Hospital, Maternity and Children Hospital and Najran General Hospital, Najran, Saudi Arabia. All RTA victims admitted to the emergency departments of the pre-mentioned hospitals. Data collected from 435 Saudis and non-Saudis’ files were statistically analyzed with regard to age, gender, the timing of road traffic accidents, injury pattern, and neurological deficits incidence. Most of the RTAs’ cases (92%) were male victims with the highest peak in the age group 20 - 29 years. 58% of the RTAs happened in the evening (6:00 PM-9:00 PM) while 20% occurred in the morning. Head injury represented the most frequent pattern (36%) followed by the spinal injury (23%), lower limb injury (23%), upper limb injury (20%), thoracic injury (17%), pelvic injury and abdominal injury (8%). 4.4% of RTAs resulted in death whilst 9% of cases experienced neurological deficits. In conclusion, young male drivers in Najran recorded the highest frequency of RTAs. Initiation of road safety education and expansion of speed detectors (Saher) system deployment is highly recommended.

Road traffic injury in Thailand:systematically underestimated?

Road traffic injury is the fifth leading cause of death and disability in Thailand,with an estimated one million people seriously injured and 14000 deaths each year.Given the magnitude of the problem,it is important to validate road traffic injury statistics,in order to determine trends and the effect of prevention efforts.The Ministry of Public Health established an injury surveillance system in 1995 to collect injury data from 4 provincial hospitals and one hospital in Bangkok.This system was designed to evaluate the quality of acute trauma care and referral services,and to improve injury prevention and control at local and national level.However,many injuries are not treated at health facilities where these data are collected.This is the first study to measure the reporting gap for injury statistics on a national level.We compared data from the Thai National Injury Survey to that gathered by the injury surveillance system and find that the former records a rate 3 times higher than the hospital-based injury surveillance system in all five regions(mean injury incidence:596/100000 vs 129/100000).Most injuries that need medical care are not treated in hospital,and do not count in the national statistics in Thailand.

常见道路交通事故损伤在交通行为方式司法鉴定中的辨识与运用

道路交通事故涉案者交通行为方式鉴定是道路交通事故痕迹物证综合鉴定的重要内容,其涉及多学科交叉知识。具有认定交通行为方式的典型特征损伤、痕迹物证和运动轨迹可作为交通行为方式判断的关键性依据,能够得出认定性的意见。在道路交通事故中,因车辆碰撞造成涉案者不同程度的损伤,通过损伤的形态及对损伤机制的分析,能够客观地判断涉案者的交通行为方式。其中,典型特征损伤更是起到了关键证据的作用。通过梳理、归纳十种常见典型特征损伤的形态、致伤方式及鉴定实践,探讨如何辨识和运用典型特征损伤的关键证据;结合符合性成立条件,综合判断涉案者交通行为方式,以期对司法鉴定实践提供参考。

实时远程会诊系统对严重交通伤救治的应用效果研究

目的探讨基于增强现实(AR)技术的交通伤医疗资源共享平台在交通伤患者处置过程中的应用效果。方法回顾性分析2016年6月—2020年12月厦门大学附属东南医院急诊科应用基于AR的交通伤医疗资源共享平台模式救治严重交通伤患者56例(观察组),2012年6月—2016年5月该平台启用前严重交通伤患者68例(对照组)。两组患者均按创伤中心严重创伤患者常规救治流程进行规范救治,观察组在此基础上由院前“120”急救医师利用实时远程视频会诊信息系统实时传输患者情况,院内急救专家根据实时音视频远程指导事发现场与运送途中抢救,指导包括建立人工气道、损伤控制性复苏、大血管夹闭等救命性操作。比较两组患者急诊室滞留时间,入院至手术时间和住院天数,漏诊发生率和并发症发生率,会诊次数,在呼吸机使用、抢救、休克、器官功能障碍等方面的发生率,抢救成功率及病死率。结果两组患者性别、年龄、ISS等指标比较差异无统计学意义(P>0.05);观察组急诊室滞留时间(18.8±5.4)min、入院至手术时间(44.1±9.1)min、住院天数(21.5±3.4)d均短于对照组(27.0±4.1)min、(62.6±7.2)min、(31.0±5.6)d(P<0.05);观察组漏诊发生率12.5%和并发症发生率19.6%低于对照组30.8%、38.2%(P<0.05);观察组会诊次数(1.2±0.2)次少于对照组(2.1±0.3)次(P<0.001);观察组呼吸机使用(21.4%)、抢救(19.6%)、休克(17.8%)、器官功能障碍(23.2%)发生率均低于对照组39.7%、44.1%、38.2%、42.6%(P<0.05);观察组抢救成功率89.3%高于对照组82.4%(P<0.05),病死率10.7%低于对照组17.6%(P<0.05)。结论基于AR技术的交通伤医疗资源共享平台模式在急诊室滞留时间,入院至手术时间和住院天数,漏诊发生率和并发症发生率,会诊次数,在呼吸机使用、抢救、休克、器官功能障碍等方面的发生率,抢救成功率,病死率等方面均优于该平台启用前,降低了患者的漏诊和并发症风险,在危重症患者的救治方面有更好的效果。

Risk factors and predictive model of cerebral edema after road traffic accidents-related traumatic brain injury

Purpose:Cerebral edema(CE)is the main secondary injury following traumatic brain injury(TBI)caused by road traffic accidents(RTAs).It is challenging to be predicted timely.In this study,we aimed to develop a prediction model for CE by identifying its risk factors and comparing the timing of edema occurrence in TBI patients with varying levels of injuries.Methods:This case-control study included 218 patients with TBI caused by RTAs.The cohort was divided into CE and non-CE groups,according to CT results within 7 days.Demographic data,imaging data,and clinical data were collected and analyzed.Quantitative variables that follow normal distribution were presented as mean±standard deviation,those that do not follow normal distribution were presented as median(Q1,Q3).Categorical variables were expressed as percentages.The Chi-square test and logistic regression analysis were used to identify risk factors for CE.Logistic curve fitting was performed to predict the time to secondary CE in TBI patients with different levels of injuries.The efficacy of the model was evaluated using the receiver operator characteristic curve.Results:According to the study,almost half(47.3%)of the patients were found to have CE.The risk factors associated with CE were bilateral frontal lobe contusion,unilateral frontal lobe contusion,cerebral contusion,subarachnoid hemorrhage,and abbreviated injury scale(AIS).The odds ratio values for these factors were 7.27(95%confidence interval(CI):2.08-25.42,p=0.002),2.85(95%CI:1.11-7.31,p=0.030),2.62(95%CI:1.12-6.13,p=0.027),2.44(95%CI:1.25-4.76,p=0.009),and 1.5(95%CI:1.10-2.04,p=0.009),respectively.We also observed that patients with mild/moderate TBI(AIS≤3)had a 50%probability of developing CE 19.7 h after injury(χ^(2)=13.82,adjusted R2=0.51),while patients with severe TBI(AIS>3)developed CE after 12.5 h(χ^(2)=18.48,adjusted R2=0.54).Finally,we conducted a receiver operator characteristic curve analysis of CE time,which showed an area under the curve of 0.744 and 0.672 for severe and mild/moderate TBI,respectively.Conclusion:Our study found that the onset of CE in individuals with TBI resulting from RTAs was correlated with the severity of the injury.Specifically,those with more severe injuries experienced an earlier onset of CE.These findings suggest that there is a critical time window for clinical intervention in cases of CE secondary to TBI.

Evaluating the short-term effect of ambient temperature on non-fatal outdoor falls and road traffic injuries among children and adolescents in China: a time-stratified case-crossover study

studies have suggested that non-optimal temperatures may increase the risk of injury,epidemiological studies focusing on the association between temperature and non-fatal injury among children and adolescents are limited.Therefore,we investigated the short-term effect of ambient temperature on non-fatal falls and road traffic injuries(RTIs)among students across Jiangsu Province,China.Meteorological data and records of non-fatal outdoor injuries due to falls and RTIs among students aged 6–17 were collected during 2018–2020.We performed a time-stratified case-crossover analysis with a distributed lag nonlinear model to examine the effect of ambient temperature on the risk of injury.Individual meteorological exposure was estimated based on the address of the selected school.We also performed stratified analyses by sex,age,and area.A total of 57322 and 5455 cases of falls and RTIs were collected,respectively.We observed inverted U-shaped curves for temperatureinjury associations,with maximum risk temperatures at 18℃(48th of daily mean temperature distribution)for falls and 22℃(67th of daily mean temperature distribution)for RTIs.The corresponding odds ratios(95%confidence intervals)were 2.193(2.011,2.391)and 3.038(1.988,4.644)for falls and RTIs,respectively.Notably,there was a significant age-dependent trend in which the temperature effect on falls was greater in older students(P-trend<0.05).This study suggests a ignificant association between ambient temperature and students’outdoor falls and RTIs.Our findings may help advance tailored strategies to reduce the incidence of outdoor falls and RTIs in children and adolescents.

A Workable Solution for Reducing the Large Number of Vehicle and Pedestrian Accidents Occurring on a Yellow Light

Traffic intersections are incredibly dangerous for drivers and pedestrians. Statistics from both Canada and the U.S. show a high number of fatalities and serious injuries related to crashes at intersections. In Canada, during 2019, the National Collision Database shows that 28% of traffic fatalities and 42% of serious injuries occurred at intersections. Likewise, the U.S. National Highway Traffic Administration (NHTSA) found that about 40% of the estimated 5,811,000 accidents in the U.S. during the year studied were intersection-related crashes. In fact, a major survey by the car insurance industry found that nearly 85% of drivers could not identify the correct action to take when approaching a yellow traffic light at an intersection. One major reason for these accidents is the “yellow light dilemma,” the ambiguous situation where a driver should stop or proceed forward when unexpectedly faced with a yellow light. This situation is even further exacerbated by the tendency of aggressive drivers to inappropriately speed up on the yellow just to get through the traffic light. A survey of Canadian drivers conducted by the Traffic Injury Research Foundation found that 9% of drivers admitted to speeding up to get through a traffic light. Another reason for these accidents is the increased danger of making a left-hand turn on yellow. According to the National Highway Traffic Safety Association (NHTSA), left turns occur in approximately 22.2% of collisions—as opposed to just 1.2% for right turns. Moreover, a study by CNN found left turns are three times as likely to kill pedestrians than right turns. The reason left turns are so much more likely to cause an accident is because they take a driver against traffic and in the path of oncoming cars. Additionally, most of these left turns occur at the driver’s discretion—as opposed to the distressingly brief left-hand arrow at busy intersections. Drive Safe Now proposes a workable solution for reducing the number of accidents occurring during a yellow light at intersections. We believe this fairly simple solution will save lives, prevent injuries, reduce damage to public and private property, and decrease insurance costs.

Maxillofacial Injuries at the Komfo Anokye Teaching Hospital, Kumasi, Ghana: A Preliminary Study

Background: The aetiology and pattern of maxillofacail injuries vary in different parts of the world and even the same country. The purpose of the study was to determine the epidemiology of maxillofacial injuries at a tertiary Hospital in Ghana. Methodology: This is a six-month (January to June 2015) prospective study. Information on age, sex, aetiology, injury type etc. was collected using a specialized design data collection form. Data was analyzed using the SPSS 17th version. Ethical approval was obtained. Result: The total study sample was 111 with a male to female ratio of 2.5:1. Majority (34.2%) were within the ages of 21 to 30 years. Majority of the victims were urban dwellers. Most of the injuries occurred on the highway (42.3%) and in the evening (35.2%). Only a small percentage (5.4%) of the road traffic crashes (RTC) victims were in some form of protection. Twenty-one (18.9%) of the injuries were intentional, of which 18 (85.7%) were assault. The commonest maxillofacial injury was a combination of soft and hard tissues 72 (64.7%). The commonest cause of maxillofacial soft tissue injuries was RTC, 72.8%. Laceration (55.6%) was the most common soft tissue injury recorded. Mandibular fractures constituted the commonest hard tissue injuries. Conclusion: This study has shown that road traffic crashes are the most common cause of injuries to the maxillofacial region. The mandible is the most frequent site of fracture, while the commonest soft tissue injury is laceration. Majority of the victims were young energetic males and adherence to road traffic regulations was very low.

Are High School Students Ready to Stop the Bleed from Injuries? Needs Assessment in a Low Resource Country

Background: Life-threatening bleeding is a major cause of trauma-related deaths. Stop the Bleed—Active bleeding control (ABC) program in Hyderabad recently showed that lay first responders can be effectively trained. However, the willingness of high school students to train in bleeding control is unknown. We report Stop the Bleed training needs assessment from high schools in India and estimate the potential multiplier effect. Methods: A cross-sectional survey was conducted from 12 randomly selected schools in Hyderabad. The study was to understand current knowledge, skills and willingness to get trained and respond to life-threatening bleeding from injuries. 107 Participants (35 Teachers and 72 students) were purposively selected for telephonic interviews with a structured questionnaire. Results: Response rate was 93% overall. 80% of participants have never been trained in bleeding control. 84% reported willingness to be trained, train others and help bleeding victims. All the teachers reported that stop the bleed training would be useful in high schools. 70.6% of teachers recommended that training could start from middle school (10 to 15 years), 47% preferred the online training mode. Only 20% of participants had prior training in lifesaving first aid and 32% did not know the number of emergency medical services (EMS). Each trained participant has the potential to train 3 to 4 people at the household level and perhaps more at the community level. Conclusion: The surveyed schools in Hyderabad do not have the knowledge, skills, or training curriculum in Stop the Bleed. Students and teachers are willing to be trained and train others, with great potential for a “multiplier-effect” in the community.

2009—2022年金华市婺城区居民道路交通伤害死亡变化趋势及疾病负担分析

目的 了解2009—2022年金华市婺城区居民道路交通伤害死亡流行病学特征和疾病负担的变化趋势,为制定道路交通伤害死亡的防控工作提供依据。方法数据来源于婺城区疾病预防控制中心的全人口全死因监测数据库,收集2009年1月1日至2022年12月31日的婺城区辖区户籍居民道路交通伤害死亡资料。采用SPSS 19.0计算道路交通伤害的粗死亡率、标化死亡率、中位年龄、潜在减寿年数。采用Joinpoint Regression Program 4.9.0,软件通过Joinpoint回归模型计算死亡率、标化死亡率的年度变化百分比(APC)和平均年度变化百分比(AAPC),并进行趋势检验。结果2009—2022年期间婺城区居民道路交通伤害粗死亡率从2009年的18.61/10万下降到2022年的9.42/10万(AAPC=-5.5%,t=-6.7;P<0.001)。婺城区农村人群的死亡率除少年儿童组和女性青年组外其他年龄段均高于城市人群,差异有统计学意义(P<0.01),其中农村50岁以上居民道路交通伤害粗死亡率为26.87/10万。道路交通伤害死亡类型中行人、骑脚踏车、摩托车与电动自行车共死亡1 078人,占交通事故死亡总数的83.76%,结论婺城区居民道路交通伤害死亡率呈下降趋势。道路交通伤害死亡主要发生在行人、骑脚踏车、摩托车与电动车这三类弱势人群,其中农村人群占79.02%,所以防控的重点应以农村特别是50岁以上人群、老年人群等为重点,结合人群特点开展有效、实用宣传控制措施,降低因道路交通伤害带来的疾病负担。

基于时间序列模型的新疆0~6岁儿童道路交通伤害住院患者人数的预测分析

目的分析新疆0~6岁儿童道路交通伤害变化趋势,利用自回归移动平均(autoregressive integrated moving average,ARIMA)模型及指数平滑模型对2011—2021年道路交通伤害住院人数进行分析,模拟验证两种模型适用性后选择最优模型,为本地区儿童道路交通伤害防控及住院人数的动态分析和短期预测提供一定理论支持。方法采取方便抽样的方法,收集新疆7所公立医院2011年1月1日至2021年12月31日0~6岁道路交通伤害入院儿童信息,使用卡方检验分析不同季节、不同受伤类型下道路交通伤害发生情况,分别建立ARIMA模型和指数平滑模型,对模型拟合效果进行评价,验证模型对未来儿童道路交通伤害住院人数预测的适用性。结果本研究共纳入2511例儿童患者,春夏季发生伤害的人数较多,道路交通伤害发生类型以行人及机动车受伤为主。简单季节性指数平滑模型为最优模型,其中稳定系数R2=0.616,均方根误差(root mean square error,RMSE)=6.177,平均绝对误差百分比(mean absolute percentageerror,MAPE)=39.209,平均绝对误差(mean absolute error,MAE)=4.852,正态化贝叶斯信息准则(Bayesian information criterions,BIC)=3.716,模型白噪声检验(P=0.302),该模型可以对未来0~6岁儿童道路交通伤害住院人数进行预测,且模型对年度数据的预测能力优于月度。结论简单季节性指数平滑模型对数据拟合效果更好,可以被用来进行道路交通伤害住院人数的预测研究,未来仍需探索更精准、更全面的预测方法,需采取防控措施预防儿童道路交通伤害的发生。

汕头市金平区食品网约配送员道路交通伤害的横断面研究

目的了解汕头市金平区食品网约配送员道路交通伤害的发生情况,为预防与控制提供理论基础与科学依据。方法采用便利抽样方法,使用纸质与电子问卷(问卷星)结合的方法对汕头市金平区的食品网约配送员进行问卷调查,以了解该群体道路交通伤害详细情况。应用描述性分析、χ^(2)检验及二元Logistic回归分析方法探讨食品网约配送员道路交通事故发生的危险因素。结果汕头市食品网约配送员道路交通事故发生率为6.85%(30/438),伤害发生率为4.11%(18/438)。在食品网约配送员最近一次道路交通事故中,事故发生的地点以混合车道(33.33%)、路口(26.67%)为主。发生事故的情形多为正面相撞(40%)。受伤部位主要为下肢(55.56%)、头面/颈部(33.33%)和躯干(11.11%);受伤性质主要为挫伤、擦伤(44.44%)和扭伤/拉伤(38.89%)。购买意外保险可能是食品网约配送员发生道路交通事故的危险因素(OR=1.62,95%CI:0.76~3.47,P<0.05);城镇户口可能是食品网约配送员发生道路交通事故的保护因素(OR=0.28,95%CI:0.11~0.70,P<0.05)。结论道路交通伤害的发生存在于食品网约配送员的配送过程中,这主要受到户口性质以及是否购买意外保险因素的影响。交管部门与配送平台应加强管理,以减少食品网约配送员的道路交通伤害。

安全头盔对电动车驾驶员道路交通伤害的影响

目的研究道路交通伤害发生时安全头盔对电动车驾驶员伤员损伤类型、伤害结局及住院日的影响,为论证佩戴安全头盔对驾驶员有保护作用提供依据。方法回顾性分析2020年4月至2022年12月急诊科接诊的在电动车与机动车交通事故中受伤的电动车驾驶员的伤情。统计伤员损伤类型及人数、留观或处置后回家人数、住院人数、转院人数、死亡人数及住院伤员住院日。在明确电动车驾驶员伤员在道路交通事故发生时是否佩戴头盔后,将伤员分为佩戴头盔组和未佩戴头盔组进行数据比较分析。结果共纳入伤员228例,佩戴头盔组57例,未佩戴头盔组171例。两组伤员的腹部损伤、胸部损伤、骨折、皮肤软组织损伤及其他损伤的发生率比较,差异均无统计学意义(P>0.05)。佩戴安全头盔组的颅脑损伤发生率低于未佩戴安全头盔组(P<0.05)。两组的转院比例和死亡比例比较,差异均无统计学意义(P>0.05)。佩戴安全头盔组的住院比例和住院日均低于未佩戴安全头盔组(P<0.05),留观或处置后回家比例则高于未佩戴安全头盔组(P<0.05)。结论安全头盔可有效减少电动车驾驶员道路交通伤害发生时的颅脑损伤、住院率及住院日,并改善伤害结局,电动车驾驶员在行驶中正确佩戴安全头盔非常重要。

2020年苏州市道路交通伤特征与预防策略

目的调查2020年苏州市道路交通伤的流行病学特征,以探索道路交通伤的预防策略。方法回顾性分析2020年1月—12月苏州市急救中心接到并进行处置的22250例道路交通伤患者资料,其中男性12002例,女性10248例;年龄0~98岁,平均45.8岁。分别统计患者年龄组、出行方式、一日内各时间节点受伤人数、受伤部位、受伤严重程度、饮酒、死亡等信息。统计分析性别、年龄组与出行方式的关系;出行方式、年龄组、受伤部位与伤情严重程度的关系;饮酒与性别、受伤部位、受伤严重程度、出行方式的关系;死亡与受伤部位、出行方式关系。结果研究表明苏州市道路交通伤早高峰时段集中于上午6点到10点,晚高峰时段集中于下午16点到20点。道路交通伤中出行交通工具为电动车的比例最高共有13036例(58.59%,P<0.001)。步行人群发生严重伤比例1.71%明显高于自行车1.02%、三轮车1.54%、电动车0.94%、摩托车0.00%、机动车1.53%(P<0.001)。老年患者严重伤比例1.49%高于未成年0.86%及青壮年人群1.11%(P<0.001)。头颈部受严重伤比例2.72%明显高于胸腹部0.19%、脊柱骨盆0.12%及四肢0.05%(P<0.001)。饮酒发生严重伤比例2.42%明显高于未饮酒人群1.16%(P<0.001)。结论道路交通伤情复杂,电动车是现阶段道路交通伤主要组成部分,而步行人群、老年人、饮酒人群更容易发生严重伤害,且头颈部为更易受伤部位。应进一步加强创伤中心体系建设及创伤科普宣传,以提高道路交通事故的救治能力。

苏州市电动自行车骑乘者头盔佩戴法规实施对相关创伤事件的影响

目的明确苏州市驾乘电动自行车佩戴安全头盔法规实施前后,电动自行车相关交通事故流行病学特征和情况变化,为加强针对性干预和政策制定提供科学依据。方法从苏州市急救中心调度系统数据库和院前电子病历系统数据库,收集法规实施前后(2019年8月1日至12月31日和2020年8月1日至12月31日)电动自行车相关交通事故案例,分析比较伤者基本特征、生命体征信息、创伤评分、急救医生判定危重度、创伤部位信息。结果法规实施前后电动自行车骑乘伤者(骑行者与搭乘者)数量为3766例和5324例,占交通事故伤者总数的33.10%和44.20%。在骑乘伤者构成上,法规实施前后电动自行车骑乘伤者男性比例(52.28%VS.52.37%)均多于女性(42.72%VS.47.63%),机动车与电动自行车事故(67.37%VS.69.42%)发生最多;在伤情评价上,其中危重伤者占比有所减少(5.97%VS.5.03%),病情判断构成变化存在统计学差异(χ2=7.85,P=0.04);在损伤部位上,实施前后部位分布有统计学差异(χ2=75.83,P<0.001),其中头面部伤害率有所减少(45.58%VS.33.15%)。结论强制性佩戴安全头盔法规的实施对减少电动自行车骑乘者创伤情况存在积极影响,应针对性开展电动自行车骑乘者头盔佩戴法规的教育普及。