scholarly journals Traumatic subdural haematoma: integrating case-based clinical judgement with guidelines

2020 ◽  
Vol 13 (9) ◽  
pp. e233197
Author(s):  
Aditya Samitinjay ◽  
Satya Revanth Karri ◽  
Praveen Khairkar ◽  
Rakesh Biswas
Keyword(s):  
Traffic Accidents ◽  
Subdural Haematoma ◽  
Road Traffic ◽  
Significant Loss ◽  
Clinical Judgement ◽  
Mortality And Morbidity ◽  
Brain Trauma Foundation ◽  
Severe Tbi ◽  
Causes Of Mortality ◽  
Socioeconomic Burden

Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity with a significant loss of functional capacity and a huge socioeconomic burden. Road traffic accidents are the most common (60%) cause followed by falls and violence in India and worldwide. This case discusses the story of a 23-year-old man with severe TBI–subdural haematoma, who presented in a comatose state. The patient was a purported candidate for emergency decompressive surgery as per Brain Trauma Foundation (BTF) guidelines but was managed conservatively. This case questions the plausibility of the BTF guidelines for severe TBI, particularly in rural hospitals in India and how such cases are often managed with clinical judgement based on the review of literature. The patient recovered well with a perfect 8/8 on Glasgow Outcome Scale Extended Score.

scholarly journals Emergency Management of Traumatic Spinal Cord Injuries

2020 ◽  
Vol 17 (02) ◽  
pp. 057-061
Author(s):  
Mohammed Maan Abdul Azeez ◽  
Luis Rafael Moscote-Salazar ◽  
Gabriel Alcala-Cerra ◽  
Ezequiel García-Ballestas ◽  
Diego Bustos-Salazar ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Traffic Accidents ◽  
Spinal Cord Injuries ◽  
Road Traffic ◽  
Sports Injuries ◽  
Mortality And Morbidity ◽  
Causes Of Mortality ◽  
Magnetic Resonance Imaging Mri ◽  
Almost All ◽  
No Gold Standard

AbstractSpinal cord trauma constitutes one of the main causes of mortality and morbidity in young adults around the world, with an estimated 2 to 3 new cases for every 100,000 population. Road traffic accidents, falls from high heights, sports injuries, and violent actions are common causes of spinal cord injuries. There is no “gold standard” for the diagnosis of spinal cord traumatic injuries; however, the rational use of conventional radiologic test, computed tomography scan, and magnetic resonance imaging (MRI) will allow to identify almost all clinically relevant injuries. MRI is recommended according to surgeon’s criteria, who after evaluating the specific characteristics of the injury will determine its usefulness. Therapeutic strategies need to be directed to maintain airway, breathing and circulation, maintenance of mean arterial pressure prevention of hypotension, and assessment of other associated injuries. Intensive treatment must be focused on the prevention and management of ventilatory and cardiovascular abnormalities related to muscle weakness and loss of autonomic innervation.

scholarly journals Epidemiology of Fatal Injuries reported in the mortuary of a tertiary care hospital

2019 ◽  
Vol 6 (2) ◽  
pp. 633
Author(s):  
Subrat Kumar Pradhan ◽  
Himansu Prasad Acharya ◽  
Rudra Prasanna Mishra ◽  
Jay Kumar Panda ◽  
Durga Madhab Satapathy ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Adult Population ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Care Hospital ◽  
Age Group ◽  
Microsoft Excel ◽  
Mortality And Morbidity ◽  
Fatal Injuries

Background: Injuries are an increasingly recognized global, preventable public health problem and are an important cause of mortality and morbidity in adult population. The major causes of injury related deaths may be intentional and unintentional. The major unintentional or “accidental” causes are road traffic accidents (RTAs), falls and drowning whereas the leading intentional causes are suicide and homicide. A robust Surveillance System for Injury Mortality is almost non-existent in our country due to which the data for the same is not available and haphazard. Keeping these factors in mind, the following study was under taken to identify the various epidemiological factors related to fatal injury cases.Methods: A record based retrospective study was conducted in the Department of Community Medicine, VSSIMAR, Burla, Odisha. The data were collected from the autopsy reports preserved at the Dept of FM & T, VSSIMSAR. Variables like age, sex, number of injury cause of death, place of death etc. were collected. Data were entered in Microsoft Excel and analysed using proportions and percentages.Results: The age group 25-44 years recorded the maximum number of deaths (37.49%). Males suffered the highest casualty accounting for 61.85% of deaths. Unintentional fatal injuries constituted 63.58% of deaths. The most number of fatal injuries resulting in deaths were RTAs (36.41%).Conclusions: The age group 25-44 years recorded maximum deaths. Males were the major death victims. RTAs constituted maximum of deaths among unintentional fatal injuries. Homicidal injuries constituted maximum of deaths due to intentional fatal injuries.

scholarly journals High Mortality from Major Vascular Trauma in Traffic Accidents: A Population-Based Study

2019 ◽  
Vol 109 (4) ◽  
pp. 328-335
Author(s):  
B. K. Johannesdottir ◽  
U. Johannesdottir ◽  
T. Jonsson ◽  
S. H. Lund ◽  
B. Mogensen ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Injury Severity ◽  
Road Traffic ◽  
Population Based ◽  
Vascular Trauma ◽  
Term Survival ◽  
Mortality And Morbidity ◽  
New Injury Severity Score ◽  
Discharged Patients ◽  
Discharge From Hospital

Background and Aims: Injuries involving major arteries are an important cause of mortality and morbidity, most often from road traffic accidents. Our aim was to study the outcome of major vascular trauma from traffic accidents in an entire population, including patients who die at the scene and those who reach hospital alive. Materials and Methods: This was a retrospective analysis of all patients who sustained major vascular trauma in traffic accidents in Iceland from 2000 to 2011. Patient demographics, mechanism, and location of vascular injury and treatment were registered. Injury scores were calculated and overall survival estimated. Results: There were 62 individuals (mean age 44 years, 79% males) with 95 major vascular traumas, giving an incidence of 1.69/100,000 inhabitants (95% confidence interval: 1.27–2.21). A total of 33 died at the scene and 8 during transportation to hospital but 21 (34%) reached hospital alive. Most patients who succumbed had thoracic major vascular traumas (76%) or abdominal major vascular traumas (23%). Mean new injury severity score for the 21 admitted patients was 44. A total of 18 were operated with vascular repair, 3 with endovascular stent graft insertion. The mean hospital stay for discharged patients was 34 days. Altogether, 15 of the 62 patients (24%) survived to discharge from hospital, with a 5-year survival of 86% for discharged patients. Conclusion: Every other patient with major vascular trauma following traffic accidents died at the scene and a further 13% died during transportation to hospital, most of whom sustained major vascular trauma to the thoracic aorta. However, one-third of the patients reached hospital alive and 71% of them survived to discharge, with excellent long-term survival.

scholarly journals Assessment of road traffic accidents trauma using computed tomography scan in King Khalid Hospital, Najran province, KSA

2021 ◽  
Vol 6 (1) ◽  
pp. 056-063
Author(s):  
Samia A Fathelrahman ◽  
Maryam J Al Haydar ◽  
Fatimah A Alabbad ◽  
Bayan M Alhajri ◽  
Zahraa A Alshhri ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Road Accidents ◽  
Microsoft Excel ◽  
Body Regions ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Causes Of Mortality ◽  
And Gender ◽  
Gender Categories

Road accidents have been considered to be one of the primary causes of mortality and lifelong disability in the early decades of life in different countries, and road traffic injuries (RTI) have been identified as the ninth most common cause of disability adjusted life years (DALYs) lost for all age and gender categories. Multi-Detector Computerized Tomography( MDCT) scanners are widely used because they rapidly produce high-resolution scans of large areas, offering short examination times for multiple body regions under emergency conditions. A retrospective descriptive quantitative hospital based study conducted in 2522 patients their ages ranged (1-80) , aimed to assess RTA trauma in Saudi Population in Najran province (KSA) in King Khalid Hospital, using CT scan . Statistical analysis of the data was performed using the Microsoft Excel. The study found that there were 2295 males (91%) 227 females (9%), were effected by RTA , age group (21-30 years) which signified 1011(40.1%.), were frequently affected, spine and head were more affected and reported (980) (38.9%) , (692) (27.4%) respectively .The conclusion of the study achieved that CT imaging plays a major role in diagnostic workflow in the evaluation of patients with trauma those usually have simultaneous injuries to several anatomic regions or organs, it can decrease the serious time and increase survival.

scholarly journals Incidence, causes and consequences of moderate and severe traumatic brain injury as determined by Abbreviated Injury Score in the Netherlands

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Denise Jochems ◽  
Eveline van Rein ◽  
Menco Niemeijer ◽  
Mark van Heijl ◽  
Michael A. van Es ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
The Netherlands ◽  
Traffic Accidents ◽  
Road Traffic ◽  
The Elderly ◽  
National Database ◽  
Target Prevention ◽  
Severe Tbi ◽  
Polytrauma Patients

AbstractTraumatic brain injury (TBI) is a leading cause of death and disability. Epidemiology seems to be changing. TBIs are increasingly caused by falls amongst elderly, whilst we see less polytrauma due to road traffic accidents (RTA). Data on epidemiology is essential to target prevention strategies. A nationwide retrospective cohort study was conducted. The Dutch National Trauma Database was used to identify all patients over 17 years old who were admitted to a hospital with moderate and severe TBI (AIS ≥ 3) in the Netherlands from January 2015 until December 2017. Subgroup analyses were done for the elderly and polytrauma patients. 12,295 patients were included in this study. The incidence of moderate and severe TBI was 30/100.000 person-years, 13% of whom died. Median age was 65 years and falls were the most common trauma mechanism, followed by RTAs. Amongst elderly, RTAs consisted mostly of bicycle accidents. Mortality rates were higher for elderly (18%) and polytrauma patients (24%). In this national database more elderly patients who most often sustained the injury due to a fall or an RTA were seen. Bicycle accidents were very frequent, suggesting prevention could be an important aspect in order to decrease morbidity and mortality.

Geographical variations in mortality and morbidity from road traffic accidents in England and Wales

2008 ◽  
Vol 14 (3) ◽  
pp. 519-535 ◽  
Author(s):  
A.P. Jones ◽  
R. Haynes ◽  
V. Kennedy ◽  
I.M. Harvey ◽  
T. Jewell ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Road Traffic Accidents ◽  
England And Wales ◽  
Mortality And Morbidity ◽  
Geographical Variations

scholarly journals Study of the Injured Persons and the Injury Pattern in Road Traffic Accident in Sana’a City, Yemen

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Abdulhameed Ali Al-Thaifani ◽  
Nabil Ahmed Al-Rabeei ◽  
Abdulsalam Mohammed Dallak
Keyword(s):  
Public Health ◽  
High Speed ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Public Health Problem ◽  
Road Accident ◽  
Health Concern ◽  
Road Traffic Accidents ◽  
Mortality And Morbidity ◽  
Significant Public Health

Background. Fatal road traffic accidents constitute a significant public health problem. Aim. The aim of the study was to analyze road traffic accidents in Sana’a city, Yemen, during 2013–2015. Methods. The required information and data of accidents were collected, respectively, from police reported road accident statistics, Sana’a city. 11684 cases of road traffic accidents during period 2013–2015 were studied. Results. 840 people were killed and 9760 people were injured in RTAs during 2013–2015 in Sana’a city. The accident rates per 100000 of the population were 234.8 in 2013, 180.3 in 2014, and 92.2 in 2015. Mortality rates per 100000 of the population were 15.17 in 2013, 12.2 in 2014, and 8.9 in 2015. High speed was the single most important factor responsible for accidents, deaths, and injuries accounting for 38.1% of RTAs followed by drivers’ fault accounting for 18.9% of the total RTAs. The most common age group involved was ≥18 years. Males accounted for 83.1% of killed and injured persons. Most frequent victims of road traffic accidents were vehicles motor (48.9%) followed by pedestrians (38.1%). More than half of RTAs occurred on the straight road. Conclusion. RTAs are a major source of public health concern in Sana’a city, Yemen. Preventive measures to reduce the burden of mortality and morbidity due to road accidents should be introduced.

Coma with Glasgow Coma Scale Score 3 at Admission following Acute Head Injury: Experiencing the Complete Recovery Supported through Ayurveda – A Case Report

2019 ◽  
Vol 26 (5) ◽  
pp. 353-360
Author(s):  
Sanjeev Rastogi
Keyword(s):  
Glasgow Coma Scale ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Complete Recovery ◽  
Neurological Deficits ◽  
Mortality And Morbidity ◽  
Coma Scale ◽  
Acute Head Injury ◽  
Gcs Score ◽  
The Brain

Road traffic accidents (RTAs) are a common cause of untimely death, particularly of youth. RTA mortality and morbidity are predominantly associated with trauma to the brain tissue resulting in traumatic brain injury (TBI). The Glasgow Coma Scale (GCS) is commonly employed to predict the prognosis of such cases at the time of hospital admission. A lower GCS score is invariably found to be associated with poor prognosis, often resulting in death or severely com­promised recovery. A 17-year-old male suffering from TBI due to a RTA was treated with Ayurveda after initially been kept under modern neurological care. The whole course of Ayurvedic therapy began 2 weeks after the initial trauma, continued for about 3 months, and resulted in coma reversal with near complete recovery. This case is one among few reports describing a complete recovery despite presence of bad prognostic predictors in TBI. This is the first such case reported where Ayurveda was used as the intervention in case of TBI, resulting in coma reversal and near complete recovery of neurological deficits.

scholarly journals A Comparative Study on Epidemiology, Spectrum and Outcome Analysis of Physical Trauma cases Presenting to Emergency Department of Dhulikhel Hospital, Kathmandu University Hospital and its Outreach Centers in Rural Area

2015 ◽  
Vol 11 (3) ◽  
pp. 241-246 ◽  
Author(s):  
R Shrestha ◽  
SK Shrestha ◽  
SR Kayastha ◽  
N Parajuli ◽  
D Dhoju ◽  
...  
Keyword(s):  
Emergency Department ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Outcome Evaluation ◽  
University Hospital ◽  
Mortality And Morbidity ◽  
Physical Trauma ◽  
Fall From Height ◽  
Set Up ◽  
One Year

Background Physical trauma is one of the major cause of mortality and morbidity among young and active age group and its increasing trend is of main concern. There are only few studies concerning the spectrum of physical trauma in Nepal. Objective This study aims to evaluate the epidemiological spectrum, the extent, severity of the physical trauma and the outcome evaluation of patients with physical trauma over a period of one year in the emergency department of the Kathmandu University Hospital and compare the same parameters with those patients presenting to the various outreach centers of the hospital in the community. Methods Patient treatment files from the emergency department and the reports from various outreach centers were retrieved for a period of one year (May 2011 to April 2012). Epidemiological information, mode, type and anatomic location of injuries were recorded. Outcome evaluation was assessed by number of patients discharged from emergency department of the hospital or the outreach centers after the treatment, patients admitted for inpatient management and referred to other centers for further specialty management. Result In a period of one year, total 2205 (20%) of physical trauma cases presented to the emergency department and 1994 (6.12%) in the outreach centres. Most commonly involved age group in physical trauma both in Hospital set up and in Community set up were the young adults (15 to 49 years). Fall from height was the commonest mode of injury followed by road traffic accidents among the patients coming to the hospital while significant number of trauma patients coming to outreach centers were due to fall from height. In the hospital set up, 1525 (69.2%) of the cases were discharged while 537 (24.4%) needed inpatient management and 85 (3.8%) needed referral to other centers for the specialty management. In case of outreaches, half of the patients were discharged after the primary treatment and almost another half were referred to the hospital, mainly for need of further investigations. Conclusion Fall related injuries and road traffic accidents are the most common mode of trauma in the hospital set up and fall related injuries are the single most important mode of trauma seen in the outreaches. Mostly young adults in their active period of life are involved in physical trauma so appropriate preventive measures through public health approach should be included in comprehensive trauma management for reducing mortality and morbidity rates related to physical trauma. DOI: http://dx.doi.org/10.3126/kumj.v11i3.12513 Kathmandu Univ Med J 2013; 43(3):241-246

scholarly journals Analysis of Road Traffic Accidents in Turkey between 2013 and 2017

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 679 ◽  
Author(s):  
Ali Kemal Erenler ◽  
Burak Gümüş
Keyword(s):  
Developing Countries ◽  
Rural Areas ◽  
Traffic Accident ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Chi Square ◽  
Mortality And Morbidity ◽  
Vehicle Type ◽  
Statistical Institute ◽  
Chi Square Test

Introduction: Road traffic accident (RTAs) is one of the top ten leading causes of death worldwide and its incidence is higher in developing countries. In this study, our aim was to determine the characteristics of RTAs in Turkey and make recommendations to reduce mortality and morbidity related to RTAs. Material and Methods: We obtained our data, which cover the years 2013 to 2017, from the database accessible at the official website of the Turkish Statistical Institute, which permits the use of its data for research purposes. The chi-square test was used for statistical analysis, and the percentage distribution and odds ratios were calculated. Results: In the study period, a total of 697,957 RTAs occurred in Turkey. A total of 1,168,121 individuals have been wounded and 3534 of them have lost their lives. The majority of RTAs occurred on weekends and in summer months. Male individuals are more likely to be exposed to death and injuries related to accidents. When the vehicle type is considered, motorcycle drivers are under more risk for RTAs. RTAs are more likely to occur in rural areas. Conclusion: Male individuals and motorcyclists are under a great risk for RTAs. Strict laws are mandatory in order to reduce morbidity and mortality related to RTAs. Additionally, educational efforts must focus on two-wheelers and tractor drivers, particularly in developing countries.

Sign in / Sign up

Export Citation Format

Share Document