scholarly journals Geriatric head injuries: impact and outcomes

2019 ◽  
Vol 7 (9) ◽  
pp. 3461
Author(s):  
Vallabh B. Nagocha ◽  
Manish Yadav ◽  
Divyam Sharma ◽  
Sunil Garg
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Treatment Options ◽  
Head Injuries ◽  
Diffuse Axonal Injury ◽  
The Elderly ◽  
Trauma Patients ◽  
Post Injury ◽  
Factors Affecting ◽  
The Impact

Background: Elderly trauma patients present unique challenges and face  more  significant obstacles in  recovery  than  their younger  counterparts. They usually experience higher morbidity and mortality and slower recovery trajectories and have, on average, worse functional, cognitive, and psychosocial outcomes months or years post-injury than do younger patients.Methods: Authors conducted a study of elderly head injury patients to understand the epidemiology of geriatric TBI, the impact of comorbidities and management issues and  outcomes in such patients. Authors had a total of 110 patients who presented with traumatic brain injury and were admitted in this hospital over 2 years. Authors also reviewed the literatures to study the factors affecting outcome after geriatric TBI and studied the role of aggressive neurosurgical management in geriatric TBI.Results: Among 68%(n=75) of the patients were male and 32% females. Age group of 60-65 years was the highest with 60.9% patients. Patients with GCS of 8 and below had the highest mortality rates of 68 %. Overall  mortality  rate  was  32.72%  and  9.09 %  of  the patients survived in a vegetative condition. The proportion of injury secondary to fall was the largest single group in 50.9% patients, and Chronic SDH was the most common pathology seen in 36.45 % patients. Highest mortality was seen in patients with Diffuse Axonal Injury (69.23 %). Out of the 110 patients , 57 patients underwent surgery for various pathologies. Chronic SDH were the most common operated pathology followed by acute SDH. Glassgow outcome scale was used as the measure of outcome in these series of patients.  32.72 % patients had a GOS score of 1 and 9.09 % had a score of 2. 18.18 % patients remained severely disabled with a score of 3 and nine patients (8.18 %) had a score of 4 and thirty five patients had good recovery (GOS-5).Conclusions: Due to the better treatment options there is an increase in the number of elderly around the world. Thus, the number of eldery individuals presenting with TBI to the emergency department is also on the rise more commonly due to falls than road traffic accidents. There is a need for specific prognostic and management guidelines for the elderly which can lead to better diagnosis, care and recovery and eventual short- and long-term outcomes in the elderly.

Brain Damage in Fatal Non-Missile Head Injury in Relation to Age and Type of Injury

1989 ◽  
Vol 34 (1) ◽  
pp. 399-401 ◽  
Author(s):  
J.H. Adams ◽  
D. Doyle ◽  
I. Ford ◽  
D.I. Graham ◽  
M. McGee ◽  
...  
Keyword(s):  
Head Injury ◽  
Brain Damage ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Head Injuries ◽  
Diffuse Axonal Injury ◽  
Diffuse Brain Swelling ◽  
Type Of Injury ◽  
The Relationship ◽  
Diffuse Brain

Brain damage in a series of 635 fatal non-missile head injuries has been analysed with particular reference to the age of the patient and the type of injury. The differences in the type of brain damage in relation to age were less than we had anticipated, lending further support to the contention that the aged brain has a reduced potential for recovery. The analysis confirms the relationship between road traffic accidents, diffuse axonal injury, gliding contusions and ‘basal ganglia’ haematomas, and the importance of diffuse brain swelling resulting from a head injury in children.

scholarly journals Geriatric presentation to the emergency department-spectrum of illness and co-relation with social factors

2018 ◽  
Vol 5 (1) ◽  
pp. 77
Author(s):  
Ramesh Gorghatta Hanumanthaiah ◽  
Sheerin Farhath ◽  
Panchakshari Prasanna Bangalore Krishnappa ◽  
Dheemantha P. ◽  
T. S. Ranganath
Keyword(s):  
Emergency Department ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Clinical Symptoms ◽  
Demographic Data ◽  
The Elderly ◽  
Trauma Patients ◽  
Prime Concern ◽  
One Year ◽  
Population Segment

Background: Increase in the elderly population presenting to Emergency Department is a prime concern as it has maximum implications on the delivery of health care. Older patients account for 12%-24% of all ED patients worldwide. A need for this study is to understand and analyze the current and future of Emergency department (ED) and examines the presentation of geriatric patient to emergency department in our institute in an urban setup of the fastest growing population segment in the city.Methods: An observational study over a period of one year from 2015 to 2016. All patients aged 60 years and above, visiting the Emergency Medicine. The following data were obtained. (I) Demographics, (II) Urban and Rural population (III) Presence of co-morbidities, (IV) Common conditions (V) Clinical symptoms and Diagnoses, Socio-demographic data collected directly from patient or immediate caregiver.Results: Total No of patients included during the study were 5489. Data was assessed male patient, predominance was found with 61%, 39% female. The urban population 74.8% was more predominant. Rural being at 25.2%, 1620 (29.2%) poisoning cases,1322 (24.1%) trauma cases,318 (5.8%) cancer cases, 247(4.5%) COPD cases and 230 (4.2%) stroke cases were encountered. Male72.58%, females 27.42%. CCU 58.5% male, 41.55% females. ICU 55.21% males and 44.79 % females. The average time was 3.75 to 4.25.Conclusions: Road Traffic accidents and poisoning together contributed to many cases. Observation was inadequate training amongst ED doctors and nurses in assessing and managing Trauma patients who lack ATLS protocols in stabilizing geriatric emergencies. Hence ED staff should be well trained to facilitate management of an ageing patients. Hazmat bay should be well organized with specific antidotes to the commonly available poisons. Atypically presentation was common in ED. Considerable overlapping of symptoms were commonly encountered in patients presenting to Emergency department.

scholarly journals P014: Incidental findings in trauma whole-body CT scans: a systematic review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S69-S69
Author(s):  
V. Tsang ◽  
K. Bao ◽  
J. Taylor
Keyword(s):  
Systematic Review ◽  
Incidental Findings ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Subsequent Treatment ◽  
Whole Body ◽  
Trauma Patients ◽  
Patient Demographics ◽  
Study Results

Introduction: Whole-body computed tomography scans (WBCT) are a mainstay in the work-up of polytrauma or multiple trauma patients in the emergency department. While incredibly useful for identifying traumatic injuries, WBCTs also reveal incidental findings in patients, some of which require further diagnostic testing and subsequent treatment. Although the presence of incidental findings in WBCTs have been well documented, there has been no systematic review conducted to organize and interpret findings, determine IF prevalence, and document strategies for best management. Methods: A systematic review was conducted using MEDLINE, PUBMED, and EMBASE. Specific journals and reference lists were hand-mined, and Google Scholar was used to find any additional papers. Data synthesis was performed to gather information on patient demographics, prevalence and type of incidental findings (IFs), and follow-up management was collected. All documents were independently assessed by the two reviewers for inclusion and any disagreements were resolved by consensus. Results: 1231 study results were identified, 59 abstracts, and 12 included in final review. A mean of 53.9% of patients had at least one IF identified, 31.5% had major findings, and 68.5% had minor findings. A mean of 2.7 IFs per patient was reported for articles that included number of total IFs. The mean age of patients included in the studies were 44 years old with IFs more common in older patients and men with more IFs than women. IFs were most commonly found in the abdominal/pelvic region followed by kidneys. Frequency of follow-up documentation was poor. The most common reported mechanisms of injury for patients included in the study were MVA and road traffic accidents (60.0%) followed by falls from >3m (23.2%). Conclusion: Although there is good documentation on the mechanism of injury, patient demographics, and type of IF, follow-up for IFs following acute trauma admission lacks documentation and follow-up and is an identified issue in patient management. There is great need for systematic protocols to address management of IFs in polytrauma patients.

Thoracic trauma in small animals: road traffic accidents

2021 ◽  
Vol 12 (1) ◽  
pp. 15-19
Author(s):  
Kate Sheard
Keyword(s):  
Traffic Accidents ◽  
Thoracic Trauma ◽  
Road Traffic ◽  
Positive Outcome ◽  
Multiple Organ ◽  
Trauma Patients ◽  
Small Animals ◽  
Road Traffic Accidents ◽  
Blunt Force Trauma ◽  
Organ Systems

Thoracic trauma is common in small animals and can be caused by a variety of insults from penetrating wounds to blunt force trauma. Patients that have sustained any form of thoracic trauma require immediate attention and intensive nursing care in order to have a positive outcome for the patient. These cases can prove challenging as multiple organ systems can be affected and surgery is often required. However, combined with the appropriate medical care, the outcome can be successful.

scholarly journals Assessing inequality, irregularity, and severity regarding road traffic safety during COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lei Lin ◽  
Feng Shi ◽  
Weizi Li
Keyword(s):  
New York ◽  
Los Angeles ◽  
Traffic Safety ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Human Mobility ◽  
Critical Conditions ◽  
Road Traffic Safety ◽  
Accident Data ◽  
The Impact

AbstractCOVID-19 has affected every sector of our society, among which human mobility is taking a dramatic change due to quarantine and social distancing. We investigate the impact of the pandemic and subsequent mobility changes on road traffic safety. Using traffic accident data from the city of Los Angeles and New York City, we find that the impact is not merely a blunt reduction in traffic and accidents; rather, (1) the proportion of accidents unexpectedly increases for “Hispanic” and “Male” groups; (2) the “hot spots” of accidents have shifted in both time and space and are likely moved from higher-income areas (e.g., Hollywood and Lower Manhattan) to lower-income areas (e.g., southern LA and southern Brooklyn); (3) the severity level of accidents decreases with the number of accidents regardless of transportation modes. Understanding those variations of traffic accidents not only sheds a light on the heterogeneous impact of COVID-19 across demographic and geographic factors, but also helps policymakers and planners design more effective safety policies and interventions during critical conditions such as the pandemic.

Analysis of Driver's Characteristics Based on Internet of Vehicles

2014 ◽  
Vol 505-506 ◽  
pp. 1148-1152
Author(s):  
Jian Qun Wang ◽  
Xiao Qing Xue ◽  
Ning Cao
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Classification Model ◽  
Economic Losses ◽  
Lane Changing ◽  
Internet Of Vehicles ◽  
Factors Affecting ◽  
The Road ◽  
The University ◽  
Driver’S Characteristics

The road traffic accidents caused huge economic losses and casualties, so it had been focused by the researchers. Lane changing characteristic is the most relevant characteristic with safety. The intent of lane changing was discussed. Firstly, the factors affecting the intent were analyzed, the speed satisfaction value and the space satisfaction value were proposed; then the data from the University of California, Berkeley was extracted and the number of vehicles changed lane more often and the vehicle ID were obtained; the BP neural network classification model was established, it was trained and testified by actual data. The results shown the method could predict the intent accurately.

A Study of the Investigation of Death (Coroner System) in Sri Lanka

2003 ◽  
Vol 43 (3) ◽  
pp. 236-240 ◽  
Author(s):  
R Fernando
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Sri Lanka ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Head Injuries ◽  
The Other ◽  
Road Traffic Accidents ◽  
Natural Death ◽  
Early Nineteenth Century

Sri Lanka (Ceylon) inherited the `coroner system' of investigating death in the early nineteenth century. Unlike in England and Wales, the coroner system in Sri Lanka did not change much in the last century. This study, the first of its kind, was performed for a period of three months in 1995 to analyse the causes and circumstances of deaths reported for inquest, and the number of autopsies performed. Of the 868 cases reported to the Inquirer, the circumstances were not determined in 94 cases at the initial inquest proceedings. Of the other 774 cases, 454 (58.7%) were natural deaths. Autopsies were performed on 44.5% of natural deaths, 58.2% of accidental deaths, 96% of road traffic accidents, 44.9 % of suicides and 81.6% of homicides. Coronary heart disease was the leading cause of natural death (33.9%). Head injuries were responsible for 31.8% of accidental deaths while burns accounted for 24.5% of accidental deaths and 46.3% of suicides. There were 38 cases (4.9%) of homicide of which autopsies were performed in 31. There is an urgent need to reform the century-old laws relating to inquest procedures in the country.

Children and Terror Casualties Receive Preference in ICU Admissions

2012 ◽  
Vol 6 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Kobi Peleg ◽  
Michael Rozenfeld ◽  
Eran Dolev ◽  
Keyword(s):  
Traffic Accidents ◽  
Injury Severity ◽  
Road Traffic ◽  
Age Groups ◽  
Trauma Patients ◽  
Trauma Centers ◽  
Severe Injuries ◽  
Level I ◽  
Hospital Emergency Departments ◽  
Trauma Type

ABSTRACTObjective: Trauma casualties caused by terror-related events and children injured as a result of trauma may be given preference in hospital emergency departments (EDs) due to their perceived importance. We investigated whether there are differences in the treatment and hospitalization of terror-related casualties compared to other types of injury events and between children and adults injured in terror-related events.Methods: Retrospective study of 121 608 trauma patients from the Israel Trauma Registry during the period of October 2000-December 2005. Of the 10 hospitals included in the registry, 6 were level I trauma centers and 4 were regional trauma centers. Patients who were hospitalized or died in the ED or were transferred between hospitals were included in the registry.Results: All analyses were controlled for Injury Severity Score (ISS). All patients with ISS 1-24 terror casualties had the highest frequency of intensive care unit (ICU) admissions when compared with patients after road traffic accidents (RTA) and other trauma. Among patients with terror-related casualties, children were admitted to ICU disproportionally to the severity of their injury. Logistic regression adjusted for injury severity and trauma type showed that both terror casualties and children have a higher probability of being admitted to the ICU.Conclusions: Injured children are admitted to ICU more often than other age groups. Also, terror-related casualties are more frequently admitted to the ICU compared to those from other types of injury events. These differences were not directly related to a higher proportion of severe injuries among the preferred groups.(Disaster Med Public Health Preparedness. 2012;6:14–19)

scholarly journals The impact of traffic law enforcement on road accident fatalities in Botswana

2011 ◽  
Vol 5 (1) ◽  
Author(s):  
Thuso Mphela
Keyword(s):  
Law Enforcement ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Secondary Data ◽  
Road Accident ◽  
Driver Behaviour ◽  
Traffic Law ◽  
Traffic Law Enforcement ◽  
To Come ◽  
The Impact

Botswana has one of the highest rates of increase in road traffic accidents and fatalities in the world. The amendment of road laws came with stricter penalties for road offences which included higher fines and longer jail terms. This study uses multiple regression analysis subjecting variables to backward stepwise regression with a view to assessing the impact traffic law enforcement has had on fatalities in Botswana after the review of the Traffic Act of Botswana in 2008. The study uses secondary data and interview data obtained from law enforcers. The findings reveal that the enforcement of the new road laws has achieved little in the reduction of fatalities. Increasing the minimum driver licensing age may be a panacea to road accidents. Licensed drivers in the age group 30 to 45 years have the lowest rate of fatalities. The study questions the ability of punitive policies (i.e. road fines) to reduce fatalities. It offers that driver behaviour should be studied to come up with relevant policies.

scholarly journals ASSESSMENT OF INJURIES IN ROAD TRAFFIC ACCIDENTS ADMITTED TO EMERGENCY DEPARTMENT OF GMCH, BETTIAH, WEST CHAMPARAN, BIHAR

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Arun Kumar Singh
Keyword(s):  
Emergency Department ◽  
Low Income ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Head Injuries ◽  
Health Sector ◽  
Road Traffic Accidents ◽  
Road Traffic Crashes ◽  
Pattern Of Injury ◽  
Traffic Rules

Majority of the world's fatalities on the roads occur in low-income and middle-income countries, even though these countries have approximately half of the world's vehicles. India is no exception and data showed that more than 1.3 lakh people died on Indian roads, giving India the dubious honour of topping the global list of fatalities from road crashes. Road traffic injuries have been neglected from the global health agenda for many years, despite being predictable and largely preventable. Evidence from many countries shows that dramatic successes in preventing road traffic crashes can be achieved through concerted efforts that involve, but are not limited to, the health sector. Hence based on above findings the present study was planned for Assessment of Injuries in Road Traffic Accidents Admitted to Emergency Department of GMCH, Bettiah, West Champaran, Bihar. The present study was planned in Department of Forensic Medicine, Government Medical College, Bettiah, West Champaran, Bihar, India from jan 2018 to Dec 2018.In the present study 20 cases suffered from the road traffic accidents were evaluated for the pattern of injury. A predesigned and pretested questionnaire especially designed for this purpose was used for interviewing the accident victims, either in the emergency itself or in the wards. In India, there are ample risk factors for RTAs to occur because of lack of proper infrastructural facilities, poor designs of roads, improper implementation of traffic rules and a high load of variety of vehicles on the roads.  Road traffic accidents with head injuries are much more common in young working males as compared to females and that to in those who were pedestrians and motor cyclists. The rate of incidence is higher in India because of bad traffic patterns and possibly the lack of awareness about traffic rules and also lack of good hospital services to our victims of RTAs. Keywords: Injuries, Road Traffic Accidents, Emergency Department, GMCH, Bettiah, West Champaran, Bihar, etc.  

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