Analysis of length of hospital stay of road crash patients in the Philippine General Hospital’s Integrated Surgical Information Systemfrom 2008–2017

Introduction@#Mobility in the Philippines has increasingly become a major issue especially with the growing economy of the country. Collisions on the road cannot be entirely avoided; thus, we focus our efforts to reducing road crashes that result in death and serious injuries. To do this, we analyzed road crash patients brought to the Philippine General Hospital (PGH). @*Objective@#The study aimed to quantify how crash factors affect length of hospital stay (LOS) of patients brought to PGH, as well as to look for associations between the LOS and demographic and clinical variables. @*Methods@#This is a retrospective study using database of patients admitted in PGH from 2008 to 2017. The study focused on LOS, which was used as the dependent variable for Poisson regression and Kruskal-Wallis H tests. The determinants considered in the study are socio-demographic variables such as age, sex, civil status, victim type, vehicle type, patient classification, and region of incidence, as well as clinical variables such as consult type, outcome of the patient, body parts injured, Glasgow coma score (GCS), among others. @*Results@#We analyzed data of 4979 road crash patients from the PGH database. We found that civil status, age, patient classification, vehicle type, and province were associated with LOS. For the clinical variables, consult type, primary service, outcome of patient, body injuries, GCS and systolic blood pressure were found significant. Poisson regression suggests longer hospital stay for patients with injuries sustained in the head and neck (RR = 1.102, p < 0.001), face (RR = 1.218, p < 0.001), and extremity (RR = 1.673, p < 0.001). @*Conclusion@#Results show that injury sustained in certain parts of the body such as head and neck, face, and extremity significantly affect LOS. Results also show that subgroups within demographic variables affect LOS. There is a need to address the ever-increasing number of road crash patients and implications to length of hospitalization.

Epidemiologic profile of vehicular accident patients in the largest hospital in the Philippines covering ten years

Introduction@#Globally, the number of people who die from road crashes continues to rise, reaching a high of 1.35 million in 2016. Due to this continued increase in fatalities and injuries within the road transport system, especially in low- and middle-income countries, 2011 to 2020 was declared by the United Nations General Assembly in 2010 as the Decade of Action for Road Safety. @*Objectives@#This study looked into the epidemiology of road crashes and injuries in Metro Manila over ten years, from 2008-2017, from data gathered at the Department of Surgery of the Philippine General Hospital (PGH). @*Method@#A retrospective review of patients’ clinical records was conducted to describe the epidemiology of road crash cases in the Trauma Division, Department of Surgery of the PGH. Clinical records of the road crash patients admitted to the division over the ten years, January 1, 2008, to December 31, 2017, were extracted from the Integrated Surgical Information System (ISIS). @*Results@#A total of 422 patients were admitted to the PGH Department of Surgery and recorded in the ISIS database, from 2008 to 2017, who suffered from road crashes in Metro Manila. Most of these patients (80.8%) were male. The mean age of patients was 32.4 years. The highest number of admissions (27.5%) and road crash deaths (6.9%) were in 2016; the highest number was from the city of Manila (26.7%), and most happened at nighttime (61.8%) between 6:00 PM and 5:59 AM. Throughout the years, motorcycle (52.8%) was the vehicle type involved. Among patients with helmet use information, 65.4% were not wearing helmets, 91.2% had a history of alcohol intake. The majority incurred multiple injuries (82.7%), with the external region (53.8%) as the most common. Patients who sustained injuries to their head and neck region were five times more likely to die and six times more likely to have an unchanged patient outcome than those who did not have these injuries. Patients who had a GCS of 8 and below or those who had severe brain injuries were eight times more likely to die and six times more likely to have an unchanged patient outcome. @*Conclusion@#This study looked into the epidemiology of road crash cases admitted to the Surgery Department of the PGH. Road crash injuries and deaths remain a growing concern among the citizens of Metro Manila. It is hoped that the results of this study will provide policymakers with an objective and data-driven perspective on road crashes.

Analysis of human error as a factor in road crash in Metro Manila (2005-2015)

Introduction@#In the Philippines, data on road traffic injuries show that road injury is the 11th leading cause of premature deaths in the Philippines. The World Health Organization estimates that 1.24 million die globally due to road traffic crashes. @*Objectives@#This study aimed to show the trend of the road crash situation in Metro Manila, Philippines, over eleven years (2005–2015) and to analyze human error and other associated hazard factors for road crashes. @*Methods@#This study is a secondary analysis of an 11-year database culled from 2005–2015, for Metro Manila, Philippines. The variables included road crash classification, incidence over months and time of the day, road crash disaggregated by location, region, and city, and type of vehicle. Descriptive statistics were used to describe the incidence of a road crash, road crash fatalities, and risk factors associated with a road crash in Metro Manila. @*Results@#The incidence of road crashes in Metro Manila has increased from 65,111 in 2005 to 95,615 in 2015. Fatalities also increased from 348 to 536. The most predominant type of vehicle involved in road crashes were cars from 46% to 67%, followed by jeepneys, vans, and motorcycles. The most commonly reported human errors were speeding, inattentive and bad turning. The reported percentage of speeding from 2005–2010 ranged between 32% and 58%. In 2014, speeding (96%) was the most reported human error among the other reported errors; such as inattentiveness (range, 28 to 41%) and bad turning (0.6% and 33%). Fatigue and traffic violation made up 0.02% to 0.45% of the reported human factors of road crash-related hospitalization cases in Metro Manila for the period. Suspected alcohol use accounted for 0.04% to 4.57% of the human errors reported. For non-fatal and fatal crashes, the associated human errors were suspected alcohol use, inattentiveness, and speeding. The highest adjusted residual for both fatal and non-fatal (injurious) crashes was for inattentiveness. Human error was associated with years, suggesting that for some years, the number of crashes caused by human errors is significantly higher than expected. Alcohol-suspected crashes are significantly higher than expected for 2005 and 2011, with 2011 having the highest adjusted residual. Inattentiveness-caused crashes were significantly higher than expected for years 2005 to 2010, with 2007 having the highest adjusted residual. Bad turning was significantly higher from 2005 to 2007; while disobedience was significantly higher for 2005 to 2008. Speeding was significantly higher than expected from 2005 to 2010. @*Conclusion@#There is a need to address the public health concern posed by road crashes in Metro Manila, as well as to rectify the ergonomically related risk factors and human error components in a road crash.

Componentes descriptivos y explicativos de la accidentalidad vial en Colombia: incidencia del factor humano / Descriptive and explanatory components of road accident rate in Colombia: Influence of the human factor / Componentes descritivos e explicativos da acidentalidade rodoviária na Colômbia: incidência do fator humano

Problema: Se analizó la incidencia del factor humano en la accidentalidad vial en el territorio colombiano, y se identificó evidencia empírica para la formulación de política pública del tránsito. Metodología: El diseño es descriptivo-correlacional. Instrumentos: cuestionario de comportamiento para conductores y motociclistas (D.B.Q.) y encuesta tipo Likert. Muestra no probabilística intencional: 16.322 personas (8.631 conductores de automotores, 5.133 motociclistas y 2.558 peatones, pasajeros y acompañantes). Resultados: a) conductores con nivel educativo superior inciden en menos accidentes; b) peatones con menor nivel educativo inciden en mayores conductas riesgosas; c) las mujeres tienen actitud positiva y perciben eficacia de campañas en prevencion; d) estilos de conducción iracundo, ansioso, riesgoso y de alta velocidad cometen más infracciones y accidentes; e) desobedecer señales de tránsito, la principal causa de accidentalidad; f) agresividad, hostilidad y estrés en el tránsito son factores que aumentan la probabilidad de accidente; g) campañas de prevención no están siendo captadas por la población más afectada. Conclusiones y recomendaciones: Los factores de accidentalidad vial guardan correspondencia con el Triángulo de Seguridad Vial establecido por la Organización de las Naciones Unidas –factor humano preponderante en la accidentalidad–. Lineamientos de política pública fundamentados en procesos educativos y corporativos tendientes a disminuir la accidentalidad por lo general no se concibe aplicada a la seguridad pública. Por ello, se presenta la inteligencia criminal como una disciplina que se ocupa de anticipar los riesgos criminales contra la seguridad pública. Esto permitiría disminuir la incertidumbre durante la toma de decisiones y calcular los daños contra la seguridad pública, que se pretende prevenir.

Problem: The influence of the human factor on accident rates in the Colombian territory was analyzed, and empirical evidence was identified for the formulation of public traffic policy. Methodology: The design is descriptive-correlational. Instruments: A behavior questionnaire (the D.B.Q.) for car drivers and motorcyclists, and a Likert-type survey. An intentional non-probabilistic sample: 16,322 individuals (8,631 vehicle drivers, 5,133 motorcyclists and 2,558 pedestrians, passengers, and accompanying persons). Results: a) drivers with a higher educational level have a lower impact on the accident rate; b) pedestrians with a lower educational level exhibit more risky behaviors: c) women have a poenfusitive attitude and perceive the effectiveness of prevention campaigns; d) angry, anxious, risky and high-speed driving result in more traffic offenses and accidents; e) disobeying traffic signs is the main cause of accidents; f) aggressiveness, hostility and stress are factors tending to increase the likelihood of traffic accidents; g) prevention campaigns are not being heard by the more affected population. Conclusions and recommendations: The accident rate factors correspond to the Road Safety Triangle established by the UNO –human factor prominent in accident levels–. Public policy guidelines based on educational and corporative processes leading to reduce the accident rate.

Problema: A incidência do fator humano na acidentalidade rodoviária no território colombiano foi analisada e a evidência empírica para a formulação da política pública do tráfego foi identificada. Metodologia: O projeto é descritivo-correlacional. Instrumentos: questionário do comportamento para os motoristas e os motoqueiros (D.B.Q.) e pesquisa tipo Likert. Amostra intencional não-probabilística: 16.322 pessoas (8.631 condutores de automotores, 5.133 motoqueiros e 2.558 pedestres, passageiros e companheiros). Resultados: a) os condutores com nível educativo superior incidem em menos acidentes; b) os pedestres com nível educativo menor incidem em maiores condutas de risco; c) as mulheres têm uma atitude positiva e percebem a eficácia das campanhas na prevenção; d) os estilos de dirigir enfurecido, ansioso, riscoso e da alta velocidade contribuem a cometer mais infrações e acidentes; e) para desobedecer sinalizações rodoviárias, a causa principal da acidentalidade; f) a agressividade, a hostilidade e o stress no tráfego são os fatores que aumentam a probabilidade do acidente; g) as campanhas da prevenção não são captadas pela população afetada. Conclusões e recomendações: Os fatores da acidentalidade rodoviária correspondem ao Triângulo da Segurança Rodoviária estabelecido pelas Nações Unidas – fator humano preponderante na acidentalidade–. Diretrizes da política pública baseadas em processos educativos e corporativos tendentes a diminuir a acidentalidade.