Injury patterns of seniors in traffic accidents: A technical and medical analysis

AIM:To investigate the actual injury situation of seniors in traffic accidents and to evaluate the different injury patterns.METHODS:Injury data,environmental circumstances and crash circumstances of accidents were collected shortly after the accident event at the scene.With these data,a technical and medical analysis was performed,including Injury Severity Score,Abbreviated Injury Scale and Maximum Abbreviated Injury Scale.The method of data collection is named the German InDepth Accident Study and can be seen as representative.RESULTS:A total of 4430 injured seniors in traffic accidents were evaluated.The incidence of sustaining severe injuries to extremities,head and maxillofacial region was significantly higher in the group of elderly people compared to a younger age(P<0.05).The number of accident-related injuries was higher in the group of seniors compared to other groups.CONCLUSION:Seniors are more likely to be involved in traffic injuries and to sustain serious to severe injuries compared to other groups.

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.

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.

Otorhinolaryngological (ORL) and Cervicofacial Injuries Resulting from Road Accidents within the Otorhinolaryngology (ORL) Department of the Regional Hospital of Mamou

Introduction: Otorhinolaryngological (ORL) and cervicofacial traumas encompass injuries affecting the neck, face, and ORL region, resulting from external influence. The objective of this study was to conduct an epidemiological and clinical analysis of ORL and cervicofacial injuries observed in victims of road accidents treated at the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. Materials and Methods: This prospective and descriptive study was conducted over a period of 12 months, from January 1st to December 31st, 2021, within the Otorhinolaryngology (ORL) department of the Regional Hospital of Mamou. It included patients hospitalized for ORL and/or cervicofacial traumas resulting from road accidents during the study period. Results: A total of 348 cases were included, representing 36.22% of all traumas related to road accidents (AVP) within the Regional Hospital of Mamou. The average age of the patients was 26.44 years, with a sex ratio of 3.83, favoring males. The dominant socio-professional category was students, encompassing 32.47% of cases. Road accidents were mainly associated with motorcycle use (31.32% motorcycle-to-motorcycle, 24.43% motorcycle skidding, 13.51% motorcycle-pedestrian). Facial region injuries were the most common, accounting for 69.03% of cases, followed by rhinological injuries (17.28%) and otological injuries (13.69%). Associated injuries were predominantly closed head traumas (52.55%) and lower limb fractures (20.41%). Imaging was underutilized. Regarding surgical interventions, reconstructive surgery was the most predominant, accounting for 52.51% of cases, with a management timeframe of 30 minutes to 12 hours for 99.72% of patients. Conclusion: Road traffic accidents remain a serious public health issue, primarily affecting young males. Emphasis should be placed on road safety measures to reduce the frequency of these accidents.

Open globe injury in Hospital Universiti Sains Malaysia- a 10-year review

AIM:To identify the aetiology of open globe injuries at Hospital Universiti Sains Malaysia over a period of 10y and the prognostic factors for visual outcome.METHODS:Retrospective review of medical records of open globe injury cases that presented from January2000 to December 2009.Classification of open globe injury was based on the Birmingham Eye Trauma Terminology(BETT).Records were obtained with hospital permission via the in-house electronic patient management system,and the case notes of all patients with a diagnosis of open globe injury were scrutinised.Patients with prior ocular trauma,pre-existing ocular conditions affecting the visual acuity,contrast sensitivity,central vision or corneal thickness,as well as those with a history of previous intraocular or refractive surgery were excluded.Analysis of data was with SPSS version20.0.Ordinal logistic regression analysis was used to examine the association between prognostic factors and visual outcome.RESULTS:This study involved 220 patients(n=222eyes).The most common place of injury was the home(51.8%),followed by the workplace(23.4%).Among children aged less than 16y of age,domestic-related injury was the predominant cause(54.6%),while in those aged 16y and above,occupational injuries were the most common cause(40.0%).Most eyes(76.5%)had an initial visual acuity worse than 3/60,and in half of these,the visual acuity improved.The visual outcome was found to be significantly associated with the initial visual acuity(P【0.005),posterior extent of wound(P【0.001),length of wound(P【0.001),presence of hyphaema(P【0.001)and presence of vitreous prolapse(P【0.005).CONCLUSION:The most common causes of open globe injury are domestic accidents and occupational injuries.Significant prognostic factors for final visual outcome in patients with open globe injury are initial visual acuity,posterior extent and length of wound,presence of hyphaema and presence of vitreous prolapse.Awareness of the factors predicting a poor visual outcome may be helpful during counselling of patients with open globe injuries.

BRAIN INJURY BIOMECHANICS IN REAL WORLD VEHICLE ACCIDENT USING MATHEMATICAL MODELS

This paper aims at investigating brain injury mechanisms and predicting head injuries in real world accidents. For this purpose, a 3D human head finite element model （HBM-head） was developed based on head-brain anatomy. The HBM head model was validated with two experimental tests. Then the head finite element（FE） model and a multi-body system （MBS） model were used to carry out reconstructions of real world vehicle-pedestrian accidents and brain injuries. The MBS models were used for calculating the head impact conditions in vehicle impacts. The HBM-head model was used for calculating the injury related physical parameters, such as intracranial pressure, stress, and strain. The calculated intracranial pressure and strain distribution were correlated with the injury outcomes observed from accidents. It is shown that this model can predict the intracranial biomechanical response and calculate the injury related physical parameters. The head FE model has good biofidelity and will be a valuable tool for the study of injury mechanisms and the tolerance level of the brain.

Comparative numerical study on the child head injury under different child safety seat angles

It has been shown that annually around 1250 children younger than 15 years old die in traffic accident.The number of children who also injured as a consequence of car accidents is noticeably higher.According to the ECE-R44 regulation the safety of children in the cars,the use of a child safety seat(CSS)is highly recommended.Using a CSS would dramatically diminish the injuries of traffic accidents.However,the posture,especially the angle,of a child when seating on a seat may also affect the amount of injury occurs during the accident.It has been revealed that during the accident only few children remained seated in the standard position,and most of them whether slouched or slanted and turned their head to the side-support of the CSS.Extreme positions,such as leaning forward,escaping from the harness or holding feet were also observed.This study aimed to perform a finite element(FE)study to figure out what angle of seating would result in the least amount of injury to the child head in a typical car crash under the speed of 47 km/h.To do that,a 1.5 years old child dummy(a dummy representing the anthropometry of a 1.5 years old child)has been accommodated on a seat under the angles of 15°,30°,and 45°.The results revealed.The resulted displacements in the head after the accident were also calculated at X,Y,and Z directions.The results in this regard indicated a higher displacement at X direction whereas the lowest one was seen at Y direction.The results have implications not only for understanding the amount of injury to the child head after the accident under different seating angles,but also for giving an insight to the CSS industries and families to choose the right seating posture for the child in the car to reduce the severity of injury.

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.

Trends in Injury-related Incidence and Mortality Among Inpatients in Guangdong Province in 1997-2001

Objective Currently, China is in short of thorough and systemic data concerning the patterns and incidence of injuries and related deaths. Guangdong Province as one of the economically advanced areas in China is faced with a relatively serious injury problem, and investigation of this problem in this Province will provide valuable information for other provinces and areas in this Country, as well as scientific basis for policy making for injury prevention and control. Methods Analyses are based on the computerized hospital discharge data collected from 322 hospitals in Guangdong Province between 1997 and 2001. Diagnoses are coded according to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Results The total hospitalization rate related with injuries increased year by year from 1997 to 2001. The ratio of case-fatality has a decline trend for all injury inpatients, who were mainly caused by motor vehicle accidents, unintentional falls, puncture and cut by machine and others. The constituent ratio of death among patients caused by motor vehicle accidents accounted for 56.13% among the total deaths, which ranked as the first place. The direct medical cost also had an increased trend. Conclusions Data on injuries requiring hospitalization can be used to design and target more effective injury prevention programs. Injury prevention would decrease human sufferings, disability, and associated economic losses.

Relationship between hypothermia and heart rate yarialion in severe brain injury

AIM:To investigate effects of heart automatic nerve variations and hypothermia(HT) therapy on heart rate variation(HRV).METHODS:We studied the dynamic electrocardiagraph(ECG) of 41 cases of severe brain injury.The patients were devided into HT therapy group(n=21,body temprature 32-33℃),non-HT therapy group(n=20) and normal control(n=20).RESULTS:In group 1,the reduction of time domain indexes and frequency domain indexes were 3-6 folds and 30-50folds respectively compared with those of the control group,while the corresponding indexes reduction were 2-3 folds and 4-5folds in the group 2(P<0.05,P<0.01,respectively).The difference between groups were significant(P<0.05-0.01);the HRV reduction was more significant in the cerebrovascular accident patients than that of brain injured(P<0.05-0.01);the HRV indexes increased significantly in resuscitated patients than those in coma(P<0.01);the HRV in dead was much lower than that in survival(P=0.01).CONCLUSION:Injury of central nervous system can induce abnormal function of automatic nerve of heart and reduction of HRV.HT therapy can reduce HRV on a higher level;HRV examination can be applied into the prediction of prognosis of the brain injured.

Numerical Reconstruction and Injury Biomechanism in a Car- Pedestrian Crash Accident

Objective To reconstruct a car-pedestrian crash accident using numerical simulation technology and explore the injury biomechanism as forensic evidence for injury identification. Methods An integration of multi-body dynamic, finite element (FE), and classical method was applied to a car-pedestrian crash accident. The location of the collision and the details of the traffic accident were determined by vehicle trace verification and autopsy. The accident reconstruction was performed by coupling the three-dimensional car behavior from PC-CRASH with a MADYMO dummy model. The collision FE models of head and leg, developed from CT scans of human remains, were loaded with calculated dummy collision parameters. The data of the impact biomechanical responses were extracted in terms of von Mises stress, relative displacement, strain and stress fringes. Results The accident reconstruction results were identical with the examined ones and the biomechanism of head and leg injuries, illustrated through the FE methods, were consistent with the classical injury theories. Conclusion The numerical simulation technology is proved to be effective in identifying traffic accidents and exploring of injury biomechanism.

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.

Characteristics of injuries caused by paragliding accidents: A cross-sectional study

BACKGROUND: This study was undertaken to analyze the characteristics and risk factors relating to fatalities and injuries caused by paragliding.METHODS: The judicial examination reports and hospital documents of 82 patients traumatized in 64 accidents during 242 355 paragliding jumps between August 2004 and September 2011 were analyzed.RESULTS: In these accidents, 18 of the 82 patients lost their lives. In the patients with a confirmed cause of accident, most of them were involved with multiple fractures and internal organ injuries(n=8, 44.4%).CONCLUSION: We investigated the incidence of paragliding injuries, the types of the injuries, and the severity of affected anatomical regions. The findings are significant for the prevention of paragliding injuries and future research.

Traumatic Brain Injury and Cerebral Vascular Accident: Application of Rasch Analysis to Examine Differences in Disability and Outcome in Post-Hospital Rehabilitation

The purpose of this study was to demonstrate an application of Rasch analysis to identify differences in disability profiles resulting from traumatic brain injury (TBI) and cerebral vascular accident (CVA) and to examine outcome differences between the two groups following post-hospital residential rehabilitation. Participant data were collected from 32 facilities in 16 states. From 2990 neurologically impaired individuals with consecutive admissions from 2011 through 2017, 874 met inclusion criteria: TBI (n = 687) or CVA (n = 187), 18 years or older, minimum length of stay of one month, and maximum chronicity of 1 year. Participants were evaluated at admission and discharge on the Mayo Portland Adaptability Inventory-Version 4 (MPAI-4). Rasch analysis was performed to establish item reliability, construct validity and item difficulty. A Repeated Measures Multivariate Analysis of Covariance (RM MANCOVA) determined group differences and improvement from admission and discharge. Rasch Analysis demonstrated satisfactory construct validity and internal consistency (Person reliability > 0.90, Item reliability > 0.98 for admission and discharge MPAI-4s). Both groups showed significant improvement on the MPAI-4 (p 0.0005). The TBI group was more impaired on the adjustment scale at both admission and discharge (p 0.001). Rasch analysis identified two distinct impairment patterns. CVA participants exhibited deficits characteristic of focal impairment while the TBI group presented with deficits reflective of diffuse impairment. Rehabilitation was shown to be beneficial in reducing disability following neurologic injury in both groups. Importantly, Rasch Analysis accurately produced unique disability profiles that differentiated the treatment groups. This unique statistical technique offers a promising prescriptive hierarchical model for guiding neurological rehabilitation treatment.

考虑建成环境的电动自行车事故严重程度致因分析

为探究考虑建成环境影响下,电动自行车交通事故严重程度的影响因素,本文从事故属性、骑行者属性、对象车辆及驾驶员属性、道路属性及建成环境属性这5个方面,选取18个影响电动自行车交通事故严重性的潜在变量。在此基础上,构建考虑均值及方差异质性的随机参数Logit模型,利用边际效应量化显著变量对事故严重程度的影响差异。基于北京市近5年电动自行车事故抽样数据进行实证研究,结果表明:事故时段19:00-次日7:00、骑行者年龄大于40岁、重(大)型货车、到最近医院的距离增大及恶劣天气等因素会增加电动自行车事故严重程度。建成环境属性中,到最近医院的距离在死亡事故中的参数为服从正态分布的随机参数,路段及恶劣天气会增大其均值异质性,驾驶员年龄为(40,60]岁会增大其方差异质性;其他属性中,一般城市道路在受伤事故中的参数为服从正态分布的随机参数,路段会增大其均值异质性。研究结果可以为降低电动自行车事故严重程度提供理论支撑。

Road Accidents in Urban and Rural Areas

Motorcycles transport commonly known as(Boda boda)in Tanzania has been growing up in the recently years in both urban and rural areas.Since motorcycles transport being authorized to carry passengers in the Tanzania it has been associated with many accidents resulting to large number of deaths and injuries in the country.Most of the Road Traffic Injuries victims are passengers,motorcyclists and pedestrians.Males are over represented in all causes.Most of the deceased were 18-29 years old.The major social-economic benefit of this study was to found out the main causes and measures of reducing the number of accidents associated with motorcycle transport service in both urban and rural areas.

基于交通事故案例的3岁儿童乘员损伤机制研究

目的通过再现真实交通事故案例探究3岁儿童乘员碰撞损伤机制。方法应用车辆有限元模型和图斯特3岁儿童乘员损伤仿生模型(TUST IBMs 3YO-O),再现CIREN数据库中的交通事故案例,通过综合分析Δv、车辆质量和变形能反求碰撞前车辆的速度,设置碰撞仿真试验再现案例所描述的儿童乘员损伤,分析损伤机制。结果TUST IBMs 3YO-O模型完整地再现出碰撞事故中儿童乘员的损伤。儿童乘员头部运动学响应与生物力学响应表现出差异性,儿童乘员胸腔内部组织器官生物力学响应表明其没有出现损伤,但是胸部3 ms合成加速度达到54 g,超出阈值。结论未来乘员安全评价需要引入生物力学参数。应用高生物逼真度的人体生物力学模型再现交通事故中乘员损伤,不仅更加清晰观察事故中乘员的运动学响应,深度分析碰撞损伤机制,还为数字化评估提供参考依据,也将为儿童乘员保护装置研发和安全法规制定提供参考。

耦合均值-相关性的起重伤害事故致因ZIP模型研究

近些年来,起重伤害事故高发频发,导致了较大的直接经济损失和人员伤亡,受到行业的高度关注。为探究起重伤害事故致因的影响程度,采集2011—2021年376份起重伤害事故调查报告,依据事故致因24Model和系统安全分析法识别事故致因,构建起重伤害事故致因的零膨胀泊松回归模型(Zero-Inflated Poisson,ZIP),并通过Vuong方法和拟合优度检验准则进行检验;综合考虑事故致因发生频次的均值、致因和事故发生的相关性,运用弹性分析方法对事故致因的影响程度进行定量排序。结果表明:ZIP回归模型拟合效果优于泊松回归模型,各事故致因对起重伤害事故的影响程度排序为安全监管不到位C_(6)(T_(k)=1.0221)、安全意识淡薄H_(1)(T_(k)=0.5117)、作业人员违规作业H_(3)(T_(k)=0.4758)、作业人员无证上岗H_(2)(T_(k)=0.2116)、专项施工方案不合格C_(7)(T_(k)=0.1234)和结构构件破坏或连接不可靠M_(3)(T_(k)=0.1045)。研究从事故致因发生频次的均值、致因和事故发生的相关性两个维度刻画事故致因对起重伤害事故的影响程度,为起重伤害事故风险分级管控提供了新的研究思路和方法。

人车碰撞事故中人地碰撞损伤研究进展

为了解人车碰撞事故中人地碰撞损伤的研究进展,并对可行的人地碰撞损伤防护方法做出展望。本文从人车碰撞事故特征、人体损伤评价指标、人体损伤来源、人地碰撞损伤影响因素及人地碰撞损伤防护方法5个方面回顾了已有研究成果,并对已有研究中存在的问题进行讨论,就人地碰撞防护方法的发展作出展望。人地碰撞损伤研究仍然存在许多不成熟的地方,特别是人地碰撞损伤的致伤机理和影响因素方面仍须开展深入的研究。通过回顾现有的人地碰撞损伤防护技术指出,未来可从优化车辆前部形状、安装行人安全装置以及控制车辆制动等方面来降低行人损伤风险。大部分事故中碰撞速度为中低速,而在低车速下的人地碰撞损伤不容忽视,可通过控制车辆制动降低人地碰撞损伤。此外,人地碰撞损害评价指标仍存在不足。本文可为后续更好地开展人地碰撞损伤致伤机理及防护方法的研究提供参考。

建成环境对交叉口行人事故严重程度异质性影响

为探索建成环境及其他因素对行人事故伤害严重程度的影响,通过建立均值和方差异质性随机参数Logit模型对交叉口行人事故严重程度进行异质性分析。利用行人碰撞事故数据,从行人、驾驶员、车辆、道路、环境、时间、建成环境7个方面筛选出27个影响因素,通过弹性系数分析显著变量对事故严重程度的影响程度。结果表明:地铁站可达性为“存在”是随机参数,车辆状态为“其他”会减小该随机参数的均值,降低交叉口行人事故严重程度;方差与“下午”显著相关,此变量会使随机参数的离散程度增加,分布变宽,随机性增加;不同用地类型与交叉口类型对行人事故严重程度的影响具有显著差异,用地类型为商业区、地铁站的可达性为“存在”时,交叉口行人发生交通事故的概率与伤害严重程度降低;行人有不当行为等因素显著增加了交叉口行人事故严重程度。研究结果为制定交叉口建成环境的优化改善措施提供参考和依据。