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Popa Ș, Bulgaru-Iliescu D, Ciongradi CI, Surd AO, Candussi IL, Popa IP, Sârbu I. Trauma Outcomes in Pediatric Nonfatal Road Traffic Accidents. CHILDREN (BASEL, SWITZERLAND) 2024; 11:425. [PMID: 38671642 PMCID: PMC11049463 DOI: 10.3390/children11040425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/26/2024] [Accepted: 03/30/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND By 2025, road traffic injuries are projected to rank third in the global burden of disease, posing a significant challenge that affects health, social well-being, and economic aspects. According to data from the Romanian Police National Statistics Center, there have been an average of 342 traffic accidents per year involving pediatric patients over the past 10 years. MATERIALS AND METHODS A retrospective research study was conducted, encompassing 358 cases of road traffic accidents identified for the study, with data collected over a span of eight years, and with the aim of analyzing the types of injury and treatment methods in relation to age and sex, while also focusing on the duration of hospitalization and the occurrence of complications. RESULTS An oscillating trend is observed from 2015 to 2020, with its lowest value recorded in 2017 at around 6.8% and its peak in 2019 at 20.1%. Notably, post-pandemic (COVID-19), the cases underwent a substantial decline of approximately 60%. At least 78.7% of those who did not undergo orthopedic reduction required surgery, whereas among those who underwent orthopedic reduction, only 23.4% needed surgery. Regarding the frequency of complications 17.3% of the total cases experienced complications. CONCLUSIONS According to our findings, age has a significant effect on the type of accident (p < 0.05). Complications occurred in 17.3% of patients, most commonly surgical (24 cases, 38.7%), orthopedic (17 cases, 27.4%), and neurological (15 cases, 24.2%).
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Affiliation(s)
- Ștefan Popa
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.)
| | - Diana Bulgaru-Iliescu
- 3rd Department of Medical Specialities–Legal Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania;
| | - Carmen Iulia Ciongradi
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.)
| | - Adrian Onisim Surd
- Department of Pediatric Surgery, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania;
| | - Iuliana-Laura Candussi
- Clinical Surgery Department, Faculty of Medicine and Pharmacy, “Dunărea de Jos“ University, 800008 Galați, Romania;
| | - Irene Paula Popa
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Ioan Sârbu
- 2nd Department of Surgery–Pediatric Surgery and Orthopedics, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iași, Romania; (Ș.P.); (I.S.)
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Cunha-Diniz F, Taveira-Gomes T, Teixeira JM, Magalhães T. Trauma outcomes in nonfatal road traffic accidents: a Portuguese medico-legal approach. Forensic Sci Res 2022; 7:528-539. [PMID: 36353310 PMCID: PMC9639525 DOI: 10.1080/20961790.2022.2031548] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
The objective of this study was to compare the outcomes of nonfatal road traffic accidents by the victims’ age group and sex. We used the Portuguese medico-legal rules for personal injury assessment, in the scope of the Civil Law in that country, which includes a three-dimensional methodology. This was a retrospective study including 667 victims of road traffic accidents aged 3–94 years old. Their final medico-legal reports all used the Portuguese methodology for personal injury assessment. Outcomes were analysed by the victims’ age group (children, working-age adults, and older people) and sex. Road traffic accidents were generally serious (ISS mean 9.5), with higher severity in children and older people. The most frequent body sequelae were musculoskeletal (64.8%), which were associated with functional and situational outcomes. Temporary damage resulted in an average length of impairment of daily life of 199.6 days, 171.7 days to return to work, and an average degree of quantum doloris (noneconomic damage related to physical and psychological harm) of 3.7/7. The average permanent damage was 7.3/100 points for Permanent Functional Deficit, 0.43/3 for Permanent Professional Repercussion, 2/7 for Permanent Aesthetic Damage, 3.9/7 for Permanent Repercussion on Sexual Activity and 3.2/7 for Permanent Repercussion on Sport and Leisure Activities. Overall, 19% of people became permanently dependent (10.6% needed third-party assistance). The medico-legal methodology used, considering victims’ real-life situation, allows a comprehensive assessment. There were several significant differences among the three age groups but none between sexes. These differences and the impact of the more severe cases justify further detailed medico-legal studies in these specific situations on children, older people, and severely injured victims.Key points: This was a retrospective study of accident mechanisms and injury outcomes in Portugal, and considered the outcomes in the victims’ real-life situation. Lesions from road traffic accidents were generally serious, with higher severity among children and older people. The most frequent sequels were musculoskeletal, and associated with functional and situational outcomes. Both temporary and permanent outcomes had repercussions for the victims. There were significant differences between children, working-age adults and older people, but none between sexes.
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Affiliation(s)
| | - Tiago Taveira-Gomes
- CINTESIS—Faculty of Medicine, University of Porto, Porto, Portugal
- IINFACTS—Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, Portugal
- Fernando Pessoa University, Porto, Portugal
| | | | - Teresa Magalhães
- CINTESIS—Faculty of Medicine, University of Porto, Porto, Portugal
- IINFACTS—Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, Gandra, Portugal
- Porto Healthcare Unity—Accidents, Fidelidade—Insurance Company, Porto, Portugal
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Fagerlind H, Harvey L, Humburg P, Davidsson J, Brown J. Identifying individual-based injury patterns in multi-trauma road users by using an association rule mining method. ACCIDENT; ANALYSIS AND PREVENTION 2022; 164:106479. [PMID: 34775175 DOI: 10.1016/j.aap.2021.106479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 10/05/2021] [Accepted: 11/05/2021] [Indexed: 06/13/2023]
Abstract
In many road crashes the human body is exposed to high forces, commonly resulting in multiple injuries. This study of linked road crash data aimed to identify co-occurring injuries in multiple injured road users by using a novel application of a data mining technique commonly used in Market Basket Analysis. We expected that some injuries are statistically associated with each other and form Individual-Based Injury Patterns (IBIPs) and further that specific road users are associated with certain IBIPs. First, a new injury taxonomy was developed through a four-step process to allow the use of injury data recorded from either of the two major dictionaries used to document anatomical injury. Then data from the Swedish Traffic Accident Data Acquisition, which includes crash circumstances from the police and injury information from hospitals, was analysed for the years 2011 to 2017. The injury data was analysed using the Apriori algorithm to identify statistical association between injuries (IBIP). Each IBIP were then used as the outcome variable in logistic regression modelling to identify associations between specific road user types and IBIPs. A total of 48,544 individuals were included in the analysis of which 36,480 (75.1%) had a single injury category recorded and 12,064 (24.9%) were considered multiply injured. The data mining analysis identified 77 IBIPs in the multiply injured sample and 16 of these were associated with only one road user type. IBIPs and their relation to road user type are one step on the journey towards developing a tool to better understand and quantify injury severity and thereby improve the evidence-base supporting prioritisation of road safety countermeasures.
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Affiliation(s)
- Helen Fagerlind
- Neuroscience Research Australia, Sydney, NSW 2031, Australia; School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia; Division of Vehicle Safety, Chalmers University of Technology, 412 96 Gothenburg, Sweden.
| | - Lara Harvey
- Neuroscience Research Australia, Sydney, NSW 2031, Australia; School of Population Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Peter Humburg
- Neuroscience Research Australia, Sydney, NSW 2031, Australia; Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Johan Davidsson
- Division of Vehicle Safety, Chalmers University of Technology, 412 96 Gothenburg, Sweden.
| | - Julie Brown
- Neuroscience Research Australia, Sydney, NSW 2031, Australia; The George Institute for Global Health, Sydney, NSW 2042, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia.
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Stigson H, Boström M, Kullgren A. Health status and quality of life among road users with permanent medical impairment several years after the crash. TRAFFIC INJURY PREVENTION 2020; 21:S43-S48. [PMID: 33026889 DOI: 10.1080/15389588.2020.1817416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 08/20/2020] [Accepted: 08/27/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Improvements in road infrastructure and vehicle safety have been achieved in many countries during the last decades. As the number of fatalities have dropped, the consequences of non-fatal injuries have been brought into focus. Therefore, the objective was to investigate self-reported health status and health-related quality of life several years after the crash for road-users that sustained injuries resulting in permanent medical impairment (PMI). METHODS A self-administered questionnaire using instruments to measure if health, health-related quality of life and physical activity had been affected by the crash, were used. The injured road-users were identified from insurance policy holders of the Folksam Insurance Group. The response rate was 29%, a total of 2078 responses were received from the 7174 road-users with PMI that received the questionnaire. RESULTS In total 85% were still suffering from the injuries several years after the crash (8-18 year after the crash). Furthermore, road-users with injuries to the spine were having highest pain intensity. Older road-users had poorer self-reported health status than younger road-users. Although, younger road-users had the greatest change in physical activity when comparing before and after the crash. Before the crash in total 63% were physically active while only 34% after the crash. The higher the PMI the higher it affected health several years after the crash. CONCLUSIONS The Swedish definition of serious injury, an injury leading to PMI, was found to correlate with self-reported health loss; 85% of the injured road-users reported that they still had remaining symptoms several years after the accident. The injured body region leading to PMI after an accident can vary from the body regions reported to cause long-term health loss. It was found that the higher the degree of PMI the higher the health loss. Sustaining a PMI regardless severity and injured body region has the same effects on general health for men and women. Sustaining a PMI will both lower the health-related quality of life and physical activity after the crash compared to before.
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Affiliation(s)
- Helena Stigson
- Folksam Research, Folksam Insurance Group, Stockholm, Sweden
- Vehicle Safety Division, Department of Applied Mechanics, Chalmers University of Technology, Gothenburg, Sweden
- Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Boström
- Epidemiology and Social Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anders Kullgren
- Folksam Research, Folksam Insurance Group, Stockholm, Sweden
- Vehicle Safety Division, Department of Applied Mechanics, Chalmers University of Technology, Gothenburg, Sweden
- Division of Insurance Medicine, Karolinska Institutet, Stockholm, Sweden
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Zou X, Vu HL, Huang H. Fifty Years of Accident Analysis & Prevention: A Bibliometric and Scientometric Overview. ACCIDENT; ANALYSIS AND PREVENTION 2020; 144:105568. [PMID: 32562929 DOI: 10.1016/j.aap.2020.105568] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 03/31/2020] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
Accident Analysis & Prevention (AA&P) is a leading academic journal established in 1969 that serves as an important scientific communication platform for road safety studies. To celebrate its 50th anniversary of publishing outstanding and insightful studies, a multi-dimensional statistical and visualized analysis of the AA&P publications between 1969 and 2018 was performed using the Web of Science (WoS) Core Collection database, bibliometrics and mapping-knowledge-domain (MKD) analytical methods, and scientometric tools. It was shown that the annual number of AA&P's publications has grown exponentially and that over the course of its development, AA&P has been a leader in the field of road safety, both in terms of innovation and dissemination. By determining its key source countries and organizations, core authors, highly co-cited published documents, and high burst-strength publications, we showed that AA&P's areas of focus include the "effects of hazard and risk perception on driving behavior", "crash frequency modeling analysis", "intentional driving violations and aberrant driving behavior", "epidemiology, assessment and prevention of road traffic injuries", and "crash-injury severity modeling analysis". Furthermore, the key burst papers that have played an important role in advancing research and guiding AA&P in new directions - particularly those in the fields of crash frequency and crash-injury severity modeling analyses were identified. Finally, a modified Haddon matrix in the era of intelligent, connected and autonomous transportation systems is proposed to provide new insights into the emerging generation of road safety studies.
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Affiliation(s)
- Xin Zou
- Institute of Transport Studies, Monash University, Clayton, VIC 3800, Australia.
| | - Hai L Vu
- Institute of Transport Studies, Monash University, Clayton, VIC 3800, Australia
| | - Helai Huang
- School of Traffic and Transportation Engineering, Central South University, Changsha 410075, China
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Rissanen R, Ifver J, Hasselberg M, Berg HY. Quality of life following road traffic injury: the impact of age and gender. Qual Life Res 2020; 29:1587-1596. [PMID: 31960212 PMCID: PMC7253518 DOI: 10.1007/s11136-020-02427-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2020] [Indexed: 11/17/2022]
Abstract
Purpose The impact of road traffic crashes on health is well developed, in terms of deaths and direct consequences, but it is less so in terms of long-term life consequences. Few studies have compared the general impact on Health Related Quality of Life (HRQoL) following road traffic injury (RTI) by using a variety of different injured body parts and severity levels of the injury and compared them with a sample of non-injured referent individuals. Consequently, the aim of the current study is to assess how injury severity is associated with HRQoL, and if it differs between men, women, over age and injured body parts. Methods This cross-sectional study identified people with a RTI in the Swedish Traffic Accident Data Acquisition System (STRADA). A frequency matched reference group was also included. Data include both register data and self-reported HRQoL data. Results A total of 1788 out of 4761 persons with an RTI (37.6%) and 2186 out of 4761 reference persons (45.9%) returned the questionnaire, giving a total response rate of 41.9% (n = 3974). The findings show different patterns of HRQoL loss, depending on sex, age, injured body part, and levels of injury severity. Conclusion The results show that even relatively minor road traffic injuries can lead to a significantly lower of HRQoL, especially for women, compared to the non-injured reference group. Moreover, when the inherent reduction of HRQoL over age was considered, the results indicated that younger individuals have a larger difference from the reference group in HRQoL, independent of the injury severity, compared to the older individuals; hence, an improved understanding of age and gender differences in HRQoL following an RTI is needed to better understand the long-term consequences of injuries from a public health perspective. Electronic supplementary material The online version of this article (10.1007/s11136-020-02427-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- R Rissanen
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Widerströmska huset, 17177, Stockholm, Sweden.
| | - J Ifver
- Swedish Transport Agency, 781 23, Borlänge, Sweden
| | - M Hasselberg
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Widerströmska huset, 17177, Stockholm, Sweden
| | - H-Y Berg
- Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, Widerströmska huset, 17177, Stockholm, Sweden.,Swedish Transport Agency, 781 23, Borlänge, Sweden
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Hasselberg M, Rissanen R. Quality of life in the limelight: a study protocol of a Swedish register-based cohort study on quality of life after an injury. BMJ Open 2019; 9:e031023. [PMID: 31494619 PMCID: PMC6731847 DOI: 10.1136/bmjopen-2019-031023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Currently, there are very few published studies on preinjury and postinjury assessments of quality of life (QoL) based on a prospective appraisal; specifically, knowledge of those who do not seek medical care following injury is lacking. To close these knowledge gaps, this study aims to identify the psychosocial consequences in terms of loss of QoL following injury in a Swedish population and to investigate the response shift in retrospective measures of self-reported QoL. METHODS AND ANALYSIS We will analyse preinjury and postinjury (including both minor and severe unintentional injuries as well as different injury mechanisms) assessments of QoL, including the phenomenon of response shift, using register-based data from the nationwide collaboration project LifeGene, which includes over 52 000 individuals living in Sweden. In addition to LifeGene data, a short online survey including a 'ThenTest' questionnaire, that is, comparison of previous QoL to current using EuroQoL five-dimensional questionnaire, was sent out to the participants of LifeGene. This study will provide a unique opportunity to study the changes in QoL by comparing preinjury and postinjury assessments using a prospective appraisal, both for populations who have sought medical care as well as those who have not due to their injury. Similarly, the study will also assess the response shift in retrospective measures of QoL. This information can guide the next generation of QoL measures and interventions for those suffering injuries and have an impact on how to interpret evaluations of interventions. ETHICS AND DISSEMINATION The study has been reviewed and approved by the Regional Ethical Review Board in Stockholm, Sweden (case number 2018/352-31). The results will be disseminated through peer-reviewed journals, conference presentations, print media and internet and via a report for the funding agency.
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Affiliation(s)
- Marie Hasselberg
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Ritva Rissanen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
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Rissanen R, Liang Y, Moeller J, Nevriana A, Berg HY, Hasselberg M. Trajectories of sickness absence after road traffic injury: a Swedish register-based cohort study. BMJ Open 2019; 9:e031132. [PMID: 31371302 PMCID: PMC6677943 DOI: 10.1136/bmjopen-2019-031132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES Despite much focus on the health impact of road traffic injury (RTI) on life, there is a lack of knowledge of the dynamic process of return to work following RTI and its related factors. The aim of this study was to identify longitudinal patterns of sickness absence (SA) following RTI, to examine the patterns' interplay with health-related quality of life (HRQoL) and to determine if there are differences, regarding the patterns and interplay, according to injury severity. DESIGN A register-based prospective cohort study. SETTING Administrative data on RTI in Sweden from the Swedish Traffic Accident Data Acquisition System (STRADA) and Swedish Social Insurance data. PARTICIPANTS Individuals suffering an RTI (total n=4761) were identified in STRADA between 1 January 2007 and 31 December 2009. A total of 903 of these met the inclusion criteria for the current study and were included. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measure was SA following RTI. The secondary outcome measure was HRQoL. RESULTS Three distinct patterns of SA were identified; 'Stable', 'Quick decrease' and 'Gradual decrease'. The patterns differed in the number of initial SA days and the rate of reduction of SA days. After 3 years, all three patterns had almost the same level of SA. Higher injury severity and a higher number of SA days had a negative interplay with HRQoL. Participants who initially had a higher number of SA days were more likely to report a low HRQoL, indicating that people with a slower return to work are more vulnerable. CONCLUSION The study highlights the heterogeneity of return to work after an RTI. People with a more severe injury and slower pace of return to work seem to be more vulnerable with regards to HRQoL loss following RTI.
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Affiliation(s)
- Ritva Rissanen
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Yajun Liang
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Jette Moeller
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Alicia Nevriana
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Hans-Yngve Berg
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
- Swedish Transport Agency, Borlänge, Sweden
| | - Marie Hasselberg
- Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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