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Giovannini E, Santelli S, Pelletti G, Bonasoni MP, Cornacchia A, Pelotti S, Fais P. Pediatric motor vehicle crashes injuries: A systematic review for forensic evaluation. Int J Legal Med 2024; 138:1329-1341. [PMID: 38337078 PMCID: PMC11164731 DOI: 10.1007/s00414-024-03174-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Abstract
Children involved in car crashes can experience either direct trauma or inertial injuries resulting from interactions with external objects, such as other vehicles, or with the restraint system. Furthermore, improper use of restraint systems can lead to additional severe injuries. Recent reports from international institutions underscored the persistent prevalence of inadequate restraint systems utilization and this widespread issue increases children's vulnerability and risk of injuries.The aim of this study is to provide a systematic review of the literature on injuries sustained in children involved in road accidents describing and analyzing elements useful for forensic assessment.The literature search was performed using PubMed, Scopus and Web of Science from January 1970 to March 2023. Eligible studies have investigated issues of interest to forensic medicine about traffic accidents involving pediatric passengers. A total of 69 studies satisfied the inclusion criteria and were categorized and analyzed according to the anatomical regions of the body affected (head, neck, thoraco-abdominal, and limb injuries), and the assessment of lesions in reconstruction of the accident was examined and discussed.The review highlights that in motor vehicle accidents involving children, the forensic evaluation of both the cause of death and accident dynamics needs to consider several factors, such as the child's age, the type of restraint system employed, and the specific passenger seat occupied. Considering the complexity of the factors that can be involved in this road accident, it is crucial that there is a comprehensive exchange of information between the judge and the medical expert.
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Affiliation(s)
- Elena Giovannini
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Simone Santelli
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Guido Pelletti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Maria Paola Bonasoni
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy.
| | - Angela Cornacchia
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Susi Pelotti
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
| | - Paolo Fais
- Department of Medical and Surgical Sciences, Unit of Legal Medicine, University of Bologna, Via Irnerio 49, Bologna, 40126, Italy
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Phelps TB, Archer AD, Leonard M, Collins H, Burns JB. Outcome of Seatbelt Education and Safety Program Among Teenagers. Am Surg 2024; 90:1931-1933. [PMID: 38523078 DOI: 10.1177/00031348241241744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Despite the effectiveness of seatbelts, concerns persist about compliance, especially among teenagers. Survey data from a local high school and registry data from a level 1 trauma center were used to observe seatbelt and motor vehicle accident trends. The survey data was analyzed to gauge student's sentiments on seatbelt education. The trauma center data was analyzed to identify characteristics and trends among teenage motor vehicle accidents. Social media was the most common strategy selected for seatbelt safety awareness. Random seatbelt checks performed over 4 months revealed seatbelt compliance rates of 90%, 93.55%, and 96.94% after education intervention. Trauma center data showed that lack of seatbelt usage resulted in greater morbidity. These findings emphasize the need for targeted interventions. This study provides insights into creating effective education campaigns that can be used to enhance safety belt compliance and potentially reduce injury.
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Affiliation(s)
- Trevor B Phelps
- Department of Surgery, East Tennessee State University, Quillen College of Medicine, Johnson City, TN, USA
| | - Allen D Archer
- Department of Surgery, East Tennessee State University, Quillen College of Medicine, Johnson City, TN, USA
| | | | | | - J Bracken Burns
- Department of Surgery, East Tennessee State University, Quillen College of Medicine, Johnson City, TN, USA
- Ballad Health, Johnson City, TN, USA
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Pape HC, Starr AJ, Gueorguiev B, Wanner GA. The role of big data management, data registries, and machine learning algorithms for optimizing safe definitive surgery in trauma: a review. Patient Saf Surg 2024; 18:22. [PMID: 38902828 PMCID: PMC11191186 DOI: 10.1186/s13037-024-00404-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/28/2024] [Indexed: 06/22/2024] Open
Abstract
Digital data processing has revolutionized medical documentation and enabled the aggregation of patient data across hospitals. Initiatives such as those from the AO Foundation about fracture treatment (AO Sammelstudie, 1986), the Major Trauma Outcome Study (MTOS) about survival, and the Trauma Audit and Research Network (TARN) pioneered multi-hospital data collection. Large trauma registries, like the German Trauma Registry (TR-DGU) helped improve evidence levels but were still constrained by predefined data sets and limited physiological parameters. The improvement in the understanding of pathophysiological reactions substantiated that decision making about fracture care led to development of patient's tailored dynamic approaches like the Safe Definitive Surgery algorithm. In the future, artificial intelligence (AI) may provide further steps by potentially transforming fracture recognition and/or outcome prediction. The evolution towards flexible decision making and AI-driven innovations may be of further help. The current manuscript summarizes the development of big data from local databases and subsequent trauma registries to AI-based algorithms, such as Parkland Trauma Mortality Index and the IBM Watson Pathway Explorer.
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Affiliation(s)
- Hans-Christoph Pape
- Department of Trauma Surgery, University Hospital of Zurich, Raemistr. 100, Zurich, 8091, Switzerland.
| | - Adam J Starr
- Department of Orthopaedic Surgery, Parkland Memorial Hospital, University of Texas Southwestern, 4900 Harry Hines Blvd, Dallas, TX, 75235, USA
| | - Boyko Gueorguiev
- AO Research Institute Davos, Clavadelerstr. 8, Davos, 7270, Switzerland
| | - Guido A Wanner
- Department of Spine & Trauma Surgery, Bethanien Hospital, Toberlstr. 51, Zurich, 8044, Switzerland
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Bonsignore-Opp L, O'Donnell J, Agha O, Bach K, Metz L, Swarup I. Evaluation and Management of Thoracolumbar Spine Trauma in Pediatric Patients: A Critical Analysis Review. JBJS Rev 2024; 12:01874474-202406000-00002. [PMID: 38885326 DOI: 10.2106/jbjs.rvw.24.00045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
» Pediatric thoracolumbar trauma, though rare, is an important cause of morbidity and mortality and necessitates early, accurate diagnosis and management.» Obtaining a detailed history and physical examination in the pediatric population can be difficult. Therefore, the threshold for advanced imaging, such as magnetic resonance imaging, is low and should be performed in patients with head injuries, altered mental status, inability to cooperate with examination, and fractures involving more than 1 column of the spine.» The classification of pediatric thoracolumbar trauma is based primarily on adult studies and there is little high-level evidence examining validity and accuracy in pediatric populations.» Injury pattern and neurologic status of the patient are the most important factors when determining whether to proceed with operative management.
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Affiliation(s)
- Lisa Bonsignore-Opp
- Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California
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Topal H, Açıkel SB, Şirin H, Polat E, Terin H, Yılmaz MM, Şenel S. Evaluation of Adolescents' Awareness of Seat Belt Use and the Relationship with Risky Behaviors. CHILDREN (BASEL, SWITZERLAND) 2024; 11:656. [PMID: 38929235 PMCID: PMC11201637 DOI: 10.3390/children11060656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/22/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
The one of the leading causes of adolescent morbidity and mortality worldwide is motor vehicle accidents (MVA). The use of seat belts significantly lowers MVA fatalities and injuries. The aim of this study is to investigate adolescent seat belt usage patterns and relation with risky behaviors. The study conducted at two medical institutions with non-immigrant and literate adolescents aged 12-18. Demographics, seat belt use, and risk-taking behavior were collected through questionnaires. 726 teenagers (422 girls and 304 boys) with an average age of 176.7 ± 23.37 months participated in the study. Parents' educational levels and front-seat belt use have been found to be correlated. Comparatively to non-users, seat belt users demonstrated lower risk scores (total, traffic, substance, and social). The use of seat belts was significantly predicted by traffic risk, according to logistic regression. The frequency of seatbelt use was higher among participants from cities with higher socioeconomic status. As a result, it was found that adolescents who exhibited more risky behaviors had a lower frequency of seat belt use and seat belt use was associated with socioeconomic level and parental education level. It is thought that population-based studies to be conducted on this subject are important.
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Affiliation(s)
- Hatice Topal
- Department of Pediatrics, Faculty of Medicine, Muğla Sıtkı Koçman University, 48000 Muğla, Türkiye;
| | - Sadettin Burak Açıkel
- Department of Child and Adolescent Psychiatry, School of Medicine, Ankara University, 06260 Ankara, Türkiye
| | - Hülya Şirin
- Department of Public Health, Faculty of Medicine, University of Health Sciences Turkey, 06010 Ankara, Türkiye;
| | - Emine Polat
- Department of Pediatrics, Dr. Sami Ulus Training and Research Hospital, 06010 Ankara, Türkiye; (E.P.); (H.T.); (M.M.Y.); (S.Ş.)
| | - Harun Terin
- Department of Pediatrics, Dr. Sami Ulus Training and Research Hospital, 06010 Ankara, Türkiye; (E.P.); (H.T.); (M.M.Y.); (S.Ş.)
| | - Mehmet Mustafa Yılmaz
- Department of Pediatrics, Dr. Sami Ulus Training and Research Hospital, 06010 Ankara, Türkiye; (E.P.); (H.T.); (M.M.Y.); (S.Ş.)
| | - Saliha Şenel
- Department of Pediatrics, Dr. Sami Ulus Training and Research Hospital, 06010 Ankara, Türkiye; (E.P.); (H.T.); (M.M.Y.); (S.Ş.)
- Department of Pediatrics, Faculty of Medicine, Ankara Yıldırım Beyazıt University, 06800 Ankara, Türkiye
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Incidence, prevalence and disability of spinal cord injury in China from 1990 to 2019: a systematic analysis of the Global Burden of Disease Study 2019. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:590-600. [PMID: 36350373 DOI: 10.1007/s00586-022-07441-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/21/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE We aimed to estimate the incidence, prevalence and years lived with disability (YLDs) of spinal cord injury (SCI) in China in 2019 and temporal trends from 1990 to 2019. METHODS The Global Burden of Disease Study 2019 was used to obtain data. Outcome measures included age-standardized incidence rate (ASIR), prevalence rate (ASPR) and YLDs rate (ASYR). A Bayesian meta-regression tool, DisMod-MR 2.1, was used to produce the estimates of each value after adjustments. RESULTS In 2019, there were 234.19 [95% uncertainty interval (UI) 171.84-312.87] thousand incident cases of SCI in China, with an ASIR of 13.87 (95% UI 10.15-18.66) per 100,000. ASIR and ASYR increased by 40.81% (95% UI 32.92-49.14%) and 11.44% (95% UI 5.16-17.29%) compared with 1990, individually. Males had higher ASIR and ASYR in each year from 1990 to 2019, but the incidence and YLDs rates of females exceeded males after 70 years old. Incidence and YLDs rates both ascended with age. SCI at neck level had slightly higher incidence rate but much higher YLDs rate than that below neck level. The average incidence age increased from 38.97 in 1990 to 54.59 in 2019. Falls were the leading cause of SCI. CONCLUSION The incidence and burden of SCI in China increased significantly during the past three decades. The age structure of SCI patients showed a shift from the young to the elderly as population aging. Urgent efforts are needed to relieve the health pressure from SCI.
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