[Indicators to measure the performance of emergency trauma care]. / Principales indicadores para medir el desempeño de la atención de emergencias traumatológicas.

The objective of this paper was to identify the main indicators used to measure the performance in emergency trauma care. A literature review was carried out in the electronic databases: PubMEd, LILACS and Epistemónikos, including publications between January 2011 and December 31, 2021, in Spanish, English and Portuguese. A total of 962 publications were identified. When reviewing the full text, 48 articles were included. The indicators were classified in the dimensions of process and results. 100 different indicators were identified to analyze the performance of emergency trauma care. 71% were process indicators, including service time and triage. In the results dimension 29 indicators were identified; mortality was the indicator most analyzed as well as length of stay. Six indicators on the disability of injured people and 14 indicators related to satisfaction were identified, the most frequent being complaints. Various indicators have been used to assess the performance of emergency trauma care. In the results dimension, the indicators related to satisfaction and disability after injuries have been little explored. Decision-makers and those responsible for emergency care must promote performance evaluation exercises to learn about their current situation using appropriate and sensitive indicators with the available data.

El objetivo del presente trabajo fue identificar los principales indicadores utilizados para medir el desempeño en la atención de emergencias traumatológicas. Se realizó una revisión de la literatura de tipo narrativa en las bases de datos: PubMed, LILACS y Epistemónikos, se incluyeron publicaciones entre enero de 2011 y el 31 diciembre 2021, en español, inglés y portugués. Se identificaron 962 publicaciones. Tras revisar el texto completo, 48 artículos fueron incluidos. Los indicadores se clasificaron en las dimensiones de proceso y resultado. Se identificaron 100 diferentes indicadores para analizar el desempeño de la atención de emergencias traumatológicas. 71% fueron indicadores de proceso, entre ellos el tiempo de atención y el triaje. En la dimensión de resultados se identificaron 29 indicadores; la mortalidad fue el indicador mayormente analizado así como el periodo de estancia hospitalaria. Se identificaron seis indicadores sobre la discapacidad de las personas lesionadas y 14 indicadores relacionados con la satisfacción, el más frecuente fue quejas. Diversos indicadores han sido utilizados para evaluar el desempeño de la atención de emergencias traumatológicas. En la dimensión de resultados, los indicadores relacionados con la satisfacción y discapacidad han sido poco explorados. Los responsables de la atención de emergencias traumatológicas deben impulsar ejercicios de evaluación del desempeño para conocer su situación actual a través de indicadores sensibles y acordes con los datos disponibles.

Riesgos de accidentes en el hogar: factores asociados y su efecto sobre la ocurrencia de accidentes en grupos vulnerables.

OBJETIVO: Estimar el nivel de exposición a riesgos de ac-cidentes en hogares vulnerables, identificando sus factores asociados y analizar su relación con la ocurrencia de acciden-tes en México. Material y métodos. Estudio transversal que analiza una submuestra de información del Secretariado Técnico del Consejo Nacional para la Prevención de Acci-dentes, recolectada durante 2016-2019. Se utilizó regresión Poisson para estimar factores asociados con el número de riesgos presentes en hogares donde residía población infantil (<5) y adulta mayor (75+) y regresión logística para analizar la ocurrencia de accidentes. RESULTADOS: En hogares con <5 hubo en promedio seis riesgos; 2.9 donde residían 75+. La prevalencia de lesiones accidentales el año previo fue 3.1% (IC95%=2.0,4.6) en <1 año, 7.6% (IC95%=6.9,8.4) en 1-4 años y 17.1% (IC95%=15.6,18.7) en 75+. Las caídas fueron la principal causa. CONCLUSIONES: Existe un elevado número de riesgos en hogares con población vulnerable; es necesario fortalecer las estrategias de prevención, educación y promoción de la salud.

Riesgos de accidentes en el hogar: factores asociados y su efecto sobre la ocurrencia de accidentes en grupos vulnerables / Risks of unintentional injuries at home: associated factors and their relation on the occurrence of injuries in vulnerable populations

Resumen: Objetivo: Estimar el nivel de exposición a riesgos de accidentes en hogares vulnerables, identificando sus factores asociados y analizar su relación con la ocurrencia de accidentes en México. Material y métodos: Estudio transversal que analiza una submuestra de información del Secretariado Técnico del Consejo Nacional para la Prevención de Accidentes, recolectada durante 2016-2019. Se utilizó regresión Poisson para estimar factores asociados con el número de riesgos presentes en hogares donde residía población infantil (<5) y adulta mayor (75+) y regresión logística para analizar la ocurrencia de accidentes. Resultados: En hogares con <5 hubo en promedio seis riesgos; 2.9 donde residían 75+. La prevalencia de lesiones accidentales el año previo fue 3.1% (IC95%=2.0,4.6) en <1 año, 7.6% (IC95%=6.9,8.4) en 1-4 años y 17.1% (IC95%=15.6,18.7) en 75+. Las caídas fueron la principal causa. Conclusiones: Existe un elevado número de riesgos en hogares con población vulnerable; es necesario fortalecer las estrategias de prevención, educación y promoción de la salud.

Abstract: Objective: To estimate level of exposure to different risks of unintentional injuries (UI) at home, identifying factors associated, and to analyze its relation to the occurrence of injuries in Mexican vulnerable populations. Materials and methods: A crossover study design analyzed secondary information from the leading agency for UI prevention (Ministry of Health) collected during 2016-2019. Using Poisson regression, factors associated to the number of risks present at home were analyzed in households with children (<5) and elders (75+); logistic regression analyzed factors associated with the occurrence of UI. Results: Households with <5 had an average of six risks; 2.9 where 75+ lived. Prevalence of UI the previous year was 3.1% (95%CI=2.0,4.6) in <1 year, 7.6% (95%CI=6.9,8.4) in 1-4 years and 17.1% (95%CI=15.6,18.7) in 75+. Falls were the main cause. Conclusions: There is a high number of risks in households with vulnerable populations; it is necessary to strengthen prevention, education and health promotion strategies.

Las asfixias accidentales en México: un problema de salud pública oculto / Unintentional asphyxia in Mexico: a hidden public health problem

OBJETIVO: Caracterizar la epidemiología de las asfixias accidentales en México en el periodo 1999-2017. MÉTODO: Análisis secundario de bases de mortalidad, tres encuestas nacionales de salud e información del programa de inspecciones de seguridad de la Secretaría de Salud, para caracterizar las lesiones fatales y no fatales asociadas a ahogamientos (CIE-10: W65-W74) y otras asfixias (CIE-10: W75-W84), y determinar el grado de exposición a distintos riesgos en el interior de viviendas y guarderías. RESULTADOS: Se registraron 100.834 defunciones, el 44,66% por ahogamientos, y el 77,18% eran de varones. Los ahogamientos afectan a población infantil y adolescente, ocurren con más frecuencia en abril, julio y agosto, los domingos, y en horario vespertino; las otras asfixias afectan a población infantil y adulta mayor, ocurren con más frecuencia de diciembre a febrero, en domingo, de las 4 a las 6 h. Según la ENSANut-2012, 53.065 personas sufren una asfixia no fatal al año, el 26,21% con consecuencias permanentes en su salud. Se observaron riesgos importantes de asfixia en el 38% de las guarderías y el 80% de los hogares analizados. CONCLUSIONES: Las asfixias accidentales son un problema prioritario de salud pública que debe ser atendido urgentemente para cumplir con el objetivo de desarrollo sostenible 3.2. La evidencia presentada en este trabajo es un insumo que permite informar y orientar los esfuerzos al respecto

OBJECTIVE: To characterize the epidemiology of unintentional asphyxias in Mexico from 1999 to 2017. METHOD: Secondary analysis of vital registries, three national health surveys and information from the safety inspection program of the Ministry of Health in Mexico were used to characterize fatal and non-fatal drownings (ICD-10: W65-W74) and other asphyxias including suffocation, chocking and strangulation (ICD-10: W75-W84), and to estimate the level of exposure to different risk factors within households and daycares. RESULTS: 100,834 deaths were registered, 44.66% were drowning and 77.17% male. Drownings mainly affect children and adolescents, occur in April, July and August, on Sundays, during the afternoon. Other asphyxias affect children and the elderly more frequently, occur mainly from December to February, on Sundays and from 4 to 6 h. According to ENSANut-2012, 53,065 individuals experience a non-fatal asphyxia per year, 26.21% of them with permanent consequences in their health and wellbeing. Important risks of unintentional asphyxias are present in 38% of daycares and 80% of households analyzed. CONCLUSIONS: Unintentional asphyxias are a major public health problem that needs to be urgently attended to achieve the Sustainable Development Goals, in particular the 3.2. Evidence presented in this work constitutes an input to inform and orient efforts directed to tackle this problem

Exposure to unsafe mobility: Traveling in the cargo area of pickup trucks in three Mexican cities.

Objective: To estimate the prevalence of pickup trucks transporting people in the cargo area and to identify factors associated to this behavior in three Mexican cities.Methods: Eight rounds of roadside observations of randomly selected pickup trucks were conducted from August 2012 to November 2014 in three Mexican cities: Guadalajara-Zapopan, León and Cuernavaca.Results: Overall, 4.03% of the 4,611 pickup trucks observed were transporting people in the cargo area (95% CI: 3.48 - 4.64%). This implies that a total of 427 passengers were traveling unsafely in the cargo area of pickup trucks; of all them 22.01% were children and 82.20% were male. Prevalence of exposure to this risky behavior was higher in León (5.77%, 95% CI: 4.73 - 6.97%) than in Cuernavaca (3.73%, 95% CI: 2.49 - 5.35%) and Guadalajara-Zapopan (2.70%, 95% CI: 2.05 - 3.48%). According to this data, exposure to this risk factor has decreased in time. Male drivers, not using seatbelt correctly carried passengers in the cargo area more frequently.Conclusions: Results support the importance of improving and enforcing current legislation and evaluating strategies directed to prevent exposure to this risky behavior with the potential of contributing to lowering the high burden that road traffic injuries imposed in Mexican public health.

[Unintentional asphyxia in Mexico: a hidden public health problem]. / Las asfixias accidentales en México: un problema de salud pública oculto.

OBJECTIVE: To characterize the epidemiology of unintentional asphyxias in Mexico from 1999 to 2017. METHOD: Secondary analysis of vital registries, three national health surveys and information from the safety inspection program of the Ministry of Health in Mexico were used to characterize fatal and non-fatal drownings (ICD-10: W65-W74) and other asphyxias including suffocation, chocking and strangulation (ICD-10: W75-W84), and to estimate the level of exposure to different risk factors within households and daycares. RESULTS: 100,834 deaths were registered, 44.66% were drowning and 77.17% male. Drownings mainly affect children and adolescents, occur in April, July and August, on Sundays, during the afternoon. Other asphyxias affect children and the elderly more frequently, occur mainly from December to February, on Sundays and from 4 to 6h. According to ENSANut-2012, 53,065 individuals experience a non-fatal asphyxia per year, 26.21% of them with permanent consequences in their health and wellbeing. Important risks of unintentional asphyxias are present in 38% of daycares and 80% of households analyzed. CONCLUSIONS: Unintentional asphyxias are a major public health problem that needs to be urgently attended to achieve the Sustainable Development Goals, in particular the 3.2. Evidence presented in this work constitutes an input to inform and orient efforts directed to tackle this problem.

[Non-fatal unintentional injuries in Mexican population: prevalence and associated factors. Ensanut 2018-19]. / Accidentes no fatales en población mexicana, prevalencia y factores asociados. Ensanut 2018-19.

OBJECTIVE: To estimate the prevalence of non-fatal uninten-tional injuries in Mexican population and to analyze individual, environmental and household factors associated with its occurrence. MATERIALS AND METHODS: A cross-sectional study, analyzed the prevalence of unintentional injuries from Encuesta Nacional de Salud y Nutrición (Ensanut 2018-19), which is a nationally representative health survey designed with a probability, stratified and cluster sampling, in three stages. Association with variables of interest was explored using logistic regression analysis. RESULTS: Prevalence of non-fatal unintentional injuries was 4.5% (IC95%: 4.2-4.7), equivalent to 5.6 million people per year. Of them, 22.3% or 1.2 million suffered permanent consequences. Probability of having unintentional injuries was higher in the North and Center regions, as in Mexico City-State of Mexico; in males from 0 to 59 and females of 60 or more years of age, in people living with disabilities and those who self-reported depres-sion symptoms. CONCLUSIONS: Strengthening unintentional injury prevention is necessary and urgent, especially within vulnerable groups of population.

OBJETIVO: Estimar la prevalencia de lesiones accidentales no fatales en población mexicana y analizar los factores individuales, ambientales y del hogar asociados con su ocu-rrencia. MATERIAL Y MÉTODOS: Se analizó la prevalencia de lesiones accidentales a partir de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2018-19, diseñada con un muestreo probabilístico, estratificado y por conglomerados, en tres etapas. Se evaluó mediante regresión logística su asociación con distintas variables independientes. RESULTADOS: La pre-valencia de lesiones accidentales fue de 4.5% (IC95%: 4.2-4.7), equivalente a 5.6 millones de personas. De ellas, 22.3% o 1.2 millones sufrieron consecuencias permanentes en su estado de salud. La posibilidad de tener una lesión accidental fue mayor en región Norte, Centro y Ciudad de México-Estado de México, en hombres de 0 a 59 años, mujeres de 60 o más años, en personas con alguna discapacidad y en quienes reportaron sentir depresión. CONCLUSIONES: Es necesario y urgente reforzar la prevención de lesiones accidentales, especialmente en grupos vulnerables.

Accidentes no fatales en población mexicana, prevalencia y factores asociados. Ensanut 2018-19 / Non-fatal unintentional injuries in Mexican population: prevalence and associated factors. Ensanut 2018-19

Resumen Objetivo: Estimar la prevalencia de lesiones accidentales no fatales en población mexicana y analizar los factores individuales, ambientales y del hogar asociados con su ocurrencia. Material y métodos: Se analizó la prevalencia de lesiones accidentales a partir de la Encuesta Nacional de Salud y Nutrición (Ensanut) 2018-19, diseñada con un muestreo probabilístico, estratificado y por conglomerados, en tres etapas. Se evaluó mediante regresión logística su asociación con distintas variables independientes. Resultados: La prevalencia de lesiones accidentales fue de 4.5% (IC95%: 4.2-4.7), equivalente a 5.6 millones de personas. De ellas, 22.3% o 1.2 millones sufrieron consecuencias permanentes en su estado de salud. La posibilidad de tener una lesión accidental fue mayor en región Norte, Centro y Ciudad de México-Estado de México, en hombres de 0 a 59 años, mujeres de 60 o más años, en personas con alguna discapacidad y en quienes reportaron sentir depresión. Conclusión: Es necesario y urgente reforzar la prevención de lesiones accidentales, especialmente en grupos vulnerables.

Abstract Objective: To estimate the prevalence of non-fatal unintentional injuries in Mexican population and to analyze individual, environmental and household factors associated with its occurrence. Materials and methods: A cross-sectional study, analyzed the prevalence of unintentional injuries from Encuesta Nacional de Salud y Nutrición (Ensanut 2018-19), which is a nationally representative health survey designed with a probability, stratified and cluster sampling, in three stages. Association with variables of interest was explored using logistic regression analysis. Results: Prevalence of non-fatal unintentional injuries was 4.5% (IC95%: 4.2-4.7), equivalent to 5.6 million people per year. Of them, 22.3% or 1.2 million suffered permanent consequences. Probability of having unintentional injuries was higher in the North and Center regions, as in Mexico City-State of Mexico; in males from 0 to 59 and females of 60 or more years of age, in people living with disabilities and those who self-reported depression symptoms. Conclusions: Strengthening unintentional injury prevention is necessary and urgent, especially within vulnerable groups of population.

[The Emergency Medical System's response and its association with different outcomes in traffic accident victims in Mexican cities]. / La respuesta del Sistema Médico de Emergencias y su relación con distintos resultados en salud en personas lesionadas por el tránsito de dos ciudades mexicanas.

The aim of this article was to analyze the timeliness of emergency medical care (time transpired between the injury and the first contact with the Emergency Medical System) and its assocation with different negative health outcome in traffic accident victims treated at two Mexican hospitals, one in Guadalajara, Jalisco, and the other in León, Guanajuato, based on data from the Motor Vehicle Accident Epidemiological Surveillance System of the Bloomberg Philanthropies' Global Road Safety Program. Information was obtained on all patients treated for motor vehicle injuries in referral hospitals from May 2012 to November 2014. Multinomial logistic regression was used to model the health outcomes, categorized as short stay, prolonged hospitalization, disability, and death, compared to timeliness of care, adjusted by different target variables. A total of 2,575 patients were analyzed. Time from injury to care was 103.74 minutes (± 231.36) in León and 75.37 minutes (± 156.87) in Guadalajara; it was 38.02 and 36.23 minutes, respectively, in patients that received prehospital medical care. Timely care was associated with less prolonged hospital stay, but not with lower incidence of disability or death. Receiving prehospital medical care was associated statistically with negative health consequences. Timely care was associated with lower probability of prolonged hospitalization. Strategies are needed to evaluate and in turn improve the technical quality of prehospital medical care, including timeliness of care and adequate regulation.

El objetivo fue analizar la oportunidad de la atención médica de emergencias (tiempo transcurrido desde que ocurrió la lesión hasta el primer contacto con el Sistema Médico de Emergencias -SME) y su relación con distintas consecuencias negativas en salud, en pacientes con lesiones causadas por el tránsito, atendidos en dos hospitales de México, uno en Guadalajara, Jalisco y otro en León, Guanajuato. Se utilizó información del Sistema de Vigilancia Epidemiológica de las Lesiones Causadas por el Tránsito, establecido como parte del Programa Global de Seguridad Vial de la Filantropía de Bloomberg. Se recabó información de todos los pacientes atendidos por lesiones causadas por el tránsito en dos hospitales de referencia, de mayo 2012 a noviembre 2014. Se realizó una regresión logística multinomial para modelar los resultados en salud, categorizados en estancia corta, hospitalización prolongada, discapacidad y defunción, con la oportunidad de la atención, ajustando por distintas variables de interés. 2.575 lesionados fueron analizados. La oportunidad de la atención fue 103,74min (± 231,36) en León y 75,37min (± 156,87) en Guadalajara, siendo 38,02 y 36,23min en quienes recibieron atención médica prehospitalaria, respectivamente. La oportunidad de la atención se asoció con una menor estancia hospitalaria prolongada, pero no con una menor incidencia de discapacidad o muerte. Recibir atención médica prehospitalaria estuvo asociado con consecuencias negativas en salud. Una atención oportuna está asociada a una menor posibilidad de tener hospitalizaciones prolongadas. Es necesario impulsar estrategias para evaluar, y eventualmente mejorar la calidad técnica de la atención médica prehospitalaria, incluyendo la oportunidad de la atención y la adecuada regulación.

O objetivo deste estudo foi analisar a oportunidade da atenção médica de emergências (tempo transcorrido desde que ocorreu a lesão até o primeiro contato com o Sistema Médico de Emergências) e sua relação com distintas consequências negativas para a saúde, em pacientes com lesões causadas pelo trânsito, atendidos em dois hospitais do México, um em Guadalajara, Jalisco e outro em León, Guanajuato. Foi utilizada informação do Sistema de Vigilância Epidemiológica das Lesões Causadas pelo Trânsito, estabelecido como parte do Programa Global de Segurança Rodoviária da Filantropia de Bloomberg. Foram recolhidas informações de todos os pacientes atendidos por lesões causadas pelo trânsito nos hospitais de referência, de maio 2012 a novembro 2014. Foi realizada uma regressão logística multinomial para modelar os resultados na saúde, categorizados como: permanência curta hospitalar, hospitalização prolongada, portadores de deficiência e óbito com oportunidade de atenção, sendo ajustada por diferentes variáveis de interesse. Foram analisados 2.575 lesionados. A chance da atenção foi 103,74min (± 231,36) em León e 75,37min (± 156,87) em Guadalajara, sendo 38.02 e 36.23 min naqueles que receberam atenção médica pré-hospitalar, respectivamente. A chance da atenção foi associada com uma menor permanência hospitalar prolongada, mas não com uma menor incidência de deficiência ou morte. Receber atenção médica pré-hospitalar foi associado com consequências negativas na saúde. Uma atenção oportuna está associada à uma menor possibilidade de sofrer hospitalizações prolongadas. É necessário estimular estratégias para avaliar, e eventualmente melhorar a qualidade técnica da atenção médica pré-hospitalar, incluindo a chance da atenção e uma adequada regulação.

La respuesta del Sistema Médico de Emergencias y su relación con distintos resultados en salud en personas lesionadas por el tránsito de dos ciudades mexicanas / The Emergency Medical System's response and its association with different outcomes in traffic accident victims in Mexican cities / A resposta do Sistema Médico de Emergências e sua relação com distintos resultados na saúde em pessoas lesionadas pelo trânsito de duas cidades mexicanas

Resumen: El objetivo fue analizar la oportunidad de la atención médica de emergencias (tiempo transcurrido desde que ocurrió la lesión hasta el primer contacto con el Sistema Médico de Emergencias -SME) y su relación con distintas consecuencias negativas en salud, en pacientes con lesiones causadas por el tránsito, atendidos en dos hospitales de México, uno en Guadalajara, Jalisco y otro en León, Guanajuato. Se utilizó información del Sistema de Vigilancia Epidemiológica de las Lesiones Causadas por el Tránsito, establecido como parte del Programa Global de Seguridad Vial de la Filantropía de Bloomberg. Se recabó información de todos los pacientes atendidos por lesiones causadas por el tránsito en dos hospitales de referencia, de mayo 2012 a noviembre 2014. Se realizó una regresión logística multinomial para modelar los resultados en salud, categorizados en estancia corta, hospitalización prolongada, discapacidad y defunción, con la oportunidad de la atención, ajustando por distintas variables de interés. 2.575 lesionados fueron analizados. La oportunidad de la atención fue 103,74min (± 231,36) en León y 75,37min (± 156,87) en Guadalajara, siendo 38,02 y 36,23min en quienes recibieron atención médica prehospitalaria, respectivamente. La oportunidad de la atención se asoció con una menor estancia hospitalaria prolongada, pero no con una menor incidencia de discapacidad o muerte. Recibir atención médica prehospitalaria estuvo asociado con consecuencias negativas en salud. Una atención oportuna está asociada a una menor posibilidad de tener hospitalizaciones prolongadas. Es necesario impulsar estrategias para evaluar, y eventualmente mejorar la calidad técnica de la atención médica prehospitalaria, incluyendo la oportunidad de la atención y la adecuada regulación.

Abstract: The aim of this article was to analyze the timeliness of emergency medical care (time transpired between the injury and the first contact with the Emergency Medical System) and its assocation with different negative health outcome in traffic accident victims treated at two Mexican hospitals, one in Guadalajara, Jalisco, and the other in León, Guanajuato, based on data from the Motor Vehicle Accident Epidemiological Surveillance System of the Bloomberg Philanthropies' Global Road Safety Program. Information was obtained on all patients treated for motor vehicle injuries in referral hospitals from May 2012 to November 2014. Multinomial logistic regression was used to model the health outcomes, categorized as short stay, prolonged hospitalization, disability, and death, compared to timeliness of care, adjusted by different target variables. A total of 2,575 patients were analyzed. Time from injury to care was 103.74 minutes (± 231.36) in León and 75.37 minutes (± 156.87) in Guadalajara; it was 38.02 and 36.23 minutes, respectively, in patients that received prehospital medical care. Timely care was associated with less prolonged hospital stay, but not with lower incidence of disability or death. Receiving prehospital medical care was associated statistically with negative health consequences. Timely care was associated with lower probability of prolonged hospitalization. Strategies are needed to evaluate and in turn improve the technical quality of prehospital medical care, including timeliness of care and adequate regulation.

Resumo: O objetivo deste estudo foi analisar a oportunidade da atenção médica de emergências (tempo transcorrido desde que ocorreu a lesão até o primeiro contato com o Sistema Médico de Emergências) e sua relação com distintas consequências negativas para a saúde, em pacientes com lesões causadas pelo trânsito, atendidos em dois hospitais do México, um em Guadalajara, Jalisco e outro em León, Guanajuato. Foi utilizada informação do Sistema de Vigilância Epidemiológica das Lesões Causadas pelo Trânsito, estabelecido como parte do Programa Global de Segurança Rodoviária da Filantropia de Bloomberg. Foram recolhidas informações de todos os pacientes atendidos por lesões causadas pelo trânsito nos hospitais de referência, de maio 2012 a novembro 2014. Foi realizada uma regressão logística multinomial para modelar os resultados na saúde, categorizados como: permanência curta hospitalar, hospitalização prolongada, portadores de deficiência e óbito com oportunidade de atenção, sendo ajustada por diferentes variáveis de interesse. Foram analisados 2.575 lesionados. A chance da atenção foi 103,74min (± 231,36) em León e 75,37min (± 156,87) em Guadalajara, sendo 38.02 e 36.23 min naqueles que receberam atenção médica pré-hospitalar, respectivamente. A chance da atenção foi associada com uma menor permanência hospitalar prolongada, mas não com uma menor incidência de deficiência ou morte. Receber atenção médica pré-hospitalar foi associado com consequências negativas na saúde. Uma atenção oportuna está associada à uma menor possibilidade de sofrer hospitalizações prolongadas. É necessário estimular estratégias para avaliar, e eventualmente melhorar a qualidade técnica da atenção médica pré-hospitalar, incluindo a chance da atenção e uma adequada regulação.

[Analysis of road traffic injuries in Mexican cyclists]. / Análisis de las lesiones causadas por el tránsito sufridas por ciclistas en México.

With the objective of analyzing fatal and non-fatal road traffic injuries in cyclists and to document helmet use in this road user to inform sustainable mobility policies, a descriptive analysis of four secondary official information sources was conducted at the national level: mortality, Ministry of Health's hospital discharges, Unintentional and Violence Registry System (SIS-SS-17-P) and the 2012 National Health and Nutrition Survey (ENSANUT). Only SIS-SS-17-P and ENSANUT document helmet use. Except for ENSANUT information analyzed is of 2014.A total of 190 cyclists died in Mexico during 2014 and 392 were hospitalized; head was the anatomical region most frequently affected (63% and 32%, respectively). Only 0.75% of the 667 cases registered in SIS-17 reported helmet use and 24% suffered head injuries. Of the 165,348 non-fatally injured cyclists from ENSANUT <10% used helmet, 24% had head injuries and more than 16,000 suffered permanent injuries. Whereas cyclist-friendly infrastructure is an effective intervention to prevent injuries in the long term, helmet use could potentially reduce the frequency and severity of head injuries in the short run while bicycle use widespread as a means of transportation providing "safety in numbers".

The prevalence of mobile phone use among motorcyclists in three Mexican cities.

OBJECTIVE: To quantify the prevalence of mobile phone use among motorcyclists in 3 Mexican cities and to identify associated factors. METHODS: Two rounds of roadside observations were conducted in Guadalajara-Zapopan, León, and Cuernavaca from December 2011 to May 2012. Observation sites were selected randomly and all motorcyclists circulating at those sites were recorded. Motorcyclists observed talking into a phone (either handheld or hands-free) or texting were recorded as using a mobile phone while driving. RESULTS: A total of 4244 motorcyclists were observed. The overall prevalence of mobile phone use was 0.64 percent (95% confidence interval [CI]: 0.42-0.92); it was highest in Guadalajara-Zapopan (1.03%; 95% CI: 0.61-1.63) and among motorcyclists not using a helmet (1.45% versus 0.4%; P = .000) and those riding on 1-lane roads (1.6% versus 0.8% on 2-lane roads and 0.5% in 3- to 5-lane roads; P = .046). CONCLUSIONS: To our knowledge this is the first study that reports the prevalence of mobile phone use while driving among motorcyclists. The observed prevalence is higher than the prevalence stated in a previous report from China on electric bicycle riders. This risk factor should be monitored in the future given the growing popularity of motorcycles and the availability of mobile devices. Current legislation should be enforced to avoid potential injuries and deaths attributable to this risk factor.

Distracted driving: mobile phone use while driving in three Mexican cities.

Mexico has a significant road traffic injury and mortality burden, and several states/municipalities have begun passing legislation restricting mobile phone use while driving (MPUWD). Little information is available about the prevalence of MPUWD in Mexico. This study measures the prevalence of mobile phone talking and texting among drivers in three cities, and identifies associated demographic and environmental factors. Two rounds of roadside observations from a group of randomly selected automobile drivers were conducted during 2011-2012 in Guadalajara-Zapopan, León and Cuernavaca. The overall prevalence of MPUWD was 10.78%; it was highest in Guadalajara-Zapopan (13.93%, 95% CI 12.87 to 15.05), lowest in Cuernavaca (7.42%, 95% CI 6.29 to 8.67), and remained stable over two rounds of observations, except for León, where the prevalence increased from 5.27% to 10.37% (p=0.000). Driving alone on major roads in non-taxi cars during the weekdays was associated with MPUWD. Results highlight the importance of studying the risk of mobile phone use, and designing and evaluating specific preventive interventions to address this problem in Mexico.