Characteristics associated with alcohol consumption among emergency department patients presenting with road traffic injuries in Hyderabad,India

IntroductionEach year in India, road traffic crashes lead to more than 200,000 deaths and the country has seen an unprecedented rate of roadway fatalities in recent years. At the same time, alcohol consumption per capita among Indians is rising. Despite these increasing trends of road traffic injuries (RTIs) and alcohol use, alcohol is not routinely assessed as a risk factor for RTIs. This study aims to examine the involvement of alcohol among emergency department patients presenting with RTIs in the Indian city of Hyderabad.Patients and methodsAs part of a prospective study, data were collected from 3366 patients (88.0% male) presenting with RTIs at an emergency department in Hyderabad, India, from September 2013 to February 2014. Logistic regression models were used to assess individual-level and road traffic crash characteristics associated with suspected or reported alcohol consumption six hours prior to the RTI.ResultsAlcohol was suspected or reported among 17.9% of the patients with RTIs. Adjusting for confounders, males experienced 9.8 times greater odds of alcohol-related RTIs than females. Compared to 15–24 year-olds, the odds of alcohol consumption was 1.4 times greater among 25–34 year-olds and 1.7 times greater among 35–44 year-olds, adjusting for confounding factors. Patients who were passengers in vehicles other than motorized two-wheelers had 90% reduced odds of an alcohol-related RTI than motorized two-wheeler drivers. Drivers of non-two-wheelers, passengers on two-wheelers, and pedestrians did not have significantly different odds of an alcohol-related RTI compared to two-wheeler drivers. Nighttime crashes were associated with nearly a threefold increase in the odds of alcohol consumption.ConclusionsGiven that alcohol was suspected or reported in more than one in six injured ED patients with RTIs, it is clear that alcohol is a serious risk factor for RTIs; this evidence can guide prevention efforts. These findings suggest that evidence-based interventions to reduce drink-driving, such as random breath testing (where law enforcement officials stop drivers on the road to test them for alcohol use), could be more widespread in India. Future studies should assess the effectiveness of greater implementation and enforcement of policies to decrease alcohol's availability to reduce RTIs.     

Road traffic injuries in Yaoundé, Cameroon: A hospital-based pilot surveillance study

BackgroundRoad traffic injuries (RTIs) are a major cause of death and disability worldwide. In Cameroon, like the rest of sub-Saharan Africa, more data on RTI patterns and outcomes are needed to improve treatment and prevention. This study analyses RTIs seen in the emergency room of the busiest trauma centre in Yaoundé, Cameroon.MethodsA prospective injury surveillance study was conducted in the emergency room of the Central Hospital of Yaoundé from April 15 to October 15, 2009. RTI patterns and relationships among demographic variables, road collision characteristics, injury severity, and outcomes were identified.ResultsA total of 1686 RTI victims were enrolled. The mean age was 31 years, and 73% were male. Eighty-eight percent of road collisions occurred on paved roads. The most common user categories were ‘pedestrian’ (34%) and ‘motorcyclist’ (29%). Pedestrians were more likely to be female (p < 0.001), while motorcyclists were more likely to be male (p < 0.001). Injuries most commonly involved the pelvis and extremities (43%). Motorcyclists were more likely than other road users to have serious injuries (RR = 1.45; 95% CI: 1.25, 1.68). RTI victims of lower economic status were more likely to die than those of higher economic status.DiscussionVulnerable road users represent the majority of RTI victims in this surveillance study. The burden of RTI on hospitals in Cameroon is high and likely to increase. Data on RTI victims who present to trauma centres in low- and middle-income countries are essential to improving treatment and prevention.     

Epidemiology of Injuries at a Tertiary Care Center in Malawi

Background  Injury surveillance is an ongoing process required for primary, secondary, and tertiary injury prevention. In Malawi, hospital-based injury data are not available. Methods  From February to June 2008 we collected data on injured patients presenting to Kamuzu Central Hospital in Lilongwe, Malawi. The sample (n = 1,474) was predominantly male (75.7%), and age distribution was bimodal (peak age groups <5 years and 26–30 years). Road-traffic injury (RTI) was the most common reason for treatment (43.4%), followed by assault (24.0%), which was more common than expected. The most common injuries were lacerations, contusions, and abrasions. We observed both gender- and age-specific patterns in injury mechanism: Injured females were more likely than injured males to have suffered an injury as a passenger in a car or on a bicycle, or to have suffered from falls, foreign bodies, and burns; injured males were more likely than injured females to have suffered an injury as an automobile driver or bicyclist, or from an assault. Falls, burns, and foreign bodies affected younger victims, whereas bicyclists, automobile drivers, and motorcycle operators were generally older persons. Results  The hospital admission rate was 26.8%. Most patients arrived by private vehicle (43.8%), which was also the fastest means of transportation. There were 25 mass casualties leading to 102 admissions; all but one were due to RTIs, and seven were associated with at least one fatality. Conclusions  This study elucidated injury epidemiology in Malawi and identified questions for future research. Other developing countries should conduct such prospective data collection to identify region-specific injury patterns and to promote injury prevention.     

Road use pattern and risk factors for non-fatal road traffic injuries among children in urban India

Objective

We assessed the road use pattern and incidence and risk factors of non-fatal road traffic injuries (RTI) among children aged 5-14 years in Hyderabad, India.

Methods

In a cross-sectional population-based survey, data were collected on 2809 participants aged 5-14 years (98.4% participation) selected using multi-stage cluster sampling. Participants recalled non-fatal RTI during the previous 3 and 12 months. RTI was defined as an injury resulting from a road traffic crash irrespective of severity and outcome.

Results

Boys (11.5) had a higher mean number of road trips per day than girls (9.6), and the latter were more likely to walk and less likely to use a cycle (p < 0.001). With increasing household income quartile, the proportion of trips using cycles or motorised two-wheeled vehicles increased while trips as pedestrians decreased (p < 0.001). Based on the 3-month recall period, the age-sex-adjusted annual rate of RTI requiring recovery period of >7 days was 5.8% (95% CI 4.9-6.6). Boys and girls had similar RTI rates as pedestrians but boys had a three times higher rate as cyclists. Considering the most recent RTI in the last 12 months, children of the highest household income quartile were significantly less likely to sustain pedestrian RTI (0.26, 95% CI 0.08-0.86). The odds of overall RTI were significantly higher for those who rode a cycle (2.45, 95% CI 1.75-3.42) and who currently drove a motorised two-wheeled vehicle (2.83, 95% CI 1.60-5.00).

Conclusion

These findings can assist in planning appropriate road safety initiatives to reduce cycle and pedestrian RTI among children to reduce RTI burden in India.     

Investigation of effective factors on traumatic amputations due to road traffic accidents

AimTo determine factors associated with the locations, types and levels of traumatic limb amputations caused by road traffic accidents.Materials and MethodsThe files sent by the courts to the expert committee chaired by the authors for the determination of applicants’ disability rate over the 10-year period between 2011 and 2020 were examined retrospectively.ResultsOf the 27 cases with traumatic amputations caused by road traffic accidents, 63% of them were male and the mean age of the cases was 29.0 ± 20.0 years. The cases comprised 12 passengers, 10 pedestrians, and 5 drivers. Of all, 66.7% of the amputations were caused by automobile accidents, 59.3% of them were in lower limbs, 51.9% of them were on the right side, and most of them occurred below the elbow/knee levels. Amputations occurred more frequently in lower limbs that are contralateral to the side of the traffic flow, in drivers, and in front seat passengers.ConclusionThe findings in this preliminary study need to be confirmed in studies to be conducted in larger series. The findings of these studies will shed light on technological developments that can be used in the prevention of serious injuries that lead to post-accident traumatic amputations.     

Musculoskeletal Trauma Services in Uganda

Approximately 2000 lives are lost in Uganda annually through road traffic accidents. In Kampala, they account for 39% of all injuries, primarily in males aged 16–44 years. They are a result of rapid motorization and urbanization in a country with a poor economy. Uganda’s population is an estimated 28 million with a growth rate of 3.4% per year. Motorcycles and omnibuses, the main taxi vehicles, are the primary contributors to the accidents. Poor roads and drivers compound the situation. Twenty-three orthopaedic surgeons (one for every 1,300,000 people) provide specialist services that are available only at three regional hospitals and the National Referral Hospital in Kampala. The majority of musculoskeletal injuries are managed nonoperatively by 200 orthopaedic officers distributed at the district, regional and national referral hospitals. Because of the poor economy, 9% of the national budget is allocated to the health sector. Patients with musculoskeletal injuries in Uganda frequently fail to receive immediate care due to inadequate resources and most are treated by traditional bonesetters. Neglected injuries typically result in poor outcomes. Possible solutions include a public health approach for prevention of road traffic injuries, training of adequate human resources, and infrastructure development. The author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.     

Magnitude and factors associated with road traffic injuries in Brazil: results from the National Health Survey, 2019

ObjectiveTo estimate the magnitude and factors associated with self-reported road traffic injuries (RTI) in Brazil.MethodsCross-sectional study conducted using data from individuals aged 18 years or older, participants in the 2019 National Health Survey, a population-based conducted on 88,531 adult individuals in Brazil. Three indicators were analyzed: (i) Proportion (%) of individuals aged 18 years or older who were involved in RTI in the past 12 months; (ii) Proportion (%) of car drivers who were involved in RTI in the past 12 months; and (iii), Proportion (%) of motorcycle drivers who were involved in RTI in the past 12 months. In the inferential analysis, multiple Poisson regression was used to analyze the association between demographic and socioeconomic variables and RTI, stratified for the general population, population of car and motorcycle drivers.ResultsThe estimated prevalence of self-reported RTI in the past 12 months was 2.4%. The South, Southeast, Northeast, Central-West, and North regions of Brazil had prevalences of 2.0%, 2.1%, 2.7%, 3.2%, and 3.4%, respectively. The results also show that most developed regions (South and Southeast) showed the lowest prevalence's, the highest frequencies were observed in those with lower socioeconomic development levels (Central-West, North, and Northeast). The prevalence was also higher in the subgroup of motorcyclists when compared to car drivers. In the general sample, the Poisson model showed an association between male sex, younger age, low level of education, residing outside capitals and metropolitan regions, in the North, Northeast and South regions and the prevalence of RTI. In car drivers, similar associations were found, except for area of residence. In motorcycle drivers, young age, low level of education, living in urban areas were associated with increased prevalence of RTI.ConclusionThe prevalence of RTI is still high within the country, with disparities between regions, affecting more motorcyclists, young people, males, individuals with low education, and residents of the countryside.     

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.     

Increased morbidity associated with weekend paediatric road traffic injuries: 10-year analysis of trauma registry data

BackgroundRoad traffic injuries (RTIs) are a significant cause of paediatric morbidity and mortality worldwide, with a disproportionate number of these injuries occurring in low- and middle-income countries (LMICs). Adult data from LMICs suggest that weekends are particularly high-risk for RTIs, but whether children are at increased risk of RTI on weekends has not previously been investigated in any setting. This study sought to assess patterns in paediatric RTI presentations using hospital-based trauma surveillance data in Cape Town, South Africa.MethodsData was analysed from Childsafe South Africa's prospectively collected trauma registry for injured children below 13 years of age presenting to a tertiary paediatric referral Trauma Department between 2004 and 2013.ResultsDuring the 10-year study period, a total of 71,180 patients presented with traumatic injuries, of which 8,815 (12.4%) resulted from RTIs. RTI patients had a mean age of 5.2 ± 3.6 years, and were predominantly males and pedestrians. RTIs were more common on weekends than weekdays (2.98 vs. 2.19 patients/day, p < 0.001), representing a greater proportion of daily all-cause trauma (15.5% vs. 11.2%, p < 0.001). Moreover, weekend RTI patients sustained more severe injuries than on weekdays, and compared to weekend all-cause trauma patients (injury score 1.66 vs. 1.46 and 1.43, both p < 0.001). RTI patients were more likely to require admission to both the trauma ward (1.14 vs. 0.79 patients/day, p < 0.001) and the PICU (0.10 vs. 0.07 patients/day, p < 0.05) on weekends than on weekdays. Weekend RTI patients most frequently required admission to the trauma ward (p < 0.001) and the PICU (p < 0.05) during the last annual quarter.ConclusionsIn a LMIC-setting, paediatric RTI patients are more frequently brought to medical attention, sustain more severe injuries and more frequently require hospital admission during the weekend. Weekends during the last annual quarter were particularly high-risk for paediatric RTIs. These findings highlight the importance of trauma surveillance data to inform targeted community prevention strategies for improving child road safety.     

Perioperative Outcomes of Laparoscopic Adjustable Gastric Banding in Mildly Obese (BMI < 35 kg/m<Superscript>2</Superscript>) Compared to Severely Obese

Laparoscopic adjustable gastric banding (LAGB) has become a standard restrictive procedure in the USA for the treatment of severe obesity (body mass index, BMI > 35 kg/m²). Mildly obese individuals (BMI < 35 kg/m²) are also at increased risk from obesity-related conditions. Recently, an FDA panel supported its use in this subgroup. We compared the perioperative outcomes of LAGB in mildly and severely obese. Thirty consecutive patients (mildly obese n = 10; severely obese n = 20) that underwent preoperative medical weight loss followed by LAGB procedures were prospectively evaluated. Outcome variables included: operative room (OR) time, intraoperative estimated blood loss (EBL), length of hospital (LOS), and intensive care unit (ICU) stay, reoperations, readmissions, 30-day morbidity and mortality. Demographic data was comparable between groups. BMI was significantly higher in the severely obese compared to mildly obese (44.0 ± 5 vs. 33.6 ± 1 kg/m²). OR time, EBL, LOS, and ICU admissions were similar between BMI groups. There were no reoperations or 30-day mortality in either group. Minor morbidity was only observed in the severely obese group. BMI correlated with OR time and EBL. In mildly obese, LAGB is as safe as in the severely obese with no perioperative morbidity. The perioperative outcomes and hospital resource utilization are comparable between BMI groups. Lower BMI is associated with lower operative times and blood loss.     

Time analysis of fatal traffic accidents in Fars Province of Iran

Objective:To analyze the time factor in road traffic accidents (RTAs) in Fars Province of Iran.Methods:This study was conducted in Fars Province,Iran from November 22,2009 to November 21,2011.Victims'i...     

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.     

Surgical strategy for femoral shaft fractures in severely injured patients: A 13-year experience from a tertiary trauma centre

BackgroundThe treatment strategy of femoral shaft fractures in polytraumatised patients has evolved over the years and led to improved outcomes for these patients. However, there is still controversy regarding the optimal treatment strategy and surgical care can differ markedly from one country to another. We investigate the surgical treatment strategy (Early Definitive Care (EDC) or Damage Control Orthopaedics (DCO)) implemented in the care of severely injured patients with femoral shaft fractures treated at a single tertiary trauma centre in southern Finland and factors affecting decision making.MethodsThe Helsinki Trauma Registry (HTR) was used retrospectively to identify severely injured patients (New Injury Severity Score [NISS] ≥ 16) treated from 2006 through to 2018 with concomitant femoral shaft fractures. Patients <16 years old, with isolated head injuries, dead on arrival and those admitted >24 h following the injury were excluded. Based on their initial surgical management strategy, femoral fracture patients were divided into EDC and DCO groups and compared.ResultsCompared to other trauma-registry patients, those with femoral shaft fractures are younger (30.9 ± 15.9 vs. 47.0 ± 19.7, p<0.001) and more often injured in road traffic accidents (64.1% vs. 34.4%, p<0.001). The majority (78%) of included patients underwent EDC. Patients who underwent DCO were significantly more severely injured (NISS: 40.1 ± 11.5 vs. 27.8 ± 10.1, p<0.001) with longer lengths of stay in ICU (15.4 ± 9.8 vs. 7.5 ± 6.1 days, p<0.001) and in hospital (29.9 ± 29.6 vs. 13.7 ± 11.4 days, p<0.001) than patients treated with EDC. Decision making was based primarily on injury related factors, while non-injury related factors may have contributed to choosing a DCO approach in a small number of cases.ConclusionEarly definitive care is the prevailing treatment strategy in severely injured femoral shaft fracture patients treated at a tertiary trauma centre. Patients treated with DCO strategy are more severely injured particularly having sustained worse intracranial and thoracic injuries. In addition to injury related factors, treatment strategy decision making was influenced by non-injury related factors in only a minority of cases.     

Injury factors associated with discharge status from emergency room at two major trauma hospitals in The Gambia,Africa

IntroductionInjuries are the leading cause of disability across all ages and gender. In this study, we identified predictors of discharge status and disability at discharge among patients who seek emergency room treatment.Materials and methodsThe study was conducted in two major trauma hospitals in urban Gambia. 1905 patients participated in the study. 74.9% were males, and 25.1% were females. The study includes injured patients from all mechanisms. However, patients’ records without age, gender, injury mechanism, and deposition from the emergency room were considered incomplete and excluded. We examined distributions of injury by age, gender, mechanism, place of occurrence, intent, primary body part injured, and primary nature of injury. We identified demographic and injury characteristics associated with hospital admission (compared to emergency department discharge) and discharge disability (any level of disability compared with none).ResultsThe leading mechanisms of injury were road traffic (26.1%), struck by objects (22.1%), cut/pierce (19.2%), falls (19.2%), and burns (5.4%). Injuries most commonly occurred in the home (36.7%) and on the road (33.2%). For those aged 19–44, the proportion of injuries due to assault was higher for females (35.9%) than males (29.7%). Males had increased odds for admission (aOR = 1.48 95% CI = 1.15–1.91) and for disability (aOR = 1.45; 95% CI = 1.06–1.99). Increased odds for admission were found for brain injuries, fractures, large system injuries, and musculoskeletal injuries when compared with soft tissue injuries. The highest odds for any level of discharge disability were found for brain injuries, fractures, injuries from falls, burns, and road traffic.ConclusionsEpidemiology of injuries in The Gambia is similar to other low-income countries. However, the magnitude of cases and issues uncovered highlights the need for a formal registry.     

Young Adults and Riding Position: Factors that Affect Mortality Among Inpatient Adult Motorcycle Casualties: A Major Trauma Center Experience

Background  In Singapore, road traffic accidents (RTAs) are the second most common cause of deaths in trauma. Motorcycle casualties account for 54% of all fatalities. Studies have shown that the mean age of motorcycle casualties is significantly younger than that of other RTA victims. Methods  We reviewed the mortality of all motorcycle casualties ≥16 years admitted to an acute hospital as emergencies from January 2004 to December 2006. To determine the impact of age on mortality, we divided our patients into two groups, one ≤21 years (younger group) and another >21 years (older group). A subset analysis based on riding position (driver versus passenger) was performed to determine the inpatient mortality rate in these two groups. Results  There were 96 (14%) patients in the younger group and 586 (86%) patients in the older group. The mortality rate for younger motorcycle casualties was significantly higher (14.6% versus 8%; p = 0.04). Also, there were significantly more passengers in the younger group (25% versus 8.4%; p = 0.0001). The mortality rate among young passengers was significantly higher than that among young drivers (29.2% versus 9.7%; p = 0.019). Likewise, the mortality rate of the young passengers was also significantly higher than that among older passengers (29.2% versus 10.2%; p = 0.04). Conclusions  Young motorcycle casualties have a significantly higher mortality rate than older motorcycle casualties. Young passengers have the highest mortality rate and contribute significantly to the death rate among young motorcycle casualties.     

Musculoskeletal Trauma Services in China

China is a developing country with a population over 1.3 billion with the second largest group of people in poverty next to India. There are about 159 million motor vehicles, with 163,887,372 drivers. From 2001 to 2004 over 100,000 people died each year in traffic accidents. With law enforcement and public education, traffic accidents have decreased, and the death rate is now less than 100,000 each year. One author (Li-Ze Xiong) has received funding from a grant of China’s Army (06G086).     

Road traffic injuries in Tanzanian children and adolescents: A cross-sectional household survey

ObjectiveTo measure annual rates of road traffic injuries (RTI) and to describe the characteristics of road traffic crashes experienced by children and adolescents in Tanga, Tanzania.MethodsWe conducted a cross-sectional household survey using geospatial population-weighted sampling in the city of Tanga in northern Tanzania. Data were collected in February and March of 2022. We report 12-month rates of road traffic crashes and RTI (reported by adult caregivers) among children and adolescents <18 years of age.ResultsA total of 2,794 adult respondents reported data on 6563 children and adolescents, among whom, 180 were reported to have experienced road traffic crashes in the past 12 months (crash incidence: 27.4 per 1,000 children, 95%CI 23.5-31.4) and 158 sustained injuries (RTI incidence: 24.1 per 1000 children, 95%CI 20.4-27.8). Almost a quarter of RTI (23%) were reported to be major (resulting in ≥30 days of missed activities). RTI was higher among adolescents (13-17 years) than children <5 years (21.5 vs. 14.1 per 1,000, p=0.039). Few children always or sometimes wore helmets when riding on motorcycles/motorbikes (12.8%) or wore safety restraints/seat belts in cars or other vehicles (11.9%).ConclusionThe high rate of road traffic crashes and RTI observed among children and adolescents in a medium-sized city in Tanzania underscores the urgent need to improve road safety and increase use of safety equipment in low resource settings.     

Epidemiology of patients admitted to a major trauma centre in northern India

Objective： Trauma in India is an increasingly significant problem, particularly in light of rapid development and increasing motorization. Social changes are resulting in alterations in the epidemiology of trauma. The aim of the study was to assess the various epidemiological parameters that influence the cause of injury in the patients admitted to a major trauma centre in northem India. Methods： An observational study of 748 patients chosen by random assortment was carried out over a peri- od of 1 year （August 2008 to July 2009）. Age, sex, injury type and pattern were noted. Injury mode of upper and lower limbs was also noted. Results： Injuries occur predominately in the age group of 15-30 years. Males incurred more injury with male to female ratio of 6：1. The most vulnerable group was motorcycle users. Among the injured, farmers were the most commonly involved. Blunt injuries （94.92%） were much more common than penetrating injuries. Among patients with head injury, two wheelers related accidents were the most common （40.3%）. Most spinal cord injuries were caused by falls from height （51.09%）. Most lower limb fractures were simple type. Compound fractures of the lower limb were more common than up- per limb fractures. Conclusion： Strict enforcement of traffic rules, combined with improved infrastructure and behavior change can decrease the burden of road traffic accidents in India and other developing countries. This study could assist in raising the profile of road traffic accidents as a public health problem which needs to be addressed as a preventable cause of mortality and morbidity, and plan- ning appropriate interventions for this major challenge. Preventive strategies should be made on the basis of these epidemiological trends.     

Use of alcohol and illicit drugs by trauma patients in Sao Paulo,Brazil

IntroductionAlcohol and illicit drugs impair cognitive and psychomotor skills and may thereby increase the risk of involvement in a road traffic crash and other types of injuries. However, the knowledge on the use of psychoactive substances among injured patients presenting to emergency departments in low and middle-income countries remains limited.AimsTo estimate the prevalence of alcohol and illicit drug use among patients with traumatic injuries admitted to an emergency department in Sao Paulo, Brazil.MethodsBlood samples from injured patients requiring hospitalization for more than 24 h due to road traffic crashes, falls, or violence, were collected from July 2018 to June 2019. The samples were analyzed for alcohol and illicit drugs.ResultsA total of 376 patients were included in this study; the median age was 36 years and 80% of patients were male. The majority (56%) of injuries resulted from road traffic crashes, with approximately half of them being motorcyclists. Alcohol, drugs, or both were detected in 32% of samples. The proportion that tested positive was highest for males (35%), for the age group 18–39 years (41%), for singles (43%), and for patients injured at nighttime (44%). Patients injured due to violence had the highest prevalence of alcohol or drugs in their blood samples (44%). Alcohol was most prevalent (23%), followed by cocaine (12%) and cannabis (5%).ConclusionThe use of alcohol and illicit drugs was common among injured patients in Sao Paulo; it was likely a contributing factor in a third of the injurious accidents. Alcohol was the most prevalent substance followed by cocaine and cannabis.