Road crash in China from 2003 to 2005

Objective： To analyze characteristics and causes of road crash and injuries in China from 2003 to 2005.
Methods： The data of road crash in 2003-2005 were collected to study the characteristics including total vehicle number, occurrence rates of traffic accidents and serious traffic accidents so as to discuss the causes and characteristics of road crash in China.
Results： From 2003 to 2005, the numbers of traffic accidents, injuries and deaths as well as the mortality rates per 100 000 persons and per 10 000 vehicles declined in China. Until 2005, the total number of traffic accidents decreased to 450 000 and deaths to 99 000, with the mortality rate per 10 000 vehicles being 7.6 persons. While the drivers and passengers accounted for 33.2 % and 26.6 % of death casualties respectively in 2005. Most traffic accidents were caused by drivers, especially those with driving experience less than 3 years. Traffic accidents occurred on suburban roads accounted for 60%. The mortality rate of the traffic accidents per 100 km on the first grade road ranked the highest. The mortality rate of the traffic accidents on expressways ranked the highest, with continual increase of death and injury.
Conclusions. At present, the increase trend of traffic accidents and casualties in China has been slowed down to some extent and shows a declining tendency, but the situation is far away from being optimistic. In order to cut down the number of traffic accidents and casualties, we should pay more attention to training and managing drivers with less than three driving years and those driving buses. Strict prevention measures should be laid on traffic accidents on first grade roads, expressways and suburban roads as well as the enhancement on improving first-aid system.     

Peritoneal lavage and blunt abdominal injuries in childhood

Traffic accidents are increasingly responsible for mortality in childhood in Turkey. Between 1982 and 1984, 197 children were admitted for contused abdominal injuries to the surgical casualty ward at the School of Medicine of Istanbul University. Most of these children had been involved in traffic accidents, and peritoneal lavage was applied to all of them. The diagnosis on admission was confirmed by laparotomy in 90 per cent of all cases. 20 children died (10.1 per cent). Uncontrollable abdominal bleeding was the cause of ten deaths and massive brain lesion of another six.     

The analysis of epidemiological characteristics of road traffic crashes in a mountain city in western China

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.     

Deaths while on active duty in the U.S. Armed Forces, 1990-2011

Crude mortality rates are lower among U.S. military members than their civilian counterparts; service members must be healthy when they enter service and deaths from illnesses are relatively infrequent. From 1990 through 2011, there were 29,213 deaths of U.S. military members while on active duty (crude overall mortality rate: 71.5 per 100,000 person-years). The most deaths occurred in years when major combat operations were ongoing; from 2004 to 2007, war-related injuries accounted for approximately 40 percent of all deaths. From 2000 to 2011, two-thirds of all deaths unrelated to war were caused by transportation accidents (n=4,761; 37%), other accidents (n=1,358; 10%) and suicides (n=2,634; 20%). From 2005 to 2011, the proportion of deaths due to suicide increased sharply while the proportion due to transportation accidents generally decreased; as a result in 2010 and 2011, suicides accounted for more deaths of service members than transportation accidents. The current focuses of the Services on safety and mental health are clearly indicated to minimize the premature loss of lives of young men and women in military service.     

Analysis and identification of the hidden relationships between effective factors in the mortality rate caused by road accidents: A case study of Fars Province, Iran

Purpose: An analysis and identification of the hidden relationships between effective factors in the mortality rate caused by road accidents in Fars Province of Iran to prevent and reduce traffic accidents in the future. Methods: This cross-sectional study was conducted to integrate all the pervious researches performed on mortality rate of road traffic accidents in Fars Province from March 21, 2013 to March 20, 2017. In order to reveal the relationships between the factors affecting mortality rates of road traffic accidents, the data regarding road traffic accidents extracted from resources such as Legal Medicine Organization, Traffic Police, Accident & Emergency Department, as well as Department of Roads and Urban Development of Fars Province, then cleaned and the applicable attributes embedded in the data all aggregated for further analysis. It should be noted that the data not related to Fars Province were deleted, the data analyzed, converted and the aggregation between various attributes identified. The aggregation between these different attributes as well as the FP-growth algorithm and two indexes of support and confidence calculated and interesting and effective rules extracted. In the end, several accident-provoking factors, the degree of consecutive and interdependence of each one in road accidents identified and introduced. The statistical analysis was conducted by using Rapid Miner software. Results: Of the 6216 people dead due to road traffic accidents, 4865 (79.02%) were male and 1292 (20.98%) were female, 59 of them have no clear gender. The largest portion of people died of road traffic accidents belonged to married and self-employed men who collided with motorcycles in autumn. Moreover, young individuals (aged 19e40 years) with secondary educational level who died of accidents in summer at 12:00 a.m. and then 5:00 p.m. in outer city main roads of Kazerun-Shiraz, then DarabShiraz, Fasa-Darab and in within-city main streets had the highest mortality rates. Among women, the middle-aged group (aged 41e65 years) followed by young-aged group (aged 19e40 years) with elementary educational level and then illiterate accounted for the highest mortality rate of road traffic accidents. The automobiles involved in accidents included Pride, Peugeot 405, Peykan pickup, Samand, Peugeot Pars, other vehicles and motorcycles. Conclusion: The high mortality rate of illiterate and low-literate in various age groups indicates that educational level plays a crucial role as a factor in road accidents, requiring related organizations such as Traffic Police and Ministry of Education to take necessary measures and policies.     

Analysis of 86 fatal motorcycle frontal crashes in Chongqing, China

Objective: To analyze the injuries of motorcyclists involved in fatal motorcycle frontal crashes.Methods: A survey group involving multi-discipline experts was built to randomly collect data on fatal m...     

Accidents with bicycles and motorcycles. The injury pattern, costs, and possibilities for prevention]

This review comprises all 641 patients subjected to inpatient treatment in 1976, 1980 and 1984 at the Basel district hospital after accidents involving bicycles or motorcycles. A study of the case histories--supplemented by phone conversations--yielded the following results: Accidents involving bicycles or motor-driven bicycles were seen in all age groups, but motorcycle accidents occurred exclusively among the younger generation. Whereas motorcycle accidents mostly happened during joyrides, accidents with bicycles or mobikes mainly occurred on the way to work. The incidence rate was highest during summertime and in the rush hours at noon or in the evening. Motorcycle accidents resulted in more severe injuries, longer hospitalisation, longer periods of disability and higher costs than bicycle or mobike accidents the latter being mainly characterised by mostly slight head injuries and the former by injuries of the legs and arms.     

Pilot study of injured patients seen in the University of Port Harcourt Teaching Hospital, Nigeria

A 12-month pilot study of injured patients seen in the Emergency Department of the University of Port Harcourt Teaching Hospital was carried out. Trauma (28.8 per cent) was the main reason for emergency visits; 82.1 per cent of the patients were under 31 years of age. Domestic accidents were the commonest cause of trauma (42.5 per cent), followed by criminally motivated injuries (30.4 per cent), road traffic accidents (26.0 per cent), industrial (0.5 per cent) and other accidents (0.6 per cent). The overall mortality rate due to trauma was 5.4 per cent and within the period of study, trauma was the most common cause of deaths in hospital (10.1 per cent). Road traffic accidents were responsible for 67.9 per cent of these deaths, followed by criminally motivated injuries (16.1 per cent). Domestic, industrial and boat accidents caused 7.6 per cent, 5.4 per cent and 3.1 per cent deaths, respectively. Injury Severity Scores (ISS) among 419 patients showed a 100 per cent mortality for those with scores above 35. There were 48 prehospital, 19 emergency room and 14 in-hospital deaths among patients with an ISS below 35. The deaths resulted largely from delayed transportation of victims to the hospital and partly from inadequate emergency medical services. To reduce the current high rate of preventable deaths from injury, we recommend (i) ambulance services for early transportation of victims to the hospital and (ii) improved emergency medical care.     

Epidemiology of road traffic mortality and injuries in Yazd, Iran during 2003-2008

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.     

Spinal injuries in motorcycle crashes: patterns and outcomes

BACKGROUND: The purpose of this study was to determine patterns of spinal injury and clinical outcomes resulting from motorcycle crashes. METHODS: We analyzed data collected on 1,121 motorcyclists involved in road traffic accidents (from 1993-2000) and identified those who had sustained a spinal injury. RESULTS: Spinal injury occurred in 126 (11.2%) riders (112 male riders [88.9%] and 14 female riders [11.1%]), with a mean age of 30.2 years (range, 16-61 years) and Injury Severity Score of 18.8 (range, 4-66). Isolated injuries to the spine occurred in 30 (23.8%) riders. The thoracic spine was injured in 69 (54.8%), the lumbar spine in 37 (29.4%), and the cervical spine in 34 (27.0%) cases. Multiple vertebral levels were affected in 54 (42.9%). Neurologic injury occurred in 25 riders (19.8%), with complete distal neurologic injury in 14 (4 cervical, 9 thoracic, and 1 lumbar). Eleven (8.7%) patients required spinal surgery. There were 13 (10.3%) deaths. CONCLUSION: The thoracic spine is the most commonly injured spinal region in motorcycle crashes. Multiple level injuries are common. Protocols concentrating on the radiographic clearance of the cervical region may miss a significant number of spinal injuries. Vigilance is required in assessing these patients, who often have multiple injuries.     

2005-2009年温州市甬台温高速公路（温州段）交通伤特点分析

目的通过调查分析甬台温高速公路（温州段）交通伤的特点,为进一步提高交通伤害救治水平提供依据。方法收集发生于宁波-台州-温州（简称甬台温）高速公路（温州段）交通事故的原始数据,用描述流行病学方法分析交通伤特点;采用SPSS18．0软件对调查指标进行分析。结果2005年1月1日至2009年12月31日（5年间普通程序处理的事故）甬台温高速公路发生交通事故308起,累计伤亡603人。其中死亡157人。交通事故以尾随相撞最为多发,占总事故的39．29％,主要原因为司机疲劳驾车及超速行驶。结论高速公路交通事故有时间、年龄分布不均衡性;男性青壮年为发生概率的高危人群,但高龄受累人群的死亡率更高。通过对温州段高速公路交通伤特点分析,可针对性地进行高速公路行车安全培训,借此创建安全的高速公路交通环境。     

Heel flap injuries in motorcycle accidents

Thirteen cases of heel flap injuries following motorcycle spoke accidents have been analysed. The injuries have been graded into three Grades (I, II and III) depending upon the severity and extent of the injury to the foot. The different forms of management are outlined. Most of the injuries have been confined to the right side because of poor assembly of the rear wheel of the motorcycle. Inadequate footwear is a contributory factor. It is urged that protective footwear be made compulsory for both the driver and the pillion passenger. Changes should also be made in the design of the rear wheels of motorcycles.     

Epidemiologic study of traffic crash mortality among motorcycle users in Iran(2011e2017)

Purpose: Motorcycle accident is a major cause of road traffic injuries and the motorcyclists are considered as vulnerable road users. The present study aimed to determine the epidemiological characteristics of fatal motorcycle crashes in Iran. Methods: In this cross-sectional study, a total of 28,356 motorcycle traffic fatalities registered in the Legal Medicine Organization of Iran were analyzed during the period between March 2011 and March 2017. The examined variables included demographic characteristics, helmet use, crash mechanisms, crash location, position state, type of counterpart vehicle, cause of death and place of death. In the study, road traffic mortalities involving drivers and/or passenger of motorcycles were included. Cases or events registered without these conditions were excluded from the study. To analyse the data, SPSS statistics 25 and GraphPad Prism 8 softwares were used. Results: Of the 122,682 fatal traffic injury cases, 28,356 (23.1%) were motorcycle users, of whom 95.3% were male and 4.7% were female. Most of the motorcycle fatalities belonged to the age group of 18-24 years (29.1%). Head trauma was the major cause of death (59.0%). Also, the overall proportion of safety helmet use among motorcycle crash victims was estimated at 37.4%. Most of the road traffic crash cases (46.8%) happened out of city and half of people (49.9%) died in hospital. About 77.4% of the victims were motorcycle riders and 21.1% were pillion passengers. The highest rate of mortality belonged to the selfemployed (38.4%) and then workers (21.8%) and students (10.2%). In addition, most fatalities occurred in people with low education (77.5%) and the least occurred in university graduates (5.5%). Among 31 provinces of Iran, Fars had the highest (9.3%) occurrence rate and Kohgiluyeh and Buyer-Ahmad had the lowest (0.5%). Most of the crash mechanisms were due to motorcycle-vehicle crashes (80.2%), followed by rollover (9.8%). Conclusion: Comprehensive public education and special rules are needed to reduce the rate of deaths in motorcycle crashes.     

交通事故医疗急救点的设置与经验分析

目的：探讨在城郊结合部交通事故多发路段事故伤员应急救援管理模式。方法：对我院2001年6月～2004年6月在桂林郊区设立“交通事故急救点”三年来,在医疗点的设置、人员配备方面和救治经验进行总结。结果：医疗队的设立,提高了对交通事故的快速反应能力,伤员等待救治时间平均为8min,伤员死亡率为7．9%(64/809例)。与此同时,医疗队本身的野战救护能力也得到了很大的提高。结论：在交通事故频发的城郊结合部设立医疗急救点,是提高交通伤救治能力,减少事故伤员死亡率的有效方法之一。     

Analysis on the accident casualties influenced by several economic factorsbased on the traffic-related data in China from 2004 to 2016

Purpose: By studying the economic data related to road traffic accidents in recent 10 years, this paper explores the impact of various economic factors on the number of casualties in traffic accidents in China, and puts forward related prevention and management measures. Methods: Based on five economic factors including the number of new health institutions, health investment, transportation investment and disposable income per capita, this paper collects the data of traffic accidents in 31 provinces and municipalities of China from 2004 to 2016 and estimates the parameters using fixed effect model. Results: The number of health institutions, health investment, transportation investment and disposable income per capita are negatively correlated with the number of traffic accident casualties; the number of new health institutions is positively correlated with the number of traffic accident casualties; health investment and transportation investment have a great impact on the number of road traffic accident casualties. Conclusion: Economic development has a positive impact on improving traffic conditions, but the increase in the number of new health institutions does not reduce the number of casualties in accidents. The irrational layout of health institutions and imperfect road traffic management mechanism should be taken into account.     

Epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran: a community-based survey

Objective: To determine the epidemiological characteristics of fatal pedestrian accidents in Fars Province of Iran.Methods: This cross-sectional study was conducted in Fars Province of Iran during a 29-month period from March 2009 to July 2011.The data were from the Fars Forensic Medicine Registry.In 4 923 recorded road traffic accident fatalities,971 deaths were due to pedestrian accidents.The demographic and accident-related information were analyzed by SPSS version 11.5.P value less than 0.05 was considered significant.Results: The mean age of decedents was (47.2±26.2)years,ranging from 6 months to 103 years old.Males accounted for 69.8％ of all deaths.Fatal accidents were most common in September; 56.1％ of the fatal injuries occurred on intracity roads and 33.1％ on extracity roads.Fatal head injuries were present in 60.54％ of cases.Evaluation of the injury site and the cause of death found that they were significantly associated with age,interval between injury and death.Besides,the type of roads played an important role in mortality.Conclusion: Although the clinical management of trauma patients has been improved in our country in the recent decade,decreasing the burden of injuries needs coordination among trauma system organizations.     

Comparative analysis of characteristics and risk factors of traffic injury in aged people from urban and rural areas in Chongqing

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 corresp...     

Clinical characteristics of 1653 injured motorcyclists and factors that predictmortality from motorcycle crashes in Malaysia

PurposeAmongst the ASEAN countries, Malaysia has the highest road fatality risk (>15 fatalities per 100 000 population) with 50% of these fatalities involving motorcyclist. This contributes greatly to ward admissions and poses a significant burden to the general surgery services. From mild rib fractures to severe intra-abdominal exsanguinations, the spectrum of cases managed by surgeons resulting from motorcycle accidents is extensive. The objective of this study is to report the clinical characteristics and identify predictors of death in motorcycle traumatic injuries from a Malaysian trauma surgery centre.MethodsThis is a prospective cross-sectional study of all injured motorcyclists and pillion riders that were admitted to Hospital Sultanah Aminah and treated by the trauma surgery team from May 2011 to February 2015. Only injured motorcyclists and pillion riders were included in this study. Patient demography and predictors leading to mortality were identified. Significant predictors on univariate analysis were further analysed with multivariate analysis.ResultsWe included 1653 patients with a mean age of (35 ± 16.17) years that were treated for traumatic injuries due to motorcycle accidents. The mortality rate was 8.6% (142) with equal amount of motorcycle riders (788) and pillion riders (865) that were injured. Amongst the injured were male predominant (1 537) and majority of ethnic groups were the Malays (897) and Chinese (350). Severity of injury was reflected with a mean Revised Trauma Score (RTS) of 7.31 ± 1.29, New Injury Severity Score (NISS) of 19.84 ± 13.84 and Trauma and Injury Severity Score (TRISS) of 0.91 ± 0.15. Univariate and multivariate analysis revealed that age≥35, lower GCS, head injuries, chest injuries, liver injuries, and small bowel injuries were significant predictors of motorcycle trauma related deaths with p < 0.05. Higher trauma severity represented by NISS, RTS and TRISS scores was also significant for death with p < 0.05.ConclusionAge, lower GCS, presence of head, chest, liver, small bowel injuries and higher severity on NISS, RTS and TRISS scores are predictive of death in patients involved with motorcycle accidents. This information is important for prognostic mortality risk prevention and counselling.     

Road traffic injury mortality and morbidity by country development status, 2011-2017

Purpose: This research examined road traffic injury mortality and morbidity disparities across of country development status, and discussed the possibility of reducing country disparities by various actions to accelerate the pace of achieving Sustainable Development Goals target 3.6 — to halve the number of global deaths and injuries from road traffic accidents by 2020. Methods: Data for road traffic mortality, morbidity, and socio-demographic index (SDI) were extracted by country from the estimates of the Global Burden of Disease study, and the implementation of the three types of national actions (legislation, prioritized vehicle safety standards, and trauma-related post-crash care service) were extracted from the Global Status Reporton Road Safety by World Health Organization.We fitted joinpoint regression analysis to identify and quantify the significant rate changes from 2011 to 2017. Results: Age-adjusted road traffic mortality decreased substantially for all the five SDI categories from 2011 to 2017 (by 7.52%e16.08%). Age-adjusted road traffic mortality decreased significantly as SDI increased in the study time period, while age-adjusted morbidity generally increased as SDI increased. Subgroup analysis by road user yielded similar results, but with two major differences during the study period of 2011 to 2017: (1) pedestrians in the high SDI countries experienced the lowest mortality (1.68-1.90 per 100,000 population) and morbidity (110.45-112.72 per 100,000 population for incidence and 487.48-491.24 per 100,000 population for prevalence), and (2) motor vehicle occupants in the high SDI countries had the lowest mortality (4.07-4.50 per 100,000 population) but the highest morbidity (428.74-467.78 per 100,000 population for incidence and 1025.70-1116.60 per 100,000 population for prevalence). Implementation of the three types of national actions remained nearly unchanged in all five SDI categories from 2011 to 2017 and was consistently stronger in the higher SDI countries than in the lower SDI countries. Lower income nations comprise the heaviest burden of global road traffic injuries and deaths. Conclusion: Global road traffic deaths would decrease substantially if the large mortality disparities across country development status were reduced through full implementation of proven national actions including legislation and law enforcement, prioritized vehicle safety standards and trauma-related postcrash care services.