Road traffic accident clinical pattern and management outcomes at JUMC Emergency Department; Ethiopia

Background: Road Traffic Accident is an incident on a way or street open to public traffic. It becomes one of the most significant public health problems in the world especially in developing countries. In Ethiopia, it represents a significant risk for morbidity and mortality. It is also the major public health problem even though studies done on this topic in the study area is limited. Objective: To assess clinical pattern, associated factors and management outcomes among road traffic accident Victims attending emergency department of Jimma University Medical Center. Methods: Hospital based cross sectional study design was employed to review patients' chart visited the hospital from March to April 2021. A systematic random sampling technique was applied. The data were collected using pretested checklist and analyzed using SPSS version 26. Descriptive statistics and multivariate logistic regression were computed. Variables with P<0.05 were considered statistically significant. Results: About 49.6%) were pedestrians injured of which motorcycle accounted 42.9%. More than half of victims never got any type of prehospital care. On arrival, 38.7% were classified as Red of which 71.4% of them were managed surgically. About 84.9% of victims were discharged with improvement whereas12.6% were died. Victims with head injury (AOR= 16.61: 95% CI; 3.85, 71.71), time elapsed to reach nearby health facility (AOR= 3.30; 95 CI (1.13, 9.60), condition of patient at Emergency Department (AOR= 7.78; 95% CI: 2.33, 26.06), GCS at admission (AOR= 20.12; 95% CI: 7.23, 55.96) and days spent in hospital (AOR= 6.85; 95% CI 5.81, 8.06) were independent predictors of unfavorable outcome. Conclusion: Road Traffic Accident represents a significant risk for morbidity and mortality in Ethiopia, of which head injury and multiple sites injury increase injury severity. Targeted approaches to improving care of the injured victims may improve outcomes. Thus, the clinician should take into consideration the clinical presentation and give due attention to the identified contributing factors in its management.

Factors related to motorcycle accidents with victims: an epidemiological survey / Fatores relacionados com os acidentes de motocicleta: estudo epidemiológico

OBJECTIVE: To evaluate the factors associated with traffic motorcycles accidents. METHODS: The sample consisted of 285 motorcycle accident victims in São Paulo. Data were collected from 24-hour emergency service shifts regarding: conditions of the victims, security equipment, road and vehicle conditions. RESULTS: Victims were mostly young men (92%); 23% used the motorcycle for work (average: 8 hours per day); 45% had owned a motorcycle for less than two years; 77% were licensed motorcycle drivers; 33% had less than four years of qualification; 31% had attended a course of defensive driving. Severe lesions were identified in 67% of the unlicensed drivers. Polytrauma occurred in 9% head trauma in 5% of the entire population. Lower limb fractures occurred more frequently than upper limb (17% vs. 12%). Most wore helmets (90%) but only 18% wore helmet, boots and jacket. Positive readings for alcohol (7%) and drugs (14%) occurred in 21% of victims. Most accidents occurred as a consequence of imprudence (88%), during the day (67%), in dry weather conditions (94%). A side impact was registered in 48% of cases; 80% of motorcycles had an engine capacity up to 250 cc. In 51% of the accidents the person responsible for the accident was the driver of the other vehicle in the accident. CONCLUSION: Most accidents involve motorcyclists who are young male adults, use the motorcycle as a means of transport and do not consider safety, defensive driving and the use of alcohol and drugs as important factors.

OBJETIVOS: Avaliar fatores associados com acidentes de trânsito com motocicletas. MÉTODOS: Foram avaliadas 285 vítimas de acidente de motocicleta em São Paulo. Os dados foram coletados em plantões nas unidades de emergência. Foram coletadas informações sobre: condições das vítimas, uso de equipamentos de segurança, condições de estrada e veículo. RESULTADOS: As vítimas eram principalmente homens jovens (92%); 23% usavam a motocicleta para o trabalho (média: 8 horas por dia); 45% possuíam a motocicleta por menos de dois anos; 77% tinham habilitação para dirigir; 33% tinham menos de quatro anos de habilitação; 31% tinham feito curso de direção defensiva. Lesões graves foram identificadas em 67% dos motoristas não habilitados. Houve politraumatismo em 9% das vítimas e traumatismo craniano em 5% da população avaliada. Fraturas de membros inferiores ocorreram mais frequentemente do em membros superiores (17% contra 12%). A maioria usava capacetes (90%), mas apenas 18% usava capacete, botas e jaqueta. Dosagens positivas de álcool (7%) e drogas (14%) foram vistas e totalizaram 21% de todas as vítimas. A maioria dos acidentes ocorreu como consequência de imprudência (88%), durante o dia (67%) e sem chuva (94%). CONCLUSÃO: A maioria dos acidentes envolve vítimas do sexo masculino, adultos, que usam a motocicleta como meio de transporte e não consideram equipamentos de segurança, condução defensiva e o consumo de álcool e drogas fatores importantes para prevenção dos acidentes.

Fatores de exposição, experiência no trânsito e envolvimentos anteriores em acidentes de trânsito entre estudantes universitários de cursos na área da saúde, Ponta Grossa, PR, Brasil / Factors of exposure, experience in the traffic and previous involvements in traffic accidents among college students of health courses, Ponta Grossa, PR, Brazil

Os tipos de vítimas mais freqüentes nos acidentes de trânsito são os jovens, principalmente os do sexo masculino. Essa alta incidência tem sido atribuída aos comportamentos próprios da idade, que poderiam levar os jovens a transgredir leis de trânsito e, conseqüentemente, provocar acidentes. Assim, este estudo teve como objetivo descrever o perfil socioeconômico e demográfico, além de caracterizar a exposição e os antecedentes em acidentes de trânsito, dos estudantes universitários de cursos na área da Saúde da Universidade Estadual de Ponta Grossa (PR), em 2005. Utilizou-se um questionário auto-respondido, de forma anônima, cuja amostra compreendeu 624 acadêmicos. As variáveis estudadas foram: características demográficas e socioeconômicas, fatores de exposição e experiência no trânsito, uso do cinto de segurança e antecedentes em acidentes de trânsito. O perfil dos estudantes caracterizou-se pela maioria do sexo feminino (66,67 por cento), com idade entre 18 e 23 anos, morando com a família e com renda igual ou inferior a 10 salários mínimos. Quanto à idade de aprendizagem de direção, a maior freqüência no sexo masculino foi entre 15 e 17 anos e no sexo feminino, 18 anos ou mais. Encontrou-se número expressivo de relatos de aprendizagem de direção com menos de 14 anos, em ambos os sexos. A associação do uso do cinto com o lugar ocupado no carro (condutor, passageiro do banco dianteiro e passageiro do banco traseiro), segundo o sexo, revelou que a utilização do dispositivo independe do sexo. A associação entre envolvimento em acidentes de trânsito e sexo indicou pré-disposição do sexo masculino.

The most frequent type of victims in traffic accidents is youngsters, mainly of the masculine sex. This high incidence has been attributed to age-related behaviors that could make youngsters transgress traffic laws and, consequently, provoke accidents. Thus, the present study aimed to describe the socioeconomic and demographic profile, besides characterizing the exposure and antecedents in traffic accidents, of college students of Health courses of the State University of Ponta Grossa - PR, in 2005. A questionnaire, answered by the students anonymously, was used, whose sample included 624 academics. The studied variables were: demographic and socioeconomic characteristics, exposure factors and experience in the traffic, use of the seat belt and antecedents in traffic accidents. The students' profile was characterized as follows: the majority is of the female sex (66.67 percent), with ages ranging between 18 and 23 years, living with the family and with income equal to or below 10 minimum wages. In relation to the age they learned how to drive, the largest frequency in the masculine sex was between 15 and 17 years and in the feminine sex, 18 years or above. A significant number of subjects, from both sexes, reported having learned to drive when they were less than 14 years of age. The association between the use of the belt and the place occupied in the car (driver, passenger of the front seat and passenger of the back seat), according to the sex, revealed that the use of the device does not depend on the sex. The association between involvement in traffic accidents and sex indicated a predisposition in the masculine sex.