scholarly journals The Impact of Traffic Law Enforcement Regulations on the Incidence and Severity of Maxillofacial Injuries

Author(s):  
Abdullah Albakri ◽  
Ahmed Al-Hashmi ◽  
Abdulaziz Bakathir ◽  
Shikhan Al Hashmi ◽  
Said Al Rashdi ◽  
...  

Objectives: Road traffic accidents (RTAs) are the main cause of facial injuries in Oman. This study aimed to assess the effectiveness of the new traffic law enforcement regulations (TLERs) on the incidence and severity of maxillofacial injuries in Oman. Methods: A retrospective longitudinal analytic study was conducted at three tertiary care hospitals in Muscat, Oman. All patients with RTA-related maxillofacial injuries for a five-year period from January 2005 to December 2009 (before the new TLERs) and the five-year period from January 2015 to December 2019 (after the new TLERs) were included in the study. Results: A total of 1127 patients were included in the study. Of these, 646 (57.3%) patients sustained RTA-related maxillofacial injuries before the implementation of the new TLERs compared to 481 (42.7%) after the introduction of TLERs. There was no significant difference in gender sustained injuries between the two study periods. The incidence of injury before the implementation of the TLERs was 22.7 per 100,000 population, which then reduced significantly to 11 per 100,000 after the new TLERs. Overall, there was a significant reduction in the mean facial injury severity score from 3.2 to 2.3 before and after the implementation of the new TLERs, respectively. Conclusion: The findings of this study indicate that the newly introduced TLERs have resulted in a reduction in the incidence and severity of RTA-related maxillofacial injuries. Continuous improvement and reinforcement of TLERs will further help to reduce the burden of these injuries to the society in general and health services in particular. Keywords: Law Enforcement; Traffic Accidents; Maxillofacial Injuries; Injury Severity Score; Oman.

Author(s):  
Thuso Mphela

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.


2019 ◽  
Vol 11 (4) ◽  
Author(s):  
Uwe Hamsen ◽  
André Nohl ◽  
Andreas Baumann ◽  
Rolf Lefering ◽  
Laila Boutakmant ◽  
...  

ABO blood group has a profound influence on hemostasis as it is a major determinant of plasma levels of von Willebrand Factor. In vitro studies suggest that blood group O is a risk factor for increased severe bleeding while blood group non-O is a risk factor for thromboembolic events. Yet, the impact of ABO blood group outcome after multiple trauma is unknown. Retrospective multicenter case-control study from three level-1 trauma centers in Germany from 2012-2015. Inclusion criteria were severe trauma with an Injury severity score ≥9 and admission to an intensive care unit. 1281 patients (69.5% male) were included. Mean Injury Severity Score (ISS) was 21.1±12.4; mean age was 50.2±22.4 years. Distribution of blood groups was: O: 37.4%; A: 44%, B: 12.7 and AB: 5.8%. Hospital mortality depending on blood group was 9.7 (A), 10.4 (B), 6.8 (AB) and 12.7 (O) %. Multivariant logistic regression for mortality revealed an Odds ratio of 0.79 (A), 0.60 (B) and 0.54 (AB) without statistical significance (P=0.35 (A), 0.17 (B), 0.33 (AB)). Thromboembolic events (blood group O vs. others) occurred in 2.8 (O) vs. 3.3 (others) %, P=0.619. In this retrospective study on 1281 multiple injured patients, no relevant influence of ABO blood group on hemorrhage, thromboembolic events and mortality could be found.


2018 ◽  
Vol 84 (2) ◽  
pp. 309-317 ◽  
Author(s):  
Nitin Sajankila ◽  
Jack C. He ◽  
Brenda M. Zosa ◽  
Debra L. Allen ◽  
Jeffrey A. Claridge

A Regional Trauma Network (RTN), composed of one level I and several lower-level trauma centers (TCs) across multiple hospital systems, was established in 2010. This collaborative network used a unified triage protocol and a single transfer center. The impact of this RTN was assessed by evaluating regional mortality changes before and after RTN establishment. Patients in the state trauma registry aged 15 and older from 2006 to 2012 were analyzed; 2006 to 2009 and 2010 to 2012 were designated as pre-RTN and RTN periods, respectively. The region was defined as a county containing L1TC and its adjacent counties. Any counties bordering multiple L1TC-containing counties were excluded from analysis. Mortality was compared for all regions before and after RTN implementation. The following subgroups were also included a priori for the comparison: Injury Severity Score ≥15, age ≥65, and trauma mechanisms. 121,448 patients were analyzed; 66,977 and 54,471 patients were in the pre-RTN and RTN groups, respectively. Mean age was 58; 90 per cent had blunt injuries. The overall mortality was 4.9 per cent. Mortality comparisons over time for all regions are presented. The RTN region was the only region in the state that had mortality reduction in all patient subgroups. After adjusting for age, Injury Severity Score, level of TC that performed treatment, and trauma mechanism, RTN implementation was an independent predictor of survival (odds ratio: 0.876; 95% CI: 0.771–0.995, P = 0.04, c-statistic: 0.84). These findings suggest that regional collaboration and network-wide, uniform triage practices should be key components in the development of regionalized trauma networks.


2008 ◽  
Vol 126 (3) ◽  
pp. 186-189 ◽  
Author(s):  
Javad Salimi ◽  
Ali Khaji ◽  
Mojgan Karbakhsh ◽  
Soheil Saadat ◽  
Behzad Eftekhar

CONTEXT AND OBJECTIVE: The presence of scapular fracture is believed to be associated with high rates of other injuries and accompanying morbidities. The aim was to study injury patterns and their overall outcomes in patients with scapula fractures. DESIGN AND SETTING: Cross-sectional study of trauma patients treated at six general hospitals in Tehran. METHODS: One-year trauma records were obtained from six general hospitals Among these, forty-one had sustained a scapular fracture and were included in this study. RESULTS: Scapular fracture occurred predominantly among 20 to 50-year-old patients (78%). Road traffic accidents (RTAs) were the main cause of injury (73.2%; 30/41). Pedestrians accounted for 46.7% (14/30) of the injuries due to RTAs. Falls were the next most common cause, accounting for seven cases (17.1%). Body fractures were the most common type of scapular fractures (80%). Eighteen patients (43.9%) had isolated scapular fractures. Limb fracture was the most common associated injury, detected in 18 cases (43.9%). Three patients (7.3%) had severe injuries (injury severity score, ISS > 16) which resulted in one death (2.4%). The majority of the patients were treated conservatively (87.8%). CONCLUSIONS: Patients with scapula fractures have more severe underlying chest injuries and clavicle fractures. However, this did not correlate with higher rates of injury severity score, intensive care unit admission or mortality.


2017 ◽  
pp. 16-19
Author(s):  
Dzuy Vu ◽  
Viet Trung Lam

Objectives:Surveying the relationship between Injury Severity Score features polytrauma patients.Survey correlation between Injury Severity Scorewith mortality in polytrauma patients. Subjects of study:75 patients aged 16 years, was diagnosed multiple injuries worse prognosis in the Emergency Department, Cho Ray Hospital from January 2015 to September 2015. Method: Cross-sectional descriptive. Results: Percentage of patients with polytrauma patients total points ISS > 40 points was 38.4%. Traffic accidents, patients with total points ISS > 40 points was 36.2%, labor accidents, the number of patients with total points ISS > 40 points was 54.5%. The difference was not statistically significant with p> 0.05. The percentage of patients with total points ISS > 40 points in the group with traumatic shock 48.2%, higher than the group without shock trauma. The differences are statistically significant at p <0.05. Patients with clotting disorders, who have a total point group ISS > 40 points accounted for 50%, higher than the group without coagulopathy. The differences are statistically significant at p <0.05. Patients with a total score ISS > 40 points, mortality or severe to very high, accounting for 53.6%, the differences are statistically significant with p <0.001. Key words: Polytrauma, ISS scale, Cho Ray Hospital


2019 ◽  
Vol 27 (4) ◽  
pp. 202-210
Author(s):  
Kwangmin Kim ◽  
Hongjin Shim ◽  
Pil Young Jung ◽  
Seongyup Kim ◽  
Hui-Jae Bang ◽  
...  

Background: The Korean Ministry of Health and Welfare decided to establish a trauma medical service system to reduce preventable deaths. OO hospital in Gangwon Province was selected as a regional trauma center and was inaugurated in 2015. Objectives: This study examines the impact of this center, comparing mortality and other variables before and after inaugurating the center. Methods: Severely injured patients (injury severity score > 15) presenting to OO hospital between January 2014 and December 2016 were enrolled and categorized into two groups: before trauma center (n = 365) and after trauma center (n = 904). Patient characteristics, variables, and patient outcomes (including mortality rate) before and after the establishment of trauma centers were compared accordingly for both groups. Risk factors for in-hospital mortality were also identified. Results: Probability of survival using trauma and injury severity score (%) method was significantly lower in the after trauma center group (81.3 ± 26.1) than in the before trauma center group (84.7 ± 21.0) (p = 0.014). In-hospital mortality rates were similar in both groups (before vs after trauma center group: 13.2% vs 14.2%; p = 0.638). The Z and W statistics revealed higher scores in the after trauma center group than in the before trauma center group (Z statistic, 4.69 vs 1.37; W statistic, 4.52 vs 2.10); 2.42 more patients (per 100 patients) survived after trauma center establishment. Conclusion: Although the mortality rates of trauma patients remained unchanged after the trauma center establishment, the Z and W statistics revealed improvements in the quality of care.


2020 ◽  
Vol 10 (32) ◽  
pp. 183-193
Author(s):  
Gisele Andrade Menolli ◽  
Eleine Aparecida Penha Martins

Identificar a influência da gravidade do trauma e do atendimento intra-hospitalar no óbito, em vítimas de acidentes motociclísticos. Estudo transversal, quantitativo com 31 vítimas encaminhadas para o Hospital no norte do Paraná, entre dezembro de 2016 e março de 2017. 80,6% das vítimas eram homens, 48,4% das ocorrências aconteceram durante o dia. As escalas de trauma, Injury Severity Score (TRISS), Revised Trauma Score (RTS) e Injury Severity Score (ISS) evidenciaram escores leves com baixo risco de morte.  Houve associação entre gravidade do trauma e óbito, chegaram ao hospital com imobilizações corporais 61,3%; o protocolo de atendimento ao trauma foi utilizado em 45,2% dos casos; a cirurgia ortopédica compreendeu 43,4%; houve associação das cirurgias com o desfecho óbito; 90,3% das vítimas não tiveram infecção. A gravidade do trauma e cirurgias tiveram associação com o desfecho óbito, todas as vítimas de trauma devem ser atendidas conforme protocolo.Descritores: Serviço Hospitalar de Admissão de Paciente, Acidentes de Trânsito, Índices de Gravidade do Trauma, Motocicletas. Influence of accidents and in-hospital procedures on deathAbstract: Identification of the influence of trauma severity and the in-hospital care at death, in victims of motorcycle accidents. Cross-sectional, quantitative study, considering 31 victims referred to the Hospital in northern Paraná, between December 2016 and March 2017. 80.6% of the victims were men and 48.4% of the occurrences took place during the daytime. The trauma scales, Injury Severity Score (TRISS), Revised Trauma Score (RTS) and Injury Severity Score (ISS) presented soft scores of low risks of death. There was evidence of association between trauma severity and death, 61.3% of the patients arrived at the hospital with bodily immobilizations; the trauma care protocol was used in 45.2% of cases; surgery comprised 43.4% of cases; there was an association of surgeries with the outcome of death and 90.3% of the victims had no infection. The severity of trauma and surgeries were associated with the outcome of death; all trauma victims should be treated according to the protocol.Descriptors: Hospital Service for patient Admission, Traffic-Accidents, Trauma Severity Indices, Motorcycles. Influencia de los accidentes y procedimientos intrahospitales en la muerteResumen: Identificar la influencia de la gravedad del trauma y del atendimiento intrahospitalario en la muerte, en víctimas de accidentes motociclísticos. Estudio transversal, cuantitativo con 31 víctimas encaminadas para el Hospital en el Norte del Paraná, entre diciembre de 2016 y marzo de 2017. El 80.6% de las víctimas eran hombres, un 48.4% de los casos ocurrieron durante el día. La puntuación de los traumas, Injury Severity Score (TRISS), RevisedTrauma Score (RTS) y Injury Severity Score (ISS) evidenciaron scores leves con bajo riesgo de muerte. Hubo asociación entre la gravedad del trauma y la muerte, llegaron al hospital con inmovilizaciones corporales el 61.3%; el protocolo de atendimiento al trauma fué utilizado el 45.2% de los casos; la cirugía ortopédica comprendió 43.4%; hubo asociación de las cirugías con la muerte; el 90.3% de las víctimas no tuvieron infección. La gravedad del trauma y cirugías tuvieron asociación con la muerte, todas las víctimas de trauma deben ser atendidas según el protocolo.Descriptores: Servicio Hospitalar de Admisión de Paciente, Accidentes de Transito, Indices de Gravedad del Trauma, Motocicletas.


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