Document Type : Original Article
Authors
1 Assistant Professor of Community Medicine, Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
2 M.Sc., Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Introduction: Due to the high number of road traffic accidents in Iran and the significant rate of death and adverse complications caused by these accidents, it seems necessary to investigate the related factors. The aim of this study was to investigate the epidemiological characteristics of traffic accidents and the factors affecting the death of hospitalized patients due to accidents.
Methods: In this study, injured patients due to traffic accidents referring to the trauma hospital in Shiraz were randomly entered into the study for 6 months. The factors affecting the occurrence of an accident including the risk factors before the accident, during the incident, and at the time of hospitalization were investigated in the patient's mortality rate. A multivariable logistic regression was used to investigate the effect of factors on the patients’ chances of death.
Results: In this study, 563 injured patients from traumatic accidents admitted to the recovery unit for a period of 6 months were investigated. Injuries and death in the first eight hours of admission are significantly higher than other hours. The results show that damage to the age group of 15-39 years, Glasgow coma score, injury severity score, trauma injury severity score, revised trauma score, head and neck injury score, and the history of having a surgery significantly increase the chance of death. Among the areas of injury, having head and neck injuries as well as abdomen injury makes the chance of death 3.36 and 6.62 fold, respectively.
Conclusion: It is necessary to observe safety rules for drivers and passengers of the car more than before. Also, patients referring to trauma centers should be prioritized and treated based on the existing classification criteria and the risk assessment of death according to prognostic factors.
Keywords
- Bakhtiyari M, Soori H. Epidemiology of traffic crashes outcomes and related factorsin Iran 2010. Journal of Safety Promotion and Injury Prevention 2013; 1(3): 150-159. [Persian]
- Araqi E, Vahedian M. Study on susceptible and damages from motorcycle accidents in Mashhad in 2005. The Horizon of Medical Sciences. 2007;13(1):34-9.
- Myburgh JA, Cooper DJ, Finfer SR, Venkatesh B, Jones D, Higgins A, et al. Epidemiology and 12-month outcomes from traumatic brain injury in Australia and New Zealand. Journal of Trauma and Acute Care Surgery.
2008;64(4):854-62. - Shavaleh R, Motevalian SA, Mahdavi N, Haddadi M, Mohaghegh MR, Hamedi Z. Epidemiological study of hospitalized road traffic injuries in Iran 2011. Medical journal of the Islamic Republic of Iran. 2018;32:50.
- Mock CN, Jurkovich GJ, Arreola-Risa C, Maier RV. Trauma mortality patterns in three nations at different economic levels: implications for global trauma system development. Journal of Trauma and Acute Care Surgery. 1998;44(5):804-14.
- Zamani M, Esmailian M, Mirazimi MS, Ebrahimian M, Golshani K. Cause and final outcome of trauma in patients referred to the emergency department: a cross sectional study. Iranian journal of emergency medicine. 2014;1(1):22-7.
- Karbakhsh M, Zandi N, Rouzrokh M, Zarei M-R. Injury epidemiology in Kermanshah: the National Trauma Project in Islamic Republic of Iran. 2009.
- Violence WHODo, Prevention I, Violence WHO, Prevention I, Organization WH. Global status report on road safety: time for action: World Health Organization; 2009.
- Victorino GP, Chong TJ, Pal JD. Trauma in the elderly patient. Archives
of Surgery. 2003;138(10):1093-8. - Joffe M, Ludwig S. Stairway injuries in children. Pediatrics. 1988;82(3):457-61.
- Zhang J, Fraser S, Lindsay J, Clarke K, Mao Y. Age-specific patterns of factors related to fatal motor vehicle traffic crashes: focus on young and elderly drivers. Public health. 1998;112(5):289-95.
- Perdue PW, Watts DD, Kaufmann CR, Trask AL. Differences in mortality between elderly and younger adult trauma patients: geriatric status increases risk of delayed death. Journal of Trauma and Acute Care Surgery. 1998;45(4):805-10.
- Tornetta P, Mostafavi H, Riina J, Turen C, Reimer B, Levine R, et al. Morbidity and mortality in elderly trauma patients. Journal of Trauma and Acute Care Surgery. 1999;46(4):702-6.
- Stevenson M, Segui-Gomez M, Lescohier I, Di Scala C, McDonald-Smith G. An overview of the injury severity score and the new injury severity score. Injury Prevention. 2001;7(1):10-3.
- Champion HR, Sacco WJ, Carnazzo AJ, Copes W, Fouty WJ. Trauma score. Critical care medicine. 1981;9(9):672-6.
- Mishra B, Sinha ND, Sukhla S, Sinha
A. Epidemiological study of road traffic accident cases from Western Nepal. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine. 2010;35(1):115. - Zhao FZ, Wolf SE, Nakonezny PA, Minhajuddin A, Rhodes RL, Paulk ME, et al. Estimating geriatric mortality after injury using age, injury severity, and performance of a transfusion: the geriatric trauma outcome score. Journal of palliative medicine. 2015;18(8):677-81.
- Yadollahi M, Mahmoudi A, Niakan M, Dashti MF. Evaluating Risk Factors of Geriatric Trauma Mortality by Logistic Regression; A Cross-Sectional Study in 2011-2016. Iranian Red Crescent Medical Journal. 2018;20(5).
- Benjamin ER, Khor D, Cho J, Biswas S, Inaba K, Demetriades D. The age of undertriage: current trauma triage criteria underestimate the role of age and comorbidities in early mortality. The Journal of emergency medicine. 2018;55(2):278-87.
- Wong TH, Nadkarni NV, Nguyen HV, Lim GH, Matchar DB, Seow DCC, et al. One-year and three-year mortality prediction in adult major blunt trauma survivors: a National Retrospective Cohort Analysis. Scandinavian journal of trauma, resuscitation and emergency medicine. 2018;26(1):28.
- Yadollahi, M. A study of mortality risk factors among trauma referrals to trauma center, Shiraz, Iran, 2017. Chinese journal of traumatology.2019 22(4): 212-218.
- Bouzat P, Legrand R, Gillois P, Ageron F-X, Brun J, Savary D, et al. Prediction of intra-hospital mortality
after severe trauma: which pre-hospital score is the most accurate? Injury. 2016;47(1):14-8. - elodar S, Jafari P, Yadollahi M, Jahromi GS, Khalili H, Abbasi H, et al. Potential risk factors of death in multiple trauma patients. Emergency. 2014;2(4):170.