Injury patterns in elderly cyclists and motorcyclists presenting to a tertiary trauma centre in Singapore

INTRODUCTION@#With Singapore's ageing population, there are increasing numbers of elderly cyclists and motorcyclists. Compared to younger riders, this cohort sustains more injuries and has poorer outcomes. This study aimed to describe and compare patient demographics, injury patterns and outcomes among elderly cyclists and motorcyclists at a Level 1 trauma centre.@*METHODS@#Data of all cyclists, motorcyclists and pillion riders aged 65 years and above who presented to the emergency department after accidents from 1 January 2013 to 31 December 2017 was extracted from the hospital's trauma registry and reviewed.@*RESULTS@#Cyclists and motorcyclists formed 42.0% and 58.0%, respectively, of 157 recruited patients. At the time of the accident, 40.8% of the patients were employed. The mean age of the patients was 71.6 ± 5.8 years. Extremities and pelvic girdle injuries (61.1%) were the most frequent, followed by chest injuries (48.4%), and head and neck injuries (40.1%). Among severe injuries (defined as Abbreviated Injury Scale score ≥ 3), chest injuries (39.5%) were the most common, followed by head and neck injuries (36.3%). The overall mortality rate was 9.6%, with cyclists at nearly three times the risk compared to motorcyclists. More cyclists than motorcyclists (18.2% vs. 11.0%) required intensive care. There were no significant differences in the length of hospital stay between cyclists and motorcyclists.@*CONCLUSION@#Elderly riders have unique injury patterns and consume significant healthcare resources. Trauma systems need to acknowledge this changing injury epidemiology and equip trauma centres with the necessary resources targeted at elderly patients. Future work should focus on strategies to minimise extremity and chest injuries.

Accidentes de moto: costo médico/económico en un hospital municipal de la Ciudad de Buenos Aires / Motorcycles accidents: medical and economic cost at a public hospital in Buenos Aires City

A nivel mundial, los accidentes de tránsito aportan aproximadamente 1.25 millones de muertes anuales; es una de las principales causas de muerte en personas jóvenes y la primera entre los 15 y 29 años de edad. La tasa de accidentes aumentó en la última década, posiblemente debido al incremento del parque automotor y del uso de motocicletas. Se realizó un estudio retrospectivo descriptivo sobre los casos atendidos en el Hospital Carlos G. Durand, Buenos Aires (CABA), Argentina, desde enero de 2013 hasta diciembre de 2015, con el objetivo de representar el costo médico que estos generan en nuestro Hospital. De un total de 4368 pacientes atendidos en guardia, a causa de accidentes de tránsito, el 67% (2926 pacientes) fue provocado por motocicletas, de estos, el 18% requirió internación. Hubo predominio de varones y de lesiones en miembros inferiores. Las internaciones variaron entre 5 y 150 días, con 2.1 cirugías promedio por paciente. El gasto total del tratamiento fue de 16 767 037$, lo que en 2014 representaban unos 17 936 US$ por paciente. Estos resultados reflejan parcialmente el costo de dichos accidentes, ya que no se tiene en cuenta otros parámetros como la caída de días laborales; es por esto que se debe generar conciencia y crear políticas de prevención y educación vial más rigurosas, necesarias para poder evitar los accidentes que incrementan el gasto en afecciones evitables.

Traffic accidents cause 1.25 million deaths per year worldwide, being one of the leading causes of death in young people, and the first cause between the ages of 15 - 29. There has been an increase in accidents in the last 10 years, one of the reasons for this is the increase in the sales of motorcycles and its use. We present a retrospective study about the patients who received attention at Carlos G. Durand Hospital, (CABA, Buenos Aires , Argentina) from January 2013 to December of 2015, with the intention of showing the medical and economic impact this accidents cause. Of a total of 4368 incoming patients assisted, due to traffic accidents, 67% (2926) were the result of motorcycle crashes; 18% of them required hospitalization. Males, and lower limbs lesions were predominant. Hospitalizations varied between 5 and 150 days, with 2.1 average surgeries per patient. The total cost was 16 767 037$, and in 2014 it represented 17 936 US$ per patient. These results show only partially the impact these accidents produce, because there are factors (like missing working days) that were unaccounted for. This is why it is necessary to generate awareness and develop more rigorous road safety and prevention policies, necessary to avoid accidents that increase spending on preventable conditions.

Trends in hospitalizations due to motorcycle accidents involving men aged 20 to 39 years in the state of Santa Catarina - Southern Brazil / Tendência das internações por acidentes motociclísticos em homens de 20 a 39 anos no Estado de Santa Catarina - Sul do Brasil

Abstract Introduction Motorcycles accidents are responsible for most of the injuries due to external causes and consequent high hospitalization rates. Objective This study aimed to analyze the temporal trend in motorcycle accident morbidity among young male adults in the State of Santa Catarina. Methods This is an ecological study on motorcycle accident morbidity in men aged 20 to 39 years in the State of Santa Catarina between 1998 and 2012. Data from the Hospital Information System of the Brazilian Unified Health System were used in the study. Specific hospital morbidity rates adjusted for age, age group and geographical region, were calculated to analyze the temporal trend in the State through regression model estimates obtained using the Joinpoint program. Results A total of 19.889 hospital admissions for motorcycle accidents occurred in the State of Santa Catarina in the period studied, with a significant increase of 10.9% per year. In the studied age groups, the 20-29 year old group increased 9.7% per year, whilst the 30-39 year old group increased 13.7%. Except for Foz do Rio Itajaí, all geographical regions of the state showed a significant increase of morbidity. Conclusion There has been an increasing trend of morbidity for motorcycle accidents in State of Santa Catarina. These results show the need for improvement of policies to reduce the causes of this type of accident.

Resumo Introdução Os acidentes motociclísticos são responsáveis por grande parte dos agravos devido a causas externas e ocasionam altas taxas de internação. Objetivo Este estudo objetivou analisar a tendência temporal de morbidade dos acidentes motociclísticos em adultos jovens do sexo masculino. Métodos Estudo ecológico da morbidade por acidentes motociclísticos em homens de 20 a 39 anos no Estado de Santa Catarina entre os anos de 1998 e 2012. Os dados são oriundos do Sistema de Informações Hospitalares do Sistema Único de Saúde. Calcularam-se as taxas específicas de morbidade hospitalar, ajustadas por idade, faixa etária e macrorregião, para analisar a tendência temporal no Estado por meio das estimativas de modelos de regressão pelo programa Joinpoint. Resultados Houve incremento médio significativo de 10,9% ao ano. Nas faixas etárias estudadas, a de 20-29 anos apresentou aumento anual de 9,7%, enquanto a de 30-39 anos, 13,7%. Com exceção da Foz do Rio Itajaí, todas as macrorregiões apresentaram aumento significativo na taxa de morbidade. Conclusão Houve aumento da tendência de morbidade por acidente motociclístico no Estado. Os resultados demonstram necessidade de aprimoramento das políticas de redução dessa causa de acidentes.

Motorcycle related cranio-maxillofacial injuries at a tertiary hospital in the Philippines

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To describe the type and determine the number of motorcycle related cranio-maxillofacial injuries that were seen by the ORL service in the emergency room of a tertiary hospital from January 2013 to December 2013.<br /><strong>METHODS: </strong> <br /><strong>Design:</strong> Cross sectional retrospective chart review<br /><strong>Setting:</strong> Tertiary National University Hospital<br /><strong>Participants:</strong> One hundred nine (109) charts of patients seen atr the emergency room from Jnuary 2013 to December 2013 were reviewed<br /><strong>RESULTS:</strong> Of the 109 charts of patients involved in vehicular accidents, there were 76 documented cases of motorcycle related accidents. Of these, 91% involved males and 9% involved females. Seventy one percent (71%) did not wear helmets of whom 36% were young adult males between the ages of 18-30 years. Those that wore helmets had a total of 27 different facial fracture sites: 19% zygomatic tripod fractures, 15% temporal bone fractures and 11% with no fractures noted. Among those who did not wear helmets 75 fractures were noted. Twenty four percent (24%) were tripod fractures, 15% temporal bone fractures and 12% maxillary fractures. only one did not incur any fractures.<br /><strong>CONCLUSION:</strong> Most cranio-maxillofacial fractures seen at the emergency room were from motorcycle related injuries (70%). Despite implementation of Republic Act 10054 (The Motorcycle Helmet Act of 2009) majority of motorcycle-related accidents are still incurred by riders without helmets.</p>

Acidentes de motocicleta no município de Rio Branco: caracterização e tendências / Motorcycle accidents in the municipality of Rio Branco in the State of Acre: characterization and trends

O objetivo foi caracterizar os acidentes de trânsito com motocicleta, suas vítimas e o crescimento da frota, comparado-os às ocorrências com os demais tipos de veículo, em Rio Branco, Acre. Trata-se de um estudo, descritivo e transversal. Abrangeu os acidentes ocorridos entre 2005 e 2008 notificados pelo Departamento Estadual de Trânsito do Estado do Acre. No quadriênio foram observados 3.582 acidentes com motocicleta e 3.768 vítimas. A frota de motocicletas teve um crescimento de 72,8%, com uma taxa de envolvimento em acidentes com um aumento de 42,2%, enquanto os demais tipos de veículo tiveram uma elevação de apenas 9,2%. Quanto às vítimas, há predominância do sexo masculino, os grupos etários de 20 a 29 e de 30 a 39 anos foram os de taxas mais elevadas. Quanto às características dos acidentes, o período da tarde destacou-se com 1.162 (32,4%), seguido da manhã com 1.046 (29,2%) e noite com 1.035 (28,9%). O sábado se apresentou com 657 (18,3%) e domingo com 563 (15,7%). As colisões/abalroamento foram o tipo de acidente mais comum, com 3.036 (84,8%) registros. São primordiais a efetivação contínua de programas preventivos e maior integralidade entre as instituições envolvidas, com planejamento e execuções, capazes de modificar o cenário atual.

The scope of this paper is to assess traffic accidents involving motorcycles, the victims involved and the increase in the fleet compared with other vehicles in Rio Branco, State of Acre. It is an epidemiological, descriptive and transversal study of accidents between 2005 and 2008 recorded by the Acre State Highway Department. There were 3,582 motorcycle accidents and 3,768 victims in the period. The motorcycle fleet increased by 72.8%, with involvement in accidents increasing by 42.2%, while accidents involving other vehicles only increased by 9.2%. As regards victims, there is a predominance of men, with rates of 561.1, with the age groups of between 20 and 29 and 30 and 39 being the highest, with 755.4 and 542.2, respectively. With reference to accident characteristics, the highest number of accidents - 32.4% - occurred in the afternoon, followed by the morning with 29.2% and the evening with 28.9%. 18.3% occurred on Saturdays and 15.7% on Sundays. Collisions were the commonest kind of accident, with 3,036 (84.8%) occurrences. The conclusion drawn is that it is essential to stage ongoing preventive programs and ensure greater integration among the institutions involved, with planning and campaigns to reverse the current situation.

Motociclistas vítimas de acidentes de trânsito no município de maringá: magnitude e características / Motorcyclits who are victims of traffic accident in the City of Maringá: magnitude and characteristics

Com o objetivo geral de evidenciar as características epidemiológicas dos motociclistas, envolvidos em acidentes de trânsito, no Município de Maringá-Paraná, foram analisadas 446 vítimas atendidas pelo Sistema Integrado de Atendimento ao Trauma e Emergência (SIATE). Desse total de vítimas, 206 (46,19%) eram motociclistas e o restante pertencia a outras categorias (240). Os resultados mostraram que os motociclistas diferenciaram-se das demais vítimas em relação às variáveis: idade, posição no veículo, tipo de acidente, período do dia em que ocorreu o acidente e destino após atendimento. Os motociclistas foram as vítimas mais freqüentes na faixa etária de >/ 23 e <32 anos. Foram minoria entre mulheres com idade >/ 32 e homens com idade >/ 50 anos. Os passageiros de motocicleta foram menos freqüentes que dos demais veículos (38,38% e 61,62% respectivamente). As vítimas mais freqüentes de quedas foram os motociclistas (60,32%). Quando considerado o período do dia e dia da semana da ocorrência do acidente, observou-se que da segunda à quinta-feira os motociclistas estiveram predominantemente em ocorrências entre 12 e 17h59min horas. Na sexta feira e sábado, ocupantes de motocicleta foram freqüentemente envolvidos em acidentes ocorridos nesse horário e também entre 18 e 23h59min horas. Os motociclistas encaminhados para hospitais menos especializados na assistência aos traumatizados foram em menor freqüência comparativamente às demais vítimas. A recusa de atendimento também foi menos freqüente entre motociclistas (35,00%).

Aimig at showing the epidemiological characteristics of motorcyclists involved in traffic accidents in the City of Maringá - 446 victims who were seen by Integrated System of Trauma Assistance and Emergency (ISTAE) were analyzed. Out of this total of victms, 206 (46,19%) were motorcyclists whereas the others belonged to other categories (240). The results showed that motorcyclists distinguished from the other other victims regarding: age, place, in the vehicle, kind of accident, period of the day when the accident happened, and what happened after being seen. Motorcyclists were the most frequent victims in the age group >/ 23 and <32 years old. They were the minority among women at age >/ 32 and men at age >/ 50 years. Pillion passengers were less often than those riding other vehicles (38,38% and 61,62% respectively). Victims who more often experienced falls were motocyclists (60,32%). When the period of the day and the weekday the accident happened were taken into account, it was observed that from Monday to Thursday motorcyclists were predominantly involved in accidents that happened between 12 p.m. and 5:59 p.m. On Fridays and Saturdays, motorcycle´s riders were often involved in accidents happening at the same time mentioned above and also between 6 p.m and 11:59 p.m. Motorcyclists were referred to less specialized hospitals in dealing with trauma less often than the other victims. Assistance refusal we also less often among motorcyclists (35,00%).