Facial Trauma Prevalence from Traffic Accidents in the City of Cuenca - Ecuador, 2017 / Prevalencia de Trauma Facial por Accidentes de Tránsito en el Año 2017 en la Ciudad de Cuenca-Ecuador

Trauma is defined as physical damage by the use of external force towards the human body. (Salazar et al., 2019). The etiology of facial trauma is multifactorial. Contusions caused by traffic accidents constitute the eighth cause of death worldwide. The aim of this study is to determine the prevalence of facial trauma due to vehicular accidents in 2017, and its relationship with age, gender and frequency in the level of emergency care at Vicente Corral Moscoso (VCMH) and José Carrasco Arteaga (JCAH) hospitals. In this way, real statistical information will be registered related to the degree of trauma, main causes and initial management, providing elements for the planning and execution of new studies, thus establishing prevention measures in the city of Cuenca. This is a retrospective descriptive study, carried out with data collection and authorized analysis of cases of patients diagnosed with facial trauma due to vehicular accidents who attended VCMH and JCAH emergency units in Cuenca Ecuador, in 2017. Variables were analyzed: hospital operating units, gender, age, type of facial trauma distribution, type of vehicle and ethylic status. The total prevalence of facial trauma due to vehic ular accidents in the city of Cuenca in 2017 was 3.34 % from which, the male gender exceeded the female group, representing a 69.76 %, being the 20 to 44-year-old-group more prevalent with a 57.56 %. Panfacial trauma predominated representing a 28.48 %. The kind of vehicle which was commonly used up to a 65.69 % was an automobile. Ethyl breath was detected in 38 % of the patients. A predominance of Panfacial trauma was evidenced in the male sex and in the age group of 20-44. The kind of vehicle which was commonly used was the automobile. Ethyl status was verified in 4 of 10 patients.

El trauma es definido como un daño físico por el empleo de fuerza externa, hacia el cuerpo. (Salazar et al.). La etiología del trauma facial es multifactorial. Las contusiones causadas por accidentes de tránsito, constituyen la octava causa de muerte a nivel mundial. El objetivo de este estudio es determinar la prevalencia de trauma facial por accidente vehicular en el año 2017, y su relación con; la edad, género y frecuencia en el nivel de atención de urgencias en los hospitales Vicente Corral Moscoso (HVCM) y José Carrasco Arteaga (HJCA). De esta forma se registrará información estadística real en relación al grado de trauma, sus causas principales y manejo inicial proporcionando elementos para la planificación y ejecución de nuevos estudios, estableciendo así, medidas de prevención en la ciudad de Cuenca. Este es un estudio descriptivo retrospectivo, realizado con la recopilación de datos y el análisis autorizado de los casos de pacientes diagnosticados con trauma facial por accidente vehicular que acudieron a la unidad de urgencias del HVCM y HJCA, Cuenca Ecuador, en el año 2017. Fueron analizadas las variables: unidad operativa hospitalaria, distribución de género, edad, tipo de trauma facial, tipo de vehículo y estado etílico. La prevalencia total de trauma facial por accidente vehicular en la ciudad de Cuenca en el año 2017 fue de 3.34% de los cuales, el sexo masculino supera al grupo femenino representando el 69.76 %, siendo el grupo etario de 20 a 44 años el más prevalente con 57.56 %. Predominó el trauma panfacial, representando un 28.48 %. El vehículo de uso común fue el automóvil en un 65.69 %. En el 38 % de los pacientes se detectó aliento etílico. Se evidenció predominio del sexo masculino y del grupo de edad entre 20-44; predominó el trauma panfacial. El vehículo de uso frecuente fue el automóvil. En 4 de 10 pacientes se comprobó estado etílico.

Abdominal organ involvement in blunt injuries.

Visceral injuries of the abdomen following blunt trauma present a great medico-legal problem to the forensic experts. Thus the doctor should remain alert to the development of signs and symptom after blunt trauma to the abdomen in vehicular accident otherwise he may be charged of negligence. Among 55 fatal cases of blunt abdominal injury, maximum number of cases belongs to the age group 20-29 yrs. Males were the predominant victims with ratio 4:1. It was found that road traffic accidents by heavy vehicle like bus; car and truck were responsible for 70% of blunt abdominal injuries. Among 55 cases of blunt injury, the incidence of the involvement of liver, spleen, small intestine, kidney, stomach and urinary bladder were 67%, 30.91%, 18%, 10.9%, 9.09%, 5% cases respectively. Genitals were found injured in 3% cases of blunt injury abdomen. For Blunt Injuries of Abdomen majority of the cases i.e. 78.18% were of accidental, 18.18% were homicidal and 3.6% suicidal in nature. Immediate cause of death was shock and hemorrhage and in those cases where death was delayed, cause of death was septicemia.

A postmortem study of blunt cardiac injuries.

35 cases of blunt cardiac trauma following vehicular accidents brought for autopsy to the morgue of Regional Institute of Medical Sciences, Imphal have been studied to find out types of cardiac injuries, their association with sternal and rib fractures, mechanism of causation, risk factors, etc. It was observed that 48.57% of the cases with blunt cardiac trauma had associated sternal and rib fractures. Maximum number (60%) of the cardiac rupture was seen in run-over cases. 40% of the cases had injury to the right ventricle. All the injuries were located on the anterior surface of the heart. In one (2.86%) case, laceration of the right atrium without any external injury of the chest region was observed. In assessing blunt cardiac trauma victims in vehicular accidents, knowledge about the commonest sites, types and degrees of injuries as has been highlighted in the present study will be of great help in a timely intervention.

Pattern of fatal head injuries due to vehicular accidents in manipal.

Head injury is an important cause of mortality worldwide as head is the most vulnerable part of the body involved in fatal road traffic accidents. The present study was undertaken on 100 victims of Road Traffic Accident who died due to injuries sustained to the head, which were autopsied at Kasturba Medical College, Manipal over a period of 3 years between January 1995 and December 1997. Most of the accidents had taken place in the afternoon hours (12.01 - 18.00 hrs). There was a marked male preponderance (89 %). The most vulnerable age group to accidents was found to be 21 to 30 years. Both pedestrians and occupants were equally involved. Two-wheeler occupants were most commonly involved. Head injury was present in 82 % of cases with skull fracture in 62 %. Fracture of the vault was found in 38 %, base of the skull in 34 % and both in 28 % of cases. In most of the cases, fissured fracture was found (57 %). Among intra-cranial haemorrhages, subdural haemorrhage was found in 77 % and subarachnoid haemorrhage in 55 % of cases. Contusions and lacerations of brain were found equally in 35 % of cases.