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Kim SC, Lee HJ, Kim JM, Kong SY, Park JS, Jeon HJ, In YN, Kim H, Lee SW, Kim YT. Comparison of epidemiology and injury profile between vulnerable road users and motor vehicle occupants in road traffic fatalities. Traffic Inj Prev 2019; 20:581-587. [PMID: 31329479 DOI: 10.1080/15389588.2018.1539840] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 08/04/2018] [Accepted: 10/19/2018] [Indexed: 06/10/2023]
Abstract
Objective: Road traffic injuries (RTIs) are a major global health issue causing a global burden of mortality and morbidity. Half of all fatalities on the world's roads are vulnerable road users (VRUs). The targeted intervention strategies based on fatality analysis focusing on VRUs can effectively contribute to reducing RTIs. This study aimed to compare VRUs and motor vehicle occupants (MVOs) in terms of epidemiology and injury profile. Methods: We utilized a nationwide, prospective database of RTI-related mortality cases for patients who visited 23 emergency departments between January 2011 and December 2015. All fatalities due to RTIs in the prehospital phase or in-hospital were eligible, excluding patients with unknown mode of transport and those admitted to general wards. The primary and secondary outcomes were fracture injuries and visceral injuries diagnosed using the International Classification of Diseases, Tenth Revision (ICD-10). We compared fracture injuries between VRUs and MVOs using Abbreviated Injury Scale (AIS) 2- and 2+ classification. Results: Among a total 3,694 road traffic fatalities (RTFs), 43.3% were pedestrians, followed by MVOs (27.0%), motorcyclists (18.9), bicyclists (6.6%), and agricultural vehicle users (4.2%). The elderly (>60 years old) accounted for 54.9% of VRU fatalities. RTFs occurred most frequently in the autumn and the VRU group and the MVO group showed significant differences in weekly and diurnal variation in RTFs. The injury severities (AIS 2+) of the head, neck, and thorax were significantly different between the 2 groups (P < 0.05). Head (32.1%) and intracranial (58.6%) injuries were the most common fracture and visceral injury sites for RTFs, followed by the thorax and intrathoracic organs (25.3 and 28.8%, respectively). Conclusions: Elderly pedestrians should be targeted for decreases in RTFs, and road traffic safety interventions for VRUs should be made based on the analysis of temporal epidemiology and injury profiles of RTFs.
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Affiliation(s)
- Sang-Chul Kim
- a Department of Emergency Medicine, Chungbuk National University Hospital , Seowon-gu , Cheongju-si , Chungcheongbuk-do , South Korea
| | - Hae-Ju Lee
- a Department of Emergency Medicine, Chungbuk National University Hospital , Seowon-gu , Cheongju-si , Chungcheongbuk-do , South Korea
| | - Ji-Min Kim
- a Department of Emergency Medicine, Chungbuk National University Hospital , Seowon-gu , Cheongju-si , Chungcheongbuk-do , South Korea
| | - So-Yeon Kong
- b Department of Emergency Medicine, Seoul National University Hospital , Jongno-gu , Seoul , South Korea
| | - Jung-Soo Park
- c Department of Emergency Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital , Jung-gu , Daejeon , Chungcheongnam-do , South Korea
| | - Hyeok-Jin Jeon
- d Department of Emergency Medical Technology, Choonhae College of Health Sciences , Ungchon-myeon , Ulju-gun , Ulsan , South Korea
| | - Yong-Nam In
- a Department of Emergency Medicine, Chungbuk National University Hospital , Seowon-gu , Cheongju-si , Chungcheongbuk-do , South Korea
| | - Hoon Kim
- a Department of Emergency Medicine, Chungbuk National University Hospital , Seowon-gu , Cheongju-si , Chungcheongbuk-do , South Korea
| | - Suk-Woo Lee
- a Department of Emergency Medicine, Chungbuk National University Hospital , Seowon-gu , Cheongju-si , Chungcheongbuk-do , South Korea
| | - Young-Taek Kim
- e Korea Centers for Disease Control and Prevention , Osong-eup, Heungdeok-gu , Cheongju-si , Chungcheongbuk-do , South Korea
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Park GJ, Shin J, Kim SC, Na DS, Lee HJ, Kim H, Lee SW, In YN. Protective effect of helmet use on cervical injury in motorcycle crashes: A case-control study. Injury 2019; 50:657-662. [PMID: 30765183 DOI: 10.1016/j.injury.2019.01.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Helmet use during motorcycle crashes (MCCs) has been shown to reduce traumatic brain injury and mortality. However, preventive effects of its use on cervical spine injury remain controversial. In this study, we evaluated whether helmet use can reduce cervical spine injury during MCCs. PATIENTS AND METHODS A case-control study using data from the Emergency Department-based Injury In-depth Surveillance (EDIIS) registry was conducted. Cases were defined as patients with cervical spine injury [≥2 points in the Abbreviated Injury Scale (AIS)] in MCCs from 2011 to 2016. Four controls were matched to one case with strata which included age and sex from the EDIIS registry. Primary outcome was cervical spine injury, secondary outcome was intensive care unit (ICU) admission, and tertiary outcomes was mortality. Multivariable logistic regression analysis was used to calculate odds ratios (OR) with 95% confidence intervals (CIs) to evaluate the associations between helmet use and related outcomes. RESULTS In total, 2600 patients were analysed; among these, 1145 (44.0%) used helmets at the time of crashes. The helmet group showed lower alcohol consumption and mortality rates than the no helmet group (alcohol: 3.2% vs. 9.2%, respectively, and mortality: 2.4% vs. 7.1%, respectively; p < 0.01). Compared with the no helmet group, the helmet group was less likely to have cervical spine injury [adjusted OR, 0.62 (0.51-0.77)]. In addition, helmet use has been shown to help prevent ICU admission and mortality [adjusted OR, 0.45 (0.36-0.56) and 0.32 (0.21-0.51), respectively]. CONCLUSION Helmet use was found to have significant preventive effects on cervical spine injury during MCCs.
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Affiliation(s)
- Gwan-Jin Park
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Jaeho Shin
- School of Mechanical and Automotive Engineering, Kyungil University, South Korea.
| | - Sang-Chul Kim
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Dae-Seok Na
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Hae-Ju Lee
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Hoon Kim
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Seok-Woo Lee
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
| | - Yong-Nam In
- Department of Emergency Medicine, Chungbuk National University Hospital, South Korea.
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