Comparison of mortality prediction models for road traffic accidents: an ensemble technique for imbalanced data.

BACKGROUND: Injuries caused by RTA are classified under the International Classification of Diseases-10 as 'S00-T99' and represent imbalanced samples with a mortality rate of only 1.2% among all RTA victims. To predict the characteristics of external causes of road traffic accident (RTA) injuries and mortality, we compared performances based on differences in the correction and classification techniques for imbalanced samples. METHODS: The present study extracted and utilized data spanning over a 5-year period (2013-2017) from the Korean National Hospital Discharge In-depth Injury Survey (KNHDS), a national level survey conducted by the Korea Disease Control and Prevention Agency, A total of eight variables were used in the prediction, including patient, accident, and injury/disease characteristics. As the data was imbalanced, a sample consisting of only severe injuries was constructed and compared against the total sample. Considering the characteristics of the samples, preprocessing was performed in the study. The samples were standardized first, considering that they contained many variables with different units. Among the ensemble techniques for classification, the present study utilized Random Forest, Extra-Trees, and XGBoost. Four different over- and under-sampling techniques were used to compare the performance of algorithms using "accuracy", "precision", "recall", "F1", and "MCC". RESULTS: The results showed that among the prediction techniques, XGBoost had the best performance. While the synthetic minority oversampling technique (SMOTE), a type of over-sampling, also demonstrated a certain level of performance, under-sampling was the most superior. Overall, prediction by the XGBoost model with samples using SMOTE produced the best results. CONCLUSION: This study presented the results of an empirical comparison of the validity of sampling techniques and classification algorithms that affect the accuracy of imbalanced samples by combining two techniques. The findings could be used as reference data in classification analyses of imbalanced data in the medical field.

Analysis of Thoracic Aorta Injury in 27 Road Traffic Accident Deaths.

OBJECTIVES: To analyze the characteristics of thoracic aorta injury in road traffic accidents, to provide data reference for forensic identification. METHODS: The data of 27 traffic accident death cases with thoracic aorta injury were analyzed according to relevant parameters including sex, age, mode of transportation, and thoracic aorta injury. RESULTS: Aortic injury in traffic accidents was significantly more in males than females, and 74.1% cases were in the age range of 31-70 years. The most common mode of transportation was the motorcycle, followed by electric bike, most of which crashed with trucks. Most cases were accompanied by rib fractures and lung injuries. Thoracic aorta injury was the most common in ascending aorta, followed by aortic arch and thoracic aorta. Ascending aorta injury was most likely to occur in the range of 0-<1.6 cm from the aortic valve, while it was rare over 2.6 cm. Taking the aortic valve as the reference, the most common locations of injury were the anterior semilunar valve, followed by the right posterior semilunar valve and the left posterior semilunar valve. Thoracic aortic rupture occurred in 63.0% cases, and intima and media lacerations only occurred in 37.0% cases. A few deceased had aortic diseases. CONCLUSIONS: The proximal part of the ascending aorta is prone to be injured because of the large external force of traffic accidents. The medical examiner should carefully examine the aortic injury in traffic accident deaths, and evaluate the relationship between the injury and the disease according to the condition and degree of aortic injury.

The relationship between ambient temperatures and road traffic injuries: a systematic review and meta-analysis.

Traffic accidents cause considerable economic losses and injuries. Although the adverse effects of a change in ambient temperatures on human health have been widely documented, its effects on road traffic safety are still debated. This systematic review and meta-analysis was performed to synthesize available data on the association between ambient temperature and the risks of road traffic accidents (RTAs) and traffic accident injuries (TAIs). We searched 7 different databases to locate studies. The subgroup analyses were stratified by temperature type, temperature exposure, region, mean temperature, mortality, study period, statistical model, and source of injury data. This study was registered with PROSPERO under the number CRD42021264660. This is the first meta-analysis to investigate the association between ambient temperature and road traffic safety. A total of 34 high-temperature effect estimates were reported, and two additional studies reported the relationship between low temperatures and TAI risk. The meta-analysis results found a significant association between the high temperature and RTAs, and the pooled RR was 1.025 (95%CI 1.014, 1.035). The risk of TAI was also significantly associated with temperature increases. Subgroup analyses found that using daily mean temperatures, the RR value of road traffic accidents was 1.024 (95%CI 0.939, 1.116), and the RR value of road traffic injuries was 1.052 (95%CI 1.024, 1.080). Hourly temperatures significantly increased the risk of RTA, while the risk of TAI was not significantly increased by hourly temperature. The sensitivity analysis indicated that the results were stable, and no obvious publication bias was detected. The results of this systematic review and meta-analysis suggest that increases in ambient temperature are associated with an increased risk of RTAs and TAIs. These findings add to the evidence of the impact of ambient temperature on road traffic safety.

Short-term effects of ambient temperature and road traffic accident injuries in Dalian, Northern China: A distributed lag non-linear analysis.

BACKGROUND: Although traffic accidents cause considerable economic losses and injuries to individuals, families, and communities, little is known about the impact of meteorological factors on the incidence of traffic accident injuries (TAIs). Therefore, a time-series study was conducted to explore the effect of meteorological variables on TAIs in Dalian, Northern China. METHODS: Poisson generalized linear models (PGLM) combined with distributed lag nonlinear models (DLNM) were used to estimate the association between daily TAIs and ambient temperature in Dalian, China, 2015-2017. The injury data collected by Dalian national injury surveillance hospitals, and meteorological data were extracted and accumulated from the National Meteorological Information Center. Modified the model with variables such as pressure, humidity, precipitation, PM2.5, SO2, O3, day of the week, seasonality, and time trend. In the subgroup analysis, the modification effects of gender and age were also examined. RESULTS: Both high temperatures (RR = 1.198, 95％CI：1.017-1.411) and low temperatures (RR = 1.017, 95％CI：1.001-1.035) increased the risk of TAIs. The cumulative lag effect would last until after the 7th day. While the 40-59 years subgroup seemed to be more vulnerable in high temperature environments, those who are more than 60 years showed higher TAIs in low temperatures for both single-day and cumulative TAI risks. CONCLUSIONS: Identifying the association between ambient temperature and traffic injuries could provide needed scientific evidence for relevant public health actions.

The effect of medical social workers combined with ICU diary on the prevention and treatment of post-traumatic stress disorder in ICU traffic accident patients / 中国实用护理杂志

Objective:To study the effect of medical social workers combined with ICU diary on the prevention and treatment of post-traumatic stress disorder in ICU traffic accident patients, and to explore the application of continuing nursing services and ICU diary to ICU traffic accident patients.Methods:A total of 47 patients who were admitted to the ICU of Suzhou Science and Technology City Hospital from January to December 2019 due to traffic accidents were selected by convenient sampling method. Twenty-three patients admitted to the hospital in the first 6 months were selected as the control group (before the introduction of medical social workers and ICU diaries) for routine ICU treatment and nursing mode. Twenty-four patients admitted to the hospital in the last 6 months were selected as the experimental group (after the introduction of medical social workers and ICU diaries), and the medical social workers combined with the ICU diary were intervened. The scores of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were compared between the two groups of patients when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU. The incidence of post-traumatic stress disorder was evaluated and compared by the scores of the Impact of Event Scale-Revised of the two groups of patients one month after leaving the ICU, three months after leaving the ICU, and six months after leaving the ICU.Results:The scores of SAS in the experimental group were 58.67 ± 7.45, 44.13 ± 5.47 and 39.08 ± 5.52 when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU, and were 58.17 ± 6.75, 50.87 ± 6.35 and 42.74 ± 4.85, respectively in the control group. There was no statistical difference in the scores of the SAS between the two groups of patients when they were admitted to the ICU ( P>0.05), but there was a time difference between the two groups with time changes and different interventions ( Ftime = 110.98, P<0.01), there were also differences between groups ( Fbetween groups = 5.91, P<0.05). Compared with the control group, the SAS score of the experimental group decreased more significantly( Finteraction = 0.28, P<0.05). The scores of SDS in the experimental group were 57.75 ± 4.06, 45.29 ± 3.39 and 36.63 ± 3.49 when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU, and were 57.48 ± 2.29, 49.04 ± 5.65 and 43.57 ± 4.07 respectively in the control group. There was no statistical difference in the scores of the SDS between the two groups of patients when they were admitted to the ICU ( P>0.05), but there was a time difference between the two groups of patients with time changes and different interventions ( Ftime = 248.24, P<0.01), there are also differences between groups ( Fbetween groups = 24.39, P<0.05). Compared with the control group, the SDS score of the experimental group decreased more significantly ( Finteraction=10.44, P<0.05). The incidences of post-traumatic stress disorder in the experimental group were 9, 8, 6 cases at one month, three months and six months after leaving the ICU, which were lower than 12, 11, 8 cases in the control group. The generalized estimation equation showed that the difference was statistically significant ( χ2=4.21, P<0.05). Conclusions:The intervention model of medical social workers combined with ICU diary is conducive to the use of ICU diary and the development of continuous nursing, which improves patients′negative emotions and reduces the incidence of post-traumatic stress disorder.

Analysis of Thoracic Aorta Injury in 27 Road Traffic Accident Deaths / 法医学杂志

OBJECTIVES@#To analyze the characteristics of thoracic aorta injury in road traffic accidents, to provide data reference for forensic identification.@*METHODS@#The data of 27 traffic accident death cases with thoracic aorta injury were analyzed according to relevant parameters including sex, age, mode of transportation, and thoracic aorta injury.@*RESULTS@#Aortic injury in traffic accidents was significantly more in males than females, and 74.1% cases were in the age range of 31-70 years. The most common mode of transportation was the motorcycle, followed by electric bike, most of which crashed with trucks. Most cases were accompanied by rib fractures and lung injuries. Thoracic aorta injury was the most common in ascending aorta, followed by aortic arch and thoracic aorta. Ascending aorta injury was most likely to occur in the range of 0-<1.6 cm from the aortic valve, while it was rare over 2.6 cm. Taking the aortic valve as the reference, the most common locations of injury were the anterior semilunar valve, followed by the right posterior semilunar valve and the left posterior semilunar valve. Thoracic aortic rupture occurred in 63.0% cases, and intima and media lacerations only occurred in 37.0% cases. A few deceased had aortic diseases.@*CONCLUSIONS@#The proximal part of the ascending aorta is prone to be injured because of the large external force of traffic accidents. The medical examiner should carefully examine the aortic injury in traffic accident deaths, and evaluate the relationship between the injury and the disease according to the condition and degree of aortic injury.

A systematic review on the association between meteorological factors with traffic accident injury / 中华疾病控制杂志

In recent years, the impact of meteorological factors on health and injury has been paid more and more attention. Severe weather events were considered to be an important risk factor for traffic accident injuries. Evidence from a large number of epidemiological studies suggests that meteorological factors, including high temperatures, rainfall, snowfall, wind and visibility, might be related to the occurrence of traffic accidents. This systematic review attempts to summarize the current research status of meteorological factors on traffic accident injury, systematically review the relationship between meteorological factors and traffic accident injury, and discuss how to further carry out related research.

The characteristic analysis of the injured children under the age of 14 in Dongguan area / 中华急诊医学杂志

Objective To investigate the characteristics and risk factors of the injured children Under the age of 14 in Dongguan area and provide the basis for making the specific protective measures.Methods A retrospective analysis of 1707 clinical cases of the injured children in the emergency department of our hospital from 2006 to 2010.Results The incidence rate of child injury in Dongguan area is high,accounting for 3.25％ of the emergency people at the same period.Fall-wound is at the first place of the causes of injury,accounting for 30.52％ ; traffic accident injury and bums are in the second place,accounting for 19.22％ and 11.42％ ; the incidence rate of 7-10 years-old child injury is the highest,38.25％ ; the incidence rate of boys injury is higher than girls; the incidence rate of the child injury of the children in these family such as their parents are separated,their mother are just senior high school graduates or the per capita monthly income for the whole family is less than RMB 3000 yuan is higher.There are 7 different degree of disability cases caused by injury and 10 death cases resulted from injury.Conclusions To carry out the pointed health education,average up the level of safety protection of parents and teachers,to strengthen the management of child injury surveillance and damage hazards,so as to minimize the occurrence of child injury.

Chest Trauma Caused by Traffic Accident: The Application of Injury Severity Score / 中华创伤杂志

From January 1954 to December 1991, 348 cases of chest trauma caused by traffic accident were treated, with multiple injury in 219 cases. There were 8 deaths and the mortality was 2.6%. Injury Severity Score (ISS) and a lethal dose for 50% of the patients (LD_(50)) were used to analyse the correlation between total injury severity and mortality. The clinical characteristics and some problems in diagnosis and treatment of these patients were discussed. The authors stressed that (1) to shorten the time elapsed from admission to the efficient freatment started was the key of decreasing mortality, (2) ISS and LD_(50) were useful tools in retrospective study of the correlation between injury severity and mortality, But further researches were needed.