Investigating the Association between Orthopedic Fractures and Head Injury due to Road Traffic Accidents

Background. Traumatic head injury (THI) due to road traffic accidents (RTAs) is a global health problem. Studies exploring the association between RTA-related THI and concurrent orthopedic fractures are lacking. We aim to provide a detailed analysis of this association and its impact on inhospital outcomes. Methods. Retrospective analysis of RTA-related THI associated with orthopedic fractures admitted to a large tertiary center, Southwest, Saudi Arabia, over ten years. Descriptive statistics for participant demographics and clinical outcomes were represented by percentages. The associations between head injury diagnosis or orthopedic fractures region and patient demographics are analyzed using the Chi-square test. Post hoc analysis for the significant Chi-square values was carried out by calculating the significant adjusted residuals. Adjust p value was obtained by using the Benjamini-Hochberg procedure to control for multiplicity testing. A p value less than 0.05 was considered statistically significant. Results. Concurrent orthopedic fractures are present in one-tenth of RTA-related THI. The cohort was dominated by young males, with 46.5% of the population between 18 and 29 years old. There was a significant association between the head injury diagnosis and the region of orthopedic fracture ( p = 0.028 ). The type of head injury had significant associations with mortality and duration of hospital stay ( p = 0.039 and p = 0.037 , respectively). The region of orthopedic fracture significantly ( p = 0.018 ) affected the duration of hospital stay, with fractures in the clavicle/shoulder region significantly ( p = 0.035 ) having a short course of hospital admission. Conclusion. Orthopedic fractures concomitant with RTA-related THI are common. The associations between the two injuries tend to happen in specific patterns. The inhospital stay duration and mortality significantly correlated with the site of the head or orthopedic injury. Knowledge of these patterns improves the care of THI victims, triaging, and resource allocations.

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OUTCOME OF CEREBRAL CONTUSIONS DUE TO TRAUMATIC BRAIN INJURY

Journal of University Medical & Dental College ◽

10.37723/jumdc.v11i1.263 ◽

2020 ◽

Vol 11 (1) ◽

pp. 39-43

Author(s):

Zubair Ahmed Khan ◽

Habib sultan ◽

Amir Aziz ◽

Shahrukh Rizvi ◽

Tauqeer Ahmed ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Hospital Stay ◽

Traffic Accidents ◽

Road Traffic ◽

Road Traffic Accidents ◽

Male And Female ◽

Duration Of Hospital Stay ◽

History Of ◽

Age Range

ABSTRACT:BACKGROUND & OBJECTIVE: To compare the results of surgically operated vs conservatively treated patients of cerebral contusions due to traumatic brain injury. METHODOLOGY: This comparative study was conducted from January 2012 to December 2014 at the department of Neurosurgery, PGMI Lahore General Hospital, Lahore. A total of 50 patients were included in this study of both gender (male and female) and in the age range of 15-65 years. In our study 20 patients were managed conservatively while other 30 patients were operated for cerebral contusions. The mode of injury in our study was road traﬃc accidents and history of falls. RESULTS: Out of 50 patients, there were 41 (82%) males and 09 (18%) female patients. Their age ranged from 15 - 65 years. In this study the overall mean age is 38.36 years. The maximum numbers of patients were in their third and fourth decades of life. In our study the duration of hospital stay in conservatively managed patients was longer as compared to surgically treated patients who were discharged earlier. Mortality rate in surgically managed patients having a GCS ranged between 09 to 12 was very low contrary to the conservatively managed group, similarly the rate of delayed contusion formation and edema was also low in surgically managed patients as compared to those who were managed conservatively. CONCLUSION: Surgically managed patients of cerebral contusions in traumatic brain injury has better outcome and decreased hospital stay as compared to conservatively managed patients.

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The estimated cost of surgically managed isolated traumatic head injury secondary to road traffic accidents

Neurosurgical FOCUS ◽

10.3171/2018.1.focus17796 ◽

2018 ◽

Vol 44 (5) ◽

pp. E7 ◽

Cited By ~ 5

Author(s):

Xinli You ◽

Boon S. Liew ◽

Azmin K. Rosman ◽

Kamarul Imran Musa ◽

Zamzuri Idris ◽

...

Keyword(s):

Head Injury ◽

Severe Head Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Cost Of Care ◽

Road Traffic Accidents ◽

Traumatic Head Injury ◽

Traumatic Head ◽

The Mean ◽

Mean Cost

OBJECTIVETraumatic brain injury due to road traffic accidents occurs mainly in the younger age group in which injury-related disability leads to long-term impact on employment and economic and social consequences across the lifespan. This study was designed to assign a monetary cost (in Malaysian ringgits [RM]) to the treatment of patients with surgically treated isolated traumatic head injury as determined up to 1 year after injury.METHODSRelevant resource items used were identified and valued using the direct measurement of costs method, cost accounting methods, standard unit costs method, fees, charges and/or market prices method. These values were then tabulated to generate the total costs for each patient, via a combination of macro-costing and micro-costing methods. Malaysian currency values were converted to US dollars according to the average conversion rate for the period from January to May 2016: RM1 = US$0.2452.RESULTSThis costing study analyzed data from 49 patients. The estimated cost for the 1st year of care for all patients was RM1,471,919.80 (US$360,914.735), with a mean (± SD) cost per case of RM30,039.18 ± 22,986.25 or $7365.61 ± $5636.23. The mean cost of care per case was RM11,041.35 ± 10,936.88 or $2707.34 ± $2681.72 for mild head injury, RM32,550.00 ± 20,998.76 or $7981.26 ± $5148.90 for moderate head injury, and RM36,917.86 ± 23,697.34 or $9052.26 ± $5810.59 for severe head injury. Severe head injury (p = 0.001), sustaining 2 or more intracranial pathologies (p = 0.01), having a poor Glasgow Outcome Scale (GOS) score (GOS score 1–3) (p = 0.02), requiring a tracheostomy (p < 0.001), and contracting pneumonia (p < 0.001) were significantly associated with higher cost. Logistic regression analysis revealed that cost of care increased by RM591.60 or $145.06 per year increment of age (β = RM591.60, p = 0.05).CONCLUSIONSThe mean cost of treatment for traumatic head injury is high compared to the per capita income of RM37,900 in 2016. The cost values generated in this study provide baseline cost estimates that the authors hope will be used as a guide to determine where adequate funding should be allocated to provide timely and appropriate delivery of care.

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Clinical characteristics and prognosis of traumatic head injury following road traffic accidents admitted in ICU “analysis of 694 cases”

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-017-0885-4 ◽

2017 ◽

Vol 45 (2) ◽

pp. 245-253 ◽

Cited By ~ 6

Author(s):

Hedi Chelly ◽

Mabrouk Bahloul ◽

Rania Ammar ◽

Ahmed Dhouib ◽

Khaireddine Ben Mahfoudh ◽

...

Keyword(s):

Head Injury ◽

Clinical Characteristics ◽

Traffic Accidents ◽

Road Traffic ◽

Road Traffic Accidents ◽

Traumatic Head Injury ◽

Traumatic Head

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Profile of thoracic injury at College of Medical Sciences Teaching Hospital

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v9i1.9671 ◽

2014 ◽

Vol 9 (1) ◽

pp. 30-39

Author(s):

D Chapagain ◽

D Jayapal Reddy ◽

S Shah ◽

KG Shrestha

Keyword(s):

Prospective Study ◽

Hospital Stay ◽

Traffic Accidents ◽

Road Traffic ◽

Flail Chest ◽

Length Of Hospital Stay ◽

Thoracic Injury ◽

Road Traffic Accidents ◽

Medical Sciences ◽

Night Time

Objectives: Thoracic injury is a challenge to the thoracic surgeon practicing in developing countries. This prospective study was conducted to see the mode of injury, injury types and overall outcome of thoracic injury in our settings. Materials and methods: This prospective study was conducted in 100 thoracic injury patients between December 2011 to June 2012. The demographic features, type of the trauma, radiological assessment, associated organ injuries, management of the injury, surgical interventions, morbidity, mortality, length of hospital stay were analysed. Results: In this study the ages ranged from 7 to 84 years. There were 73 (73%) males and 27 (27%) females. The majority of patients (83%) were injured during the evening and night time. The majority of patients 92(92%) sustained blunt chest injuries. The mechanism of injury was not significantly associated with length of hospital stay (P > 0.05) and mortality (P > 0.05).Road traffic accident was the most common cause of injuries affecting 68(68%) of patients followed by fall injury of 19(19%). Rib fractures, haemothorax, pneumothorax and lung contusion were the most common type of injuries accounting for 83.0%, 57%,34% and 33% respectively. Associated extra-thoracic injuries were noted in 64.0% of patients. 45(45%) of the cases of haemothorax, pneumotharax and haemopneumothorax were treated by tube thoracotomy. Four patients (04%) had undergone thoracotomy. There were 09(09%) patients of flail chest and treated conservatively. Fourty six patients (46%) were admitted in the ICU. Eleven (11%) patients were treated with ventilator support. Seventeen (17%) patients had complication. The overall length of hospital stay ranged from 0 to 25 days. Conclusion: Road traffic accidents and fall from height are the major public health problems. Preventive measures at reducing road traffic accidents and timely management with closed tube thoracotomy are the main factors to be considered in the thoracic injury. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 30-39 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9671

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Epidemiology of Pediatric Trauma and Its Patterns in Western Iran: A Hospital Based Experience

Global Journal of Health Science ◽

10.5539/gjhs.v8n6p139 ◽

2015 ◽

Vol 8 (6) ◽

pp. 139 ◽

Cited By ~ 9

Author(s):

Fereshteh Jalalvandi ◽

Peyman Arasteh ◽

Roya Safari Faramani ◽

Masoumeh Esmaeilivand

Keyword(s):

Head And Neck ◽

Traffic Accidents ◽

Road Traffic ◽

Pediatric Population ◽

Care Center ◽

Pediatric Trauma ◽

Age Groups ◽

Road Traffic Accidents ◽

Orthopedic Injury ◽

The Hours

BACKGROUND & OBJECTIVE: Trauma is a major cause of mortality in children aged 1 to 14 years old and its patterns differs from country to country. In this study we investigated the epidemiology and distribution of non-intentional trauma in the pediatric population.MATERIALS & METHODS: The archives of 304 children below 10 years old who presented to Taleghani trauma care center in Kermanshah, Iran from March to September 2008, were reviewed. Patients’ demographic and injury related information were registered. The participants were categorized into three age groups of 0-2, 3-6 and 7-10 years old and the data was compared among age groups and between both sexes.FINDINGS: The most common cause for trauma was falling from heights (65.5%) and road traffic accidents (16.4%). The most common anatomical sites of injury were the upper limbs followed by the head and neck (36.8% and 31.2%, respectively). Injuries mostly occurred in homes (67.4%). The injuries were mostly related to the orthopedics and the neurosurgery division (84.1% and 13.1%, respectively). Accident rates peaked during the hours of 18-24 (41.3%). Male and female patients did display any difference regarding the variables.Children between the ages of 0-2 years old had the highest rate of injury to the head and neck area (40.3%) (p=0.024). Falls and road traffic accidents displayed increasing rates from the ages of 0-2 to 3-6 and decreasing rates to the ages of 7-10 years old (p=0.013). From the ages of 0-2 to 3-6 years old, street accidents increased and household traumas decreased. After that age household trauma rates increased and street accidents decreased (p=0.005). Children between the ages of 7-10 years old had the highest rate of orthopedic injury (p=0.029).CONCLUSION: Special planning and health policies are needed to prevent road accidents especially in children between the ages of 3-6 years old. Since homes were the place where children between the ages of 0-2 were mostly injured, parents should be educated about the correct safety measures that they need to take regarding their children's environments. The orthopedics department needs to receive the most training and resources for the management of pediatric trauma.

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DEMOGRAPHIC STUDY OF DEATHS DUE TO ROAD TRAFFIC ACCIDENTS, EXAMINED IN DR. S.N. MEDICAL COLLEGE, JODHPUR (RAJ.)

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i8.1364 ◽

2020 ◽

Vol 4 (8) ◽

Author(s):

Kana Ram Patel ◽

Jagdish Jugtawat ◽

Shalender Kumar ◽

P.C. Vyas

Keyword(s):

Head Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Head Injuries ◽

Subdural Hemorrhage ◽

Age Group ◽

Road Traffic Accidents ◽

Female Ratio ◽

Medical College ◽

Male To Female

Accidents are not due to external factors all the time but often they occur due to failure of control of self-conscience and free thoughts. Road Traffic Accidents is still the major cause of death worldwide including India. A retrospective study has been conducted in Dr. S.N. Medical College, Jodhpur (Raj.), in the year 2019 to study the pattern and distribution of Head Injuries of fatal road traffic accidents and to prepare the demographic profile of it. Out of total 901 cases, male to female ratio was 9:1, and commonest age group affected was 21-30 years (39.8%). Among total victims, Hindus were 748 (83%) and rests were Muslims 103 (11.4%) and other religions. Head injury was the most common injury, present alone in 509 cases (56.4%) and in 392 (43.6) cases along with other injuries. Skull fractures were found in 451 (50.5), in which linear/fissure fracture (32.9%) was most common. Most common bone fractured was temporal bone. The commonest variety of intracranial hemorrhage was subdural hemorrhage and craniotomy was done in 29 (3.2%) cases. Keywords: Accidents, Road traffic, Head injury, Fractures.

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Maxillofacial Injuries Related to Road Traffic Accidents: A Five Year Multi Center Analysis

Craniomaxillofacial Trauma & Reconstruction Open ◽

10.1055/s-0039-1694708 ◽

2019 ◽

Vol 3 (1) ◽

pp. s-0039-1694708

Author(s):

Utsav Singh Gurung ◽

Gaurav Singh ◽

Madan Mishra ◽

Shubhamoy Mondal ◽

Amit Gaur

Keyword(s):

Traffic Accidents ◽

Road Traffic ◽

Bone Fractures ◽

Treatment Protocol ◽

Care Program ◽

Epidemiological Data ◽

Road Traffic Accidents ◽

Maxillofacial Injuries ◽

Chi Square ◽

Periodic Evaluation

The purpose of this study was to assess the epidemiological data on maxillofacial injuries related to road traffic accidents from two multispecialty medical centers in India, and then evaluate their incidence and pattern. Data were extracted from the medical records of all road traffic accident victims with maxillofacial injuries who reported to the centers between January 2013 and December 2017. Descriptive statistics and chi-square test were used for statistical analysis; significance was set at p < 0.05. Out of 1,110 patients, highest incidence of injuries was observed in the males of age group 20 to 29 years with mean age of 25.95 years (standard deviation, 9.35 years). Head injury, laceration, and tooth luxation were the most common forms of associated injuries. The use of protective helmets and seatbelts was extremely low which was associated to higher risk of facial bone fractures. Violation of traffic rules was the most common etiology behind these accidents. These findings were statistically significant ( p < 0.05). The ever increasing incidence of maxillofacial injuries related to road traffic accidents suggests the need to deal with them promptly and wisely. Keeping an update on the changing pattern of these injuries by continuous recording and periodic evaluation of epidemiological data is helpful in the primary prevention of trauma by evolving a better trauma care program and effective treatment protocol focused on the target groups. The updated data can guide treating physicians in anticipating and diagnosing maxillofacial injuries.

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