ABSTRACT
Dooring Bicycle Accidents with Severe Injury Patterns: 10-Year Study of a Level 1 Trauma Center Abstract. Studies in Switzerland, Germany and Austria have shown that, contrary to popular belief, dooring accidents are among the most common bicycle accidents. The resulting injuries are often serious and often lead to hospital admission. All dooring accidents of the Inselspital Emergency Department in Bern between 2012 and 2021 were identified and evaluated retrospectively. The data were generated from the database of the management system (Ecare) of the University Hospital Bern by means of a search query with the German keywords: "Autotüre", "Autotuere", "Dooring" and were anonymised. Most patients were female and on average 34 years old; most injuries occurred to the head and the extremities. Treatment was mostly done on an outpatient basis. The ISS (Injury Severity Score) was an average of 3.5. One of the patients needed emergency surgery. This is the first Swiss study to systematically record and evaluate dooring accidents. Since cycling is a trend, especially in urban areas, and consequently the number of cyclists is constantly increasing, it can be assumed that the number of dooring injuries will also increase and corresponding prevention measures will have to be taken. The current COVID-19 pandemic tends to aggravate the problem, as in the context of infection control the number of cyclists and, consequently, accidents is increasing, especially in urban areas, in the context of infection control. This said, it is crucial to gain more information about the time slots of the accidents and the casualties through appropriate studies in order to take adequate preventive and protective measures.
Subject(s)
COVID-19 , Craniocerebral Trauma , Accidents , Accidents, Traffic , Adult , Bicycling/injuries , Craniocerebral Trauma/epidemiology , Female , Head Protective Devices , Humans , Male , Pandemics , Retrospective Studies , Trauma CentersABSTRACT
Background: As more and more people are travelling abroad, there are also increasing numbers who fall ill or have accidents in foreign countries. Some patients must be repatriated. While it has been reported that the number of repatriations is rising steadily, little is known about patients' characteristics, calling for in depth investigations of this patient group. Methods: We have conducted a retrospective study including 447 patients repatriated to the Emergency Department at the University Hospital (Inselspital) in Bern, Switzerland from 2013-2018. Results: Between 2013 and 2018, the number of repatriated patients increased by 42.6%, from 54 to 77 cases. In total, 59% of these patients were male and the median age was 60 years. Overall, 79% of patients were repatriated from European countries, with the top five countries being Italy, France, Spain, Germany and Austria. About half the cases (51.9%) were caused by illness, the other half by accidents. In total, 127 patients had to undergo surgical intervention abroad; another 194 patients underwent surgery after repatriation. The hospitalization rate was 81.4%, with a median length of in-hospital stay of 9 days (IQR 5-14) at the Inselspital. The mortality rate of at the Inselspital hospitalized patients was 4.4%, with 16 patients dying within the first 30 days after repatriation. The median cost per case was 12,005.79 CHF (IQR 4717.66-24,462.79). A multiple regression analysis showed a significant association of total costs with hospitalization (p = 0.001), surgical intervention (p = 0.001), as well as treatment in the intensive care unit (p = 0.001). Conclusions: The number of repatriations has been continuously increasing in recent years and reached a mean value of more than one case per week at the Inselspital (77 cases per year in 2018). The 30 day-mortality rate of 4.4% and the median cost per case are relatively high, demonstrating a neglected Public Health concern. These findings may provide impetus-not only for further research into repatriations but also for Public Health Promotion strategies.