An Examination of Child Pedestrian Rule Compliance at Crosswalks around Parks in Montreal, Canada

The Impact of Age Differences and Injury Severity on Pedestrian Traffic Crashes: An Analysis of Clinical Characteristics and Outcomes

Background/Objectives: The incidence of pedestrian traffic injuries is an escalating concern for public health worldwide. Particularly in fast-developing nations, such as Saudi Arabia, these injuries form a significant portion of trauma-related healthcare challenges. This study aims to explore age-specific differences in trends, seasonal variations, and the overall impact of pedestrian traffic injuries in Riyadh, Saudi Arabia, with a focus on injury characteristics and clinical outcomes. Methods: The study conducted a retrospective analysis using data from the Saudi Trauma Registry (STAR) covering the period between August 2017 and December 2022. It employed descriptive statistics, chi-square tests, and multivariable linear regression analyses to explore demographic trends, characteristics of injuries, and hospital-based outcomes. Results: This study analyzed data from 1062 pedestrian injury cases, revealing key demographic and clinical patterns. Most incidents occurred on weekdays (71.9%) and during nighttime hours (63.3%), with seasonal peaks observed from April to June (30.4%). The lower extremities (27.5%) and head (21.3%) were the most frequently injured body regions. ICU admissions were more common among individuals aged 30-40, females, and those with head or chest trauma, while higher in-hospital mortality was associated with patients over 60 years old, transport by private or police vehicles, and extended ICU and hospital stays. Approximately 25.6% of cases required ICU care, with an overall in-hospital mortality rate of 4.9%. Conclusions: This study provides an in-depth analysis of pedestrian traffic injuries treated at a trauma center in Riyadh, highlighting significant demographic, temporal, and clinical patterns. Understanding these trends is essential for optimizing resource allocation and improving emergency care outcomes. Furthermore, the identified age-specific risk factors and seasonal variations underscore the critical need for targeted interventions and policy enhancements to improve road safety and reduce the burden of pedestrian injuries.

Navigating Risk: A Comprehensive Study on Pedestrian-Vehicle Collision Factors

INTRODUCTION

While older adults, young children, and individuals with psychiatric illnesses are commonly believed to be most susceptible to becoming pedestrians struck by motor vehicles (PSMV), substantial empirical evidence is lacking. This study aimed to discern the risk factors predisposing trauma patients requiring hospital evaluation to being struck by a vehicle.

METHODS

The 2017-2021 Trauma Quality Improvement Program database was queried for all blunt trauma patients. Two groups were compared: PSMV and those presenting with other blunt trauma mechanisms. A multivariable logistic regression analysis was performed to identify predictors for PSMV and to analyze the risk difference between children (age <12 y), adolescents (12-17 y), and elderly patients (≥65 y) compared to adults (18-64 y).

RESULTS

Of 4,769,055 blunt trauma patients, 174,314 (3.7%) were PSMV. The pedestrian struck cohort had increased rates of lung injuries (20.8% versus 10.6%, P < 0.001) and rib fractures (24.0% versus 16.4%, P < 0.001), as well as overall complications (8.3% versus 4.3%, P < 0.001). On multivariable analysis, children (odds ratio [OR] 0.87, confidence interval [CI] 0.85-0.88, P < 0.001) and elderly patients (OR 0.36, CI 0.36-0.37, P < 0.001) were less likely to present as a pedestrian struck compared to adult patients. The strongest independent associated risk factor for PSMV was substance use disorder (OR 2.13, CI 2.09-2.16, P < 0.001), followed by alcohol use disorder (OR 1.21, CI 1.19-1.23, P < 0.001) and psychiatric illness (OR 1.12, CI 1.11-1.14, P < 0.001).

CONCLUSIONS

This study found that substance use disorders and psychiatric illness were the strongest predictor of PSMV among trauma patients. Surprisingly, children and the elderly were less likely to present as a PSMV compared to other blunt mechanisms, challenging prevailing beliefs. A 2-fold increase in complications and nearly 3-fold increase in mortality after PSMV highlights the need for both pedestrians and drivers to exercise caution in shared spaces and increased efforts for primary prevention.

Identifying the key characteristics, trends, and seasonality of pedestrian traffic injury at a major trauma center in Saudi Arabia: a registry-based retrospective cohort study, 2017-2022

BACKGROUND

Pedestrian traffic injuries are a rising public health concern worldwide. In rapidly urbanizing countries like Saudi Arabia, these injuries account for a considerable proportion of trauma cases and represent a challenge for healthcare systems. The study aims to analyze the key characteristics, seasonality, and outcomes of pedestrian traffic injuries in Riyadh, Saudi Arabia.

METHODS

This study was a retrospective cohort analysis of all pedestrian traffic injuries presented to King Saud Medical City, Riyadh, and included in the Saudi Trauma Registry (STAR) database between August 1, 2017, and December 31, 2022. The analysis of metric and nominal variables was reported as mean (standard deviation, SD) or median (interquartile range, IQR) and frequencies (%), respectively. A logistic regression analysis was performed to examine the influence of patients' pre-hospital vitals and key characteristics on arrival at the ED on the need for mechanical ventilation and in-hospital mortality.

RESULTS

During the study period, 1062 pedestrian-injured patients were included in the analysis, mostly males (89.45%) with a mean (SD) age of 33.44 (17.92) years. One-third (35.88%) of the patients were Saudi nationals. Two-thirds (67.04%) of the injuries occurred from 6 p.m. until 6 a.m. Compared to other years, a smaller % of injury events (13.28%) were noticed during the COVID-19 pandemic (2020). Half (50.19%) of the patients were transported to the emergency department by the Red Crescent ambulance, and 19.68% required intubation and mechanical ventilation. Most of the patients (87.85%) were discharged home after completion of treatment, and our cohort had a 4.89% overall mortality. The logistic regression analysis showed the influence of patients' pre-hospital vitals and key characteristics on arrival at the ED on the need for mechanical ventilation (Chi2 = 161.95, p < 0.001) and in-hospital mortality (Chi2 = 63.78, p < 0.001) as a whole significant.

CONCLUSION

This study details the demographic, temporal, and clinical trends of pedestrian traffic injuries at a major Saudi trauma center. Identifying high-risk individuals and injury timing is crucial for resource allocation, targeting road safety interventions like public awareness campaigns and regulatory reforms, and improving prehospital care and patient outcomes.