Association of Glasgow Coma Scale with Total Homocysteine Levels in Patients with Hemorrhagic Stroke

2019 ◽  
Vol 75 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Dapeng Dai ◽  
Yong Sun ◽  
Chengzhang Liu ◽  
Houxun Xing ◽  
Binyan Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glasgow Coma Scale ◽  
Hemorrhagic Stroke ◽  
Final Analysis ◽  
Inverse Association ◽  
Severe Damage ◽  
Coma Scale ◽  
Total Homocysteine ◽  
The Mean ◽  
Stratified Analysis

Objectives: We aimed to evaluate the association between Glasgow Coma Scale (GCS) and total homocysteine (tHcy) levels and examine the possible effect modifiers in patients with hemorrhagic stroke. Methods: A total of 1,516 participants with hemorrhagic stroke and having the complete data on baseline GCS and tHcy measurements were included in the final analysis. Results: The mean (SD) of age, tHcy, and GCS levels were 61.5 (11.3) years, 17.0 (10.3) μmol/L, and 13.9 (2.2), respectively. Compared with participants with severe damage (GCS <9), those with mild damage (GCS ≥13) had significantly lower transformed tHcy levels (β = –2.46; 95% CI –4.80 to –0.12). Consistently, a significantly lower transformed tHcy levels were found in participants with mild damage (GCS ≥13; β = –1.37; 95% CI –2.66 to –0.08) compared with those with moderate to severe damage (GCS <13). In the stratified analysis, a stronger inverse association between GCS categories (≥13 vs. <13) and tHcy concentrations was observed in ever smokers (vs. never; p for interaction = 0.045), and in participants with systolic blood pressure (SBP) ≥160 mm Hg (vs. <160 mm Hg; p for interaction = 0.031), or total cholesterol (TC) ≥5.2 mmol/L (vs. <5.2 mmol/L; p for interaction = 0.025). Conclusion: There was an inverse association between GCS level and tHcy concentration among patients with hemorrhagic stroke, especially in ever smokers or in participants with higher SBP or TC levels.

Retroclival Epidural Hematomas

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 404-407 ◽  
Author(s):  
R. Shane Tubbs ◽  
Christoph J. Griessenauer ◽  
Todd Hankinson ◽  
Curtis Rozzelle ◽  
John C. Wellons ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Pediatric Patients ◽  
Motor Vehicle ◽  
Coma Scale ◽  
Presenting Symptoms ◽  
Cord Injury ◽  
The Mean

Abstract BACKGROUND Retroclival epidural hematomas (REDHs) are infrequently reported. To our knowledge, only 19 case reports exist in the literature. OBJECTIVE This study was performed to better elucidate this pathology. METHODS We prospectively collected data for all pediatric patients diagnosed with REDH from July 2006 through June 2009. Data included mechanism of injury, Glasgow Coma Scale score, neurological examination, treatment modality, and outcome. Magnetic resonance imaging was used to measure REDH dimensions. RESULTS Eight children were diagnosed with REDH, and the hematomas were secondary to motor vehicle–related trauma in all cases. The mean age of patients was 12 years (range 4–17 years). The mean REDH height (craniocaudal) was 4.0 cm, and the mean thickness (dorsoventral) was 1.0 cm. At presentation, the mean Glasgow Coma Scale score was 8 (range 3–14), and there was no correlation between hematoma size and presenting symptoms. Two patients died soon after injury, and 2 additional patients had atlanto-occipital dislocation that required surgical intervention. No patient underwent surgical evacuation of the REDH. The mean follow-up was 14 months. At most recent follow-up, 4 patients are neurologically intact, 1 patient has a complete spinal cord injury, and 1 patient has mild bilateral abducens nerve palsy. CONCLUSION To our knowledge, this study of 8 pediatric patients is the largest series of patients with REDH thus far reported. Based on our study, we found that REDH is likely to be underdiagnosed, atlanto-occipital dislocation should be considered in all cases of REDH, and many patients with REDH will have minimal long-term neurological injury.

Abstract 16967: Increased Blood Pressure Variability is Associated With Worse Outcome in Acute Ischemic Stroke

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Adam de Havenon ◽  
Haimei Wang ◽  
Greg Stoddard ◽  
Lee Chung ◽  
Jennifer Majersik
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Blood Pressure Variability ◽  
Harmful Effect ◽  
Final Analysis ◽  
Ordinal Logistic Regression ◽  
Stroke Severity ◽  
The Mean

Background: Increased blood pressure variability (BPV) is detrimental in the weeks to months after ischemic stroke, but it has not been adequately studied in the acute phase. We hypothesized that increased BPV in acute ischemic stroke (AIS) patients would be associated with worse outcome. Methods: We retrospectively reviewed inpatients at our hospital between 2010-2014 with an ICD-9 code of AIS; 213 were confirmed to have AIS by a vascular neurologist. A modified Rankin Score (mRS) after discharge was available in 148/213, at a mean of 86 ± 60 days. In 45/213 the discharge mRS was either 0 or 6, in which case they were included in the final analysis. BPV was measured as the standard deviation (SD) of each patient’s systolic blood pressure readings during the first 24 hours and 5 days of hospitalization (9,844 total readings), or until discharge if discharged in <5 days (Figure 1). The SBP SD was further divided in quartiles. A multivariate ordinal logistic regression with the outcome of mRS, the primary predictor of quartiles of SBP SD, and baseline NIH stroke scale (NIHSS) to control for initial stroke severity. Results: Mean±SD age was 64.2 ± 16.3 years, NIHSS was 12.6 ± 7.9, and mRS was 2.7 ± 2.1. The mean SBP SDs for the first 24 hours and 5 days were 12.1 ± 6.2 mm Hg and 14.1 ± 4.9 mm Hg. In the ordinal logistic regression model, the quartiles of SBP SD for the first 24 hours and 5 days were positively associated with higher mRS (OR = 1.37, 95% CI 1.01 - 1.74, p = 0.009; OR = 1.30, 95% CI 1.03 - 1.63, p = 0.028). This effect became even more pronounced in patients with the highest quartile of variability (OR = 2.76, 95% CI 1.29 - 5.88, p = 0.009; OR = 2.10, 95% CI 1.01 - 4.36, p = 0.046). Conclusion: In our cohort of 193 patients with AIS, there was a significant association between increased systolic BPV and worse functional outcome, after controlling for initial stroke severity. This data suggests that increased BPV may have a harmful effect for AIS patients, which warrants a prospective observational study.

scholarly journals Evaluation of care for traffic accidents victims made by on duty emergency physicians and surgeons in the emergency room

2016 ◽  
Vol 43 (6) ◽  
pp. 458-465 ◽  
Author(s):  
VLAUDIMIR DIAS MARQUES ◽  
MAURICIO MEDEIROS LEMOS ◽  
CESAR ORLANDO PERALTA BANDEIRA ◽  
AMÉLIA CRISTINA SEIDEL ◽  
SANDRA MARIA PELOSO ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glasgow Coma Scale ◽  
Emergency Room ◽  
Hospital Stay ◽  
Traffic Accidents ◽  
Length Of Hospital Stay ◽  
Emergency Physicians ◽  
Surgical Specialty ◽  
Coma Scale ◽  
Minor Injuries

ABSTRACT Objective: to evaluate the care for victims of traffic accidents by on call emergency physicians and/or surgeons in the emergency room. Methods: we conducted a retrospective, descriptive and exploratory study on the care for traffic accidents victims in the urban area of Maringá-PR, between July 2013 and July 2014 in reference hospitals. We assessed demographics and vocational training through a questionnaire sent to the attending physicians. Results: of the 688 records evaluated, 99% of patients had a prehospital Revised Trauma Score of 12. Statistical analysis showed that in the cases conducted by the emergency physicians (n=187), the recording of the Glasgow Coma Scale and the performance of surgical procedures were less common, whereas the recording of blood pressure values was performed in greater numbers when compared with cases led by surgeons (n=501). There was a statistically significant relationship (p<0.01) between the length of hospital stay and surgical specialty, with a greater chance (crude OR=28) in the period from one to six hours for the group treated by emergency doctors. Most physicians participating in the study were young, with emergency room time of up to one to two years, and with ATLS training. Among those who had attended the ATLS course, 60% did so in the last four years. Surgeons performed 73% of hospital treatments. Conclusion: in the care of traffic victims with minor injuries, the Glasgow Coma Scale, the blood pressure levels, the type of treatment in the emergency room and hospital stay had different approaches between emergency physicians and surgeons.

Abstract TMP97: Autonomic Nervous System Dysfunction Correlates With Increased Blood Pressure Variability After Acute Ischemic, But Not Hemorrhagic, Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Melissa Cortez ◽  
Cecilia Peterson ◽  
Fa Tuuhetaufa ◽  
Nils Petersen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Blood Pressure Variability ◽  
Hemorrhagic Stroke ◽  
Light Stimulus ◽  
Pupillary Response ◽  
Autonomic Nervous System Dysfunction ◽  
Autonomic Nervous ◽  
The Mean

Background: Elevated blood pressure variability (BPV) in the days after acute stroke onset is associated with worse outcome. However, the mechanism of increased BPV remains unknown, but may be due to dysfunction of the autonomic nervous system, which can be measured by pupil response to a light stimulus. Methods: This is a retrospective study of 109 patients in a neurocritical care unit: 45 with acute ischemic stroke (AIS), 44 with intracerebral hemorrhage (ICH), and 20 with subarachnoid hemorrhage (SAH). The primary outcome is BPV, measured as standard deviation of SBP (SD), using all blood pressures from admission to 72 hours later. The primary predictors are pupillary light reflexes (PLR) from the same period, measured with a bedside pupilometer, the NPi-200. We used linear regression to evaluate the association between PLRs and BPV, and adjusted for patient age and gender. Results: The mean (SD) age was 60.7 (16.4) and 58.7% were male. The mean (SD) number of blood pressure and PLR measurements were 30.0 (9.0) and 10.4 (7.3). We found that parasympathetically mediated PLR measures were associated with BPV in AIS patients (Table 1), but no consistent pattern emerged in ICH or SAH patients (all p>0.05). The relationships between BPV and PLR for AIS patients were linear in nature (Figure 1), and were consistent with parasympathetic hypofunction in patients with the greatest BPV. Conclusions: Elevated BPV is associated with parasympathetic hypofunction, as measured by pupillary response to light, after acute ischemic, but not hemorrhagic, stroke. Further research is needed to better understand this relationship as it may represent a therapeutic target for BPV reduction.

scholarly journals Derivation and validation of an easy-to-compute trauma score that improves prognostication of mortality or the Trauma Rating Index in Age, Glasgow Coma Scale, Respiratory rate and Systolic blood pressure (TRIAGES) score

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Atsushi Shiraishi ◽  
Yasuhiro Otomo ◽  
Shunsuke Yoshikawa ◽  
Koji Morishita ◽  
Ian Roberts ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Glasgow Coma Scale ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Validation Cohort ◽  
Hospital Death ◽  
The Novel ◽  
Coma Scale ◽  
Physiological Variables ◽  
Trauma Score

Abstract Background Multiple trauma scores have been developed and validated, including the Revised Trauma Score (RTS) and the Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP) score. However, these scores are complex to calculate or have low prognostic abilities for trauma mortality. Therefore, we aimed to develop and validate a trauma score that is easier to calculate and more accurate than the RTS and the MGAP score. Methods The study was a retrospective prognostic study. Data from patients registered in the Japan Trauma Databank (JTDB) were dichotomized into derivation and validation cohorts. Patients’ data from the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage-2 (CRASH-2) trial were assigned to another validation cohort. We obtained age and physiological variables at baseline, created ordinal variables from continuous variables, and defined integer weighting coefficients. Score performance to predict all-cause in-hospital death was assessed using the area under the curve in receiver operating characteristics (AUROC) analyses. Results Based on the JTDB derivation cohort (n = 99,867 with 12.5% mortality), the novel score ranged from 0 to 14 points, including 0–2 points for age, 0–6 points for the Glasgow Coma Scale, 0–4 points for systolic blood pressure, and 0–2 points for respiratory rate. The AUROC of the novel score was 0.932 for the JTDB validation cohort (n = 76,762 with 10.1% mortality) and 0.814 for the CRASH-2 cohort (n = 19,740 with 14.6% mortality), which was superior to RTS (0.907 and 0.808, respectively) and MGAP score (0.918 and 0.774, respectively) results. Conclusions We report an easy-to-use trauma score with better prognostication ability for in-hospital mortality compared to the RTS and MGAP score. Further studies to test clinical applicability of the novel score are warranted.

Blast Injury in a Civilian Trauma Setting is Associated with a Delay in Diagnosis of Traumatic Brain Injury

2008 ◽  
Vol 74 (3) ◽  
pp. 267-270 ◽  
Author(s):  
Grant V. Bochicchio ◽  
Kimberly Lumpkins ◽  
James O'Connor ◽  
Marc Simard ◽  
Stacey Schaub ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Injury Severity ◽  
Disease Process ◽  
Blast Injury ◽  
Coma Scale ◽  
The Mean

High-pressure waves (blast) account for the majority of combat injuries and are becoming increasingly common in terrorist attacks. To our knowledge, there are no data evaluating the epidemiology of blast injury in a domestic nonterrorist setting. Data were analyzed retrospectively on patients admitted with any type of blast injury over a 10-year period at a busy urban trauma center. Injuries were classified by etiology of explosion and anatomical location. Eighty-nine cases of blast injury were identified in 57,392 patients (0.2%) treated over the study period. The majority of patients were male (78%) with a mean age of 40 ± 17 years. The mean Injury Severity Score was 13 ± 11 with an admission Trauma and Injury Severity Score of 0.9 ± 0.2 and Revised Trauma Score of 7.5 ± 0.8. The mean intensive care unit and hospital length of stay was 2 ± 7 days and 4.6 ± 10 days, respectively, with an overall mortality rate of 4.5 per cent. Private dwelling explosion [n = 31 (35%)] was the most common etiology followed by industrial pressure blast [n = 20 (22%)], industrial gas explosion [n = 16 (18%)], military training-related explosion [n = 15 (17%)], home explosive device [n = 8 (9%)], and fireworks explosion [n = 1 (1%)]. Maxillofacial injuries were the most common injury (n = 78) followed by upper extremity orthopedic (n = 29), head injury (n = 32), abdominal (n = 30), lower extremity orthopedic (n = 29), and thoracic (n = 19). The majority of patients with head injury [28 of 32 (88%)] presented with a Glasgow Coma Scale score of 15. CT scans on admission were initially positive for brain injury in 14 of 28 patients (50%). Seven patients (25%) who did not have a CT scan on admission had a CT performed later in their hospital course as a result of mental status change and were positive for traumatic brain injury (TBI). Three patients (11%) had a negative admission CT with a subsequently positive CT for TBI over the next 48 hours. The remaining four patients (14%) were diagnosed with skull fractures. All patients (n = 4) with an admission Glasgow Coma Scale score of less than 8 died from diffuse axonal injury. Blast injury is a complicated disease process, which may evolve over time, particularly with TBI. The missed injury rate for TBI in patients with a Glasgow Coma Scale score of 15 was 36 per cent. More studies are needed in the area of blast injury to better understand this disease process.

Physical training and heart rate and blood pressure variability: a 5-yr randomized trial

2004 ◽  
Vol 286 (5) ◽  
pp. H1821-H1826 ◽  
Author(s):  
Arja L. T. Uusitalo ◽  
Tomi Laitinen ◽  
Sari B. Väisänen ◽  
Esko Länsimies ◽  
Rainer Rauramaa
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Consumption ◽  
Blood Pressure Variability ◽  
Maximal Oxygen Consumption ◽  
Final Analysis ◽  
Peak Performance ◽  
Autonomic Modulation ◽  
The Mean ◽  
Time Point

We studied the effect of regular physical activity on cardiac and vascular autonomic modulation during a 5-yr controlled randomized training intervention in a representative sample of older Finnish men. Heart rate variability (HRV) and blood pressure variability (BPV) are markers of cardiac and vascular health, reflecting cardiac and vascular autonomic modulation. One hundred and forty randomly selected 53- to 63-yr-old men were randomized into two identical groups: an intervention (EX) group and a reference (CO) group, of which 89 men remained until the final analysis (EX: n = 47; CO: n = 42). The EX group trained for 30–60 min three to five times a week with an intensity of 40–60% of maximal oxygen consumption. The mean weekly energy expenditure of the training program for the 5-yr training period was 3.80 MJ, and 71% of the EX group exceeded the mean. The EX group had a significantly ( P < 0.01) higher oxygen consumption at ventilatory aerobic threshold (V̇o2VT) than the CO group at the 5-yr time point. V̇o2VT had a tendency to increase in the EX group and decrease in the CO group (interaction P < 0.001) from the baseline to the 5-yr time point. Peak performance did not change. Low-frequency power of R-R interval variability decreased in the EX group ( P < 0.01, by 6%) from the baseline to the 5-yr time point. BPV did not change. In conclusion, low-intensity regular exercise training did not prevent HRV from decreasing or change BPV in 5 yr in older Finnish men.

scholarly journals A STUDY ON CLINICO- RADIOLOGICAL PRESENTATION OF STROKE AND ITS ASSOCIATION WITH OUTCOME

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Dr. Arindam Nag ◽  
Dr. Sourav Nag ◽  
Dr Suraj Mondal ◽  
Dr Yashpal Yadav
Keyword(s):  
Computed Tomography ◽  
Blood Pressure ◽  
Ischemic Stroke ◽  
Glasgow Coma Scale ◽  
Ct Scan ◽  
Cerebrovascular Accident ◽  
Diastolic Pressure ◽  
Modified Rankin Scale ◽  
Study Population ◽  
The Mean

BACKGROUND:  Cerebrovascular diseases include some of the most common and devastating disorders: ischemic stroke, hemorrhagic stroke, and cerebrovascular anomalies such as intracranial aneurysms and arteriovenous malformations. A stroke, or cerebrovascular accident, is defined by this abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. Thus, the definition of stroke is clinical, and laboratory studies including brain imaging are used to support the diagnosis. AIMS:  1.To correlate clincoradiological findings in terms of prognosis, 2. To know different types of stroke along with its area of involvement and vascular distribution and its relation with outcome, 3. Role of CT SCAN brain as an early diagnostic modality to say clinical outcome. METHODS: This descriptive epidemiological study with a cross sectional study design is to be conducted in the department of medicine (indoor), R.G.KAR Medical College and Hospital. 1st June 2017 to 31st may 2018. 100 cases to be selected during study period based on following criteria. Detailed clinical history, clinical examinations with Radiological imaging like computed tomography of brain is done. We use scoring system like Intracerebral haemorrhage score, Glasgow coma scale, Modified rankin scale. Based on clinical examination proforma all the study population had been examined including recording of blood pressure and Glasgow coma score at the time of admission. Analysed by Modified Rankin scale till the 5th day post-hospital admission after stroke. RESULT: Among the total 100 study population 59 cases were of Infarction and 41 cases were of Haemorrhagic type of stroke. Within the 59 Cases of Infarction 39 (i.e. 66%) were male cases and 20 (i.e 34%) were female cases. Within the 41 cases of Haemorrhage 29 (i.e. 71%) were male and 12 (i.e. 29%) were female.  The mean age of the study population of Infarction cases was 55.55 years ±12.84 SD. The mean age of the study population of Haemorrhage cases was 57.48years±13.46SD. Infraction cases show increased mortality among the group having systolic blood & diastolic pressure ≥ 180 mm of Hg, ≥ 110 mm of Hg respectively. Hemorrhagic cases show increased mortality among the group having systolic blood pressure, diastolic pressure ≥ 180 mm of Hg, ≥ 110 mm of Hg respectively. CONCLUSION: Incidence of haemorrhage is much higher in India (41% as per our study). The study population between 51- 60 years is most predominant age group in both the types of stroke. Most of the infarction cases presents with unconsciousness followed by slurring of speech.  Most common presenting symptoms of Haemorrhagic stroke are unconsciousness, present at about 56% of cases. The most prominent risk factor in our study population is undetected and/or uncontrolled hypertension.  Study population with SBP ≥180 and/or DBP ≥110 mm of Hg group have increased rate of mortality from stroke. The major type of ischemic stroke in our study population is partial anterior circulation stroke (PACI) 47.4%. Most of the study population having  Infarction has developed severe disability at the end of 5 days of observation, comprising of 40.5% of the total observation. Keywords:  CVA (cerebrovascular accident), CT Scan (computed tomography), MRI (Magnetic resonance imaging), GCS Scale (Glasgow coma scale)

scholarly journals Prevalência e fatores associados aos acidentes por motocicleta segundo zona de ocorrência

2020 ◽  
Vol 19 (3) ◽  
pp. 93-134
Author(s):  
Isa Gabriela Oliveira Ramos Cavalcanti ◽  
Flávia Emília Cavalcante Valença Fernandes ◽  
Rachel Mola
Keyword(s):  
Glasgow Coma Scale ◽  
Urban Area ◽  
Rural Areas ◽  
Traffic Accidents ◽  
Prehospital Care ◽  
Night Shift ◽  
Bivariate Analysis ◽  
Coma Scale ◽  
Significant Difference ◽  
The Mean

Investigación descriptiva, analítica y documental que analiza la prevalencia y los factores asociados a los accidentes de motocicleta según el área de ocurrencia. Los datos provienen de registros de atención prehospitalaria. Se realizaron estadísticas descriptivas e inferenciales, y los factores asociados se analizaron mediante regresión logística binaria, adoptando una significación del 5% y 95% de confianza. La muestra totalizó 1.039 víctimas. La mayoría de los registros ocurrieron en el área urbana, que involucraban al hombre, donde la víctima era el conductor del vehículo, no había ingerido alcohol y usado el casco. La mayoría de las asistencias fueron realizadas por el Servicio de Asistencia Móvil de Emergencia, al final de la semana y en el turno de noche. La puntuación media de la escala de coma de Glasgow para el área urbana fue ligeramente superior a la rural, con una diferencia significativa. El tiempo medio entre la solicitud de atención y la llegada al lugar del suceso, así como entre la solicitud de atención y el ingreso hospitalario fueron significativos, prevaleciendo en las zonas rurales. En el análisis bivariado de la asociación de accidentes de tráfico en motocicleta con la zona de ocurrencia, las variables que mostraron una asociación significativa fueron: la escala de coma de Glasgow, el tiempo entre la solicitud y la llegada del servicio, el tiempo entre la solicitud del servicio y la admisión hospital, sexo, consumo de alcohol, uso de casco, otra parte involucrada, período de ocurrencia, giro del accidente, tipo de atención y tipo de alta de la víctima. Descriptive, analytical and documentary research that analyzed the prevalence and factors associated with motorcycle accidents according to the area of occurrence. The data came from prehospital care records. Descriptive and inferential statistics were performed, and the associated factors were analyzed using binary logistic regression, adopting a significance of 5% and 95% confidence. The sample totaled 1,039 victims. Most of the records occurred in the urban area, involving the male, where the victim was the driver of the vehicle, had not ingested alcohol and used the helmet. Most of the attendances were performed by the Emergency Mobile Attendance Service, at the end of the week and at night shift. The mean score of the Glasgow Coma Scale for the urban area was slightly higher than the rural one, with a significant difference. The mean time between the request for care and the arrival at the place of occurrence, as well as between the request for care and hospital admission were significant, being prevalent for rural areas. In the bivariate analysis of the association of traffic accidents by motorcycle with the occurrence zone, the variables that showed a significant association were: Glasgow coma scale, time between request and arrival of the service, time between request of service and admission hospital, sex, alcohol intake, helmet use, other party involved, period of occurrence, accident turn, type of care and discharge type of the victim.

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