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Introducción: los traumatismos craneoencefálicos son un reto para los servicios de salud. Recibir desde pregrado una formación en su atención constituye una necesidad. Objetivo: caracterizar la producción científica sobre traumatismo craneoencefálico, publicada en revistas estudiantiles cubanas entre enero de 2015 y junio de 2021. Materiales y métodos: se realizó un estudio bibliométrico, descriptivo y retrospectivo. El universo estuvo constituido por nueve artículos, de los que se analizó tipología, año de publicación, cantidad de autores, provincia y centro de procedencia de los mismos, cantidad de referencias, cantidad de artículos por revista y número de veces citados. Resultados: el 77,8 % de los artículos fueron originales, y 2020 fue el año más productivo (55,6 %). El 44,4 % de los artículos fue firmado por cinco autores; el 32,4 % de los autores pertenecían a la provincia de Pinar del Río. La media de referencias por artículos fue de 19,9; el Índice de Price se encontró entre 0,45 y 0,82, con una media de 0,75. El 55,6 % de las publicaciones aparecieron en la revista Universidad Médica Pinareña, cuyos artículos también fueron los más citados (85 %). Conclusiones: la producción científica estudiantil sobre trauma craneoencefálico es baja, y la influencia y visibilidad de los artículos disponibles, atendiendo a la cantidad de citas, es pequeña.
Introduction: crania-encephalic traumas are a challenge for health services. Receiving training on their care since undergraduate studies is a necessity. Objective: to characterize the scientific production on crania-encephalic trauma published in Cuban student journals between January 2015 and June 2021. Materials and methods: a bibliometric, descriptive and retrospective study was carried out. The universe was constituted by 9 articles, of which typology, year of publication, quantity of authors, province and centers of origin, quantity of references; quantity of articles per journal and number of times cited were analyzed. Results: 77.8% of the articles were originals, and 2020 was the most productive year (55.6%). 44% of the articles were signed by five authors; 32.4% of the authors belonged to the province of Pinar del Rio. The average number of references per articles was 19.9; the Price Index was found between 0.45 and 0.85, with an average of 0.75. 55.6% of the publications appeared in the journal Universidad Médica Pinareña, the articles of which were also the most cited ones (85%). Conclusions: the student scientific production on crania-encephalic trauma is low, and the influence and visibility of the available articles, taking into account the quantity of cites, is small.
ABSTRACT
Introduction. Les pathologies neurochirurgicales sont un ensemble d'affections qui touche le cerveau, la moelle épinière, et les paires crâniennes nécessitant une prise en charge médico-chirurgicale. Leur incidence en Afrique sub-saharienne et plus particulièrement au Gabon est mal connue. Objectif. Décrire les aspects épidémiologiques et évolutifs des pathologies neurochirurgicales chez l'enfant de moins 5 ans à Libreville. Patients et méthodes. Il s'agit d'une étude rétrospective descriptive et analytique, multicentrique portant sur des patients de moins de 5ans pris en charge pour une affection neurochirurgicale de Janvier 2019 à Décembre 2021 à Libreville. Résultats. Sur 4811 enfants hospitalisés, 130 répondaient aux critères d'inclusion (prévalence : 2,7%). L'âge moyen était de 13,1 mois. Le sex-ratio était de 1,3. Les grossesses étaient mal suivies dans 72,2% des cas. Les pathologies neurochirurgicales malformatives représentaient 63,5%. L'hydrocéphalie était la plus observée dans 71,2%. Sur les 115 enfants, 71 ont bénéficié d'un traitement chirurgical, soit un taux de 61,7% et le taux de mortalité globale était de 6,1%. Dans le groupe des enfants présentant une malformation congénitale, 8,2% n'avaient pas été traités, le taux de mortalité était de 8,2%. Les complications à court termes étaient dominées par les infections. Conclusion. Les pathologies neurochirurgicales sont en fréquentes dans notre contexte. Une prise en charge immédiate reste de mise, nécessitant donc un plateau technique de pointe pour améliorer l'évolution à court terme voire à moyen et long terme de ces affections.
Introduction. Neurosurgical pathologies are a set of conditions that affect the brain, spinal cord, and cranial pairs requiring medical and surgical management. Their incidence in subSaharan Africa and more particularly in Gabon is poorly known. Objective. To describe the epidemiological and evolutionary aspects of neurosurgical pathologies in children under 5 years old in Libreville. Patients and methods. This is a retrospective descriptive and analytical, multicenter study of patients under 5 years of age treated for a neurosurgical condition from January 2019 to December 2021 in Libreville. Results. Of the 4811 hospitalized children, 130 met the inclusion criteria (prevalence of 2.7%) and 15 were excluded for incomplete records. The average age was 13.1 months. The age group of 28 days-1 year was the most observed. The sex ratio was 1.3. Pregnancies were poorly followed in 72.2% of cases. Malformative neurosurgical pathologies accounted for 63.5% of cases. Hydrocephalus was the most observed in 71.2%. Of the 115 children, 71 received surgical treatment, a rate of 61.7% and the overall mortality rate was 6.1%. In the group of children with congenital malformation, 8.2% had not been treated, the mortality rate was 8.2%. Short-term complications were dominated by infections. Conclusion. Neurosurgical pathologies are frequent in our context. Immediate care remains essential, therefore requiring a cutting-edge technical platform to improve the short-term or even medium- and long-term evolution of these conditions.
Subject(s)
Humans , Male , Female , Child, Preschool , Spinal Dysraphism , Neurosurgical Procedures , Craniocerebral Trauma , Hydrocephalus , NeurosurgeryABSTRACT
Nowadays, one of the most important health and social policy issues concerning all countries is the problem of road accident rates. Traffic is one of the most important risk factors. For this reason, ridesharing companies have been launching electric scooters in Rome since June 2019 with the aim of reducing car traffic. In the absence of relevant legislations, the risk is that of facing an increase in deaths due to electric scooter crashes. We report the case of an electric scooter accident victim with cranio-encephalic trauma associated with limb injuries that caused immediate death. This case report emphasizes how the obligation of using helmets must be extended to all ages, in order to reduce the risk of increasing the number of deaths. Compulsory helmet use can reduce fatalities in all cases where high-speed crashes are not involved.
Subject(s)
Accidents, Traffic , Head Protective Devices , Humans , Risk Factors , BrainABSTRACT
ABSTRACT: Introduction: According to the world health organization, injuries represent more than 20% of health problems in the world. Head trauma and the absence of neurosurgery and radiology services in less populated areas make it difficult to assess and manage patients with brain injury. Objective: To describe the clinical findings and benefits derived from the implementation of teleradiology in neurotrauma in areas of difficult geographic access. Materials and methods: A systematic search was carried out in Pubmed, Scopus, Ebsco host, Sciencedirect, and Embase, with the thesauri "Teleradiology" and "Craniocerebral Trauma". Results: The decision to intervene in a patient with brain trauma and the period of time until surgery are essential for the clinical outcome. Those centers that use teleradiology require transfers to specialized hospitals, for which portable technological devices contribute to the response time of neurosurgery care. Conclusion: Teleradiology has a positive impact on patients with traumatic brain injury in geographical areas of difficult access, facilitating communication with specialists; providing timely care and optimizing transfers to high complexity centers.
RESUMEN: Introducción: Según la organización mundial de la saludlos traumatismos representan más del 20% de los pro-blemas en salud en el mundo. El trauma craneoencefálico y la ausencia de servicios de neurocirugía y radiología en zonas menos pobladas dificultan la valoración y manejo de pacientes con lesión cerebral. Objetivo: Describir los hallazgos clínicos y beneficios derivados de la implementación de la telerradiología en neurotrauma en áreas de difícil acceso geográfico. Materiales y métodos: Se realizó una búsqueda sistemática en Pubmed, Scopus, Ebsco host, Sciencedirect, y Embase, con los tesauros "Teleradiology" y "Craniocerebral Trauma". Resultados: La decisi-ón de intervenir a un paciente con traumatismo cerebral y el periodo de tiempo hasta la cirugía son fundamentales para el desenlace clínico. Aquellos centros que usan la telerradiología, precisan los traslados a los hospitales espe-cializados, por lo cual los dispositivos tecnológicos portátiles contribuyen en el tiempo de respuesta de la atención en neurocirugía. Conclusión: La telerradiología impacta positivamente en pacientes con trauma craneoencefálico en zonas geográficas de difícil acceso, facilitando la comunicación con especialistas; brindando atención oportuna y optimizando los traslados a centros de alta complejidad. (AU)
Subject(s)
Radiology , Brain Injuries , Teleradiology , Brain Injuries, Traumatic , Craniocerebral TraumaABSTRACT
Among traumas, cranial involvement occupies a special place due to their severity and the importance of the sequelae that they can cause. They are said to be serious when the Glasgow Scale (GCS) ≤ 8. The frequency of severe brain injury in the population in African studies ranges from 3.5 to 7. Mortality is, however, poorly known in developing countries, which led us to initiate this work, which aimed to study the epidemiological, clinical and evolutionary aspects of severe traumatic brain injury in the multipurpose intensive care unit of Gabriel Touré University Hospital. MATERIAL AND METHOD: 24-month retrospective study, descriptive and analytical, including all severe traumatic brain injury patients hospitalized in the resuscitation department of Gabriel Touré University Hospital during this study period. RESULTS: During the periodof 1165 patients admitted to the service, 72 were hospitalized for severe cranio-encephalic trauma for a prevalence of 6%. The age group of 21 - 40 years was the majority with (23) or 44.4% and the average age was 30.93 ± 18.8 years with extremes of 8 months and 79 years.The male sex was predominant with (65) or 90.3%, and a sex ratio of 9.28. During our study, (57) or 79.2% of serious traumatic brain injuries were due to road accidents with motorcycle-motorcycle collisions as a mechanism in (20) or 27.8%. Shopkeepers, and students were the most affected social strata with respectively (22) or 30.6% and (20) or 27.8%. Patient transport was provided by non-medical ambulances for (31) or 43.1% and admission time was between 30 minutes and 6 hours in (16) or 22.2% of cases. (62) or 86.1% had GCS between 6-8 and bilateral mydriasis was present in (10) or 13.9% of patients. (9)or 12.5% of patients had hypotension (systolic blood pressure<90 mm Hg) on admission and average blood pressure<90 mmHg was observed in (32) or 44.4% of patients. (23) or 31.9% had a SPO2 <90%. Cranio-encephalic scanning was performed in 62 or 86.1% and discovered as lesions (25) or 34.9% hemorrhagic contusions followed by extradural hematomas (13) or 18.1%. (63) or 87.5%, patients were intubated-ventilated-sedated in addition to resuscitation. (28) or 38.9% of patients had undergone a surgical intervention with (9) or 12.5% having osmotherapy.The evolution was marked by death of (48) or 66.7%. CONCLUSION: Severe cranio-encephalic trauma represents a major cause of morbidity and mortality. The establishment of pre-hospital medicine will allow better care and reduction of mortality by early and continuous management of ACSOS and respiratory and / or hemodynamic distress, which are very often associated with severe TCE.
Parmi les traumatismes, les atteintes crâniennes occupent une place particulière du fait de leur gravité et de l'importance des séquelles qu'elles peuvent entraîner. Ils sont dits graves quand le score de Glasgow (GCS) ≤ 8. La fréquence des traumatismes crânio-encéphaliques (TCE) graves au sein de la population dans les études africaines varie entre 3,5 et 7. La mortalité est cependant mal connue dans les pays en voie de développement ce qui nous a conduit à initier ce travail qui avait pour objetd'étudier les aspects épidémiologiques, cliniques et évolution des traumatisés crâniens graves au service de réanimation polyvalente du centre hospitalier universitaire Gabriel Touré. MATÉRIEL ET MÉTHODE: Etude, descriptive et analytique à collecte rétrospective s'étant déroulée sur 24 mois, incluant tous les patients traumatisés crânio-encéphaliques graves hospitalisés dans le service de réanimation du centre hospitalier universitaire Gabriel Touré durant cette période d'étude. RÉSULTATS: Durant la période sur 1165 patients admis dans le service.72 ont été hospitalisés pour traumatisme crânio-encéphalique grave soit une prévalence de 6%. La tranche d'âge de 21 - 40 ans était majoritaire avec(32) soit 44,4% et l'âge moyen était de 30,93 ±18,8 ans avec des extrêmes de 8 mois et 79 ans. Le sexe masculin était prédominant avec (65) soit 90,3%, et un sex-ratio de 9,28. Durant notre étude (57) soit 79,2% des TCE graves étaient dus aux accidents de la voie publique avec comme mécanisme les collisions moto-moto dans (20) soit27,8%. Les commerçants, et les élèves et étudiants étaient les couches sociales les plus touchées avec respectivement(22) soit 30,6% et (20) soit 27,8%. Le transport était assuré par des ambulances non médicalisées à(31) soit 43,1% et le délai d'admission était compris entre 30 minutes et 6 heures dans (16) soit 22,2% des cas.(62) soit 86,1% avaient GCS entre 6-8 et une mydriase bilatérale était présente chez (10) soit 13,9 % des patients. (9) soit 12,5% des patients avaient présenté une hypotension (pression artérielle systolique< 90 mm Hg) à l'admission et une pression artérielle systolique ≤ 90 mm Hg avait été observée chez (32) soit 44,4% des patients. Durant notre (23) soit 31,9% avaient une SPO2 < 90%. Le scanner cranio-encéphalique a été réalisé chez (62) soit 86,1% et retrouvait comme lésions, les contusions hémorragiques (25) soit 34,9% suivis des hématomes extraduraux (13) soit 18,1%.(63) soit 87,5% des patients ontété intubés -ventilés-sédatés en plus à des mesures de réanimation. (28) soit 38,9% des patients avaient subi une intervention chirurgicale associée chez (9) soit 12,5% à une osmothérapie. L'évolution a été marquée par une létalité de (48) soit 66,7%. CONCLUSION: Les traumatismes crânio-encéphaliques graves représentent une cause majeure de morbi-mortalité. La mise en place d'une médecine préhospitalière permettra une meilleure prise en charge et la réduction de lamortalité.Par une prise en charge précoce et continue des ACSOS et des détressés respiratoires et/ou hémodynamiques qui sont très souvent associées au TCE grave.
ABSTRACT
OBJECTIVE: To study the epidemiological, clinical and evolutionary aspects of head trauma in children at the emergency room. METHOD: This was a descriptive longitudinal study over 1 year from February 2016 to February 2017, which included any patient aged 0 to 15 years who had cranial trauma The data were collected from a pre-established questionnaire, analyzed by the software (SPSS 22.0, EXCEL and WORD 2010).The chi-square test or Fisher's exact test was used for the statistical analysis, a value <0.5 considered significant. RESULTS: During the study period, 19825 consultations were performed at the emergency service of which 297 cranial trauma occurred in children, ie 1.5%. The male sex was predominant at 68% with a Sex ratio (H / F) = 2.13. The 6-10 age group was the most represented with 39.4%. The students were the most represented with 58.9%. Road accidents were the predominant mechanism of injury with 54.9%. Civil protection transported 29% of the wounded. The motorcycle-pedestrian mechanism was more frequent at 27.6% (n = 82). CT was severe in 17.8% (n = 53) of patients. The photomotor reflex was abnormal in 29% (n = 86). The trauma of the lower limb was associated in 39.3%. Craniosphalic CT with cervical scan was the most performed with 73.8%. The brain lesions were in the majority with 41.1%. The average care time was 9.82h in 54.2%. Exclusive medical treatment was adopted in 91.2% of cases. The tramadol and paracetamol combination was mainly used in analgesia with 78.1% of cases The evacuation of the hematoma was the most used surgical procedure with 65.4%. Hyperthermia was the most represented ACSOS (secondary cerebral aggression of systemic origin) with 6.7%. Death before care accounted for 5.4% (n = 16), hospital death at 12.8% (n = 38). The admission time to UE was 24-48h in 31.6% (n = 168). Prognostic factors were related to Motor Photo Reflex (p = 0.002), mechanism (p = 0.01), Glasgow score
OBJECTIF: Analyser l'aspect épidémioclinique et évolutif des traumatismes crâniens chez l'enfant au service d'accueil des urgences (SAU). MÉTHODE: Etude longitudinale descriptive sur 1 an qui a inclus tout patient âgé de 0 à 15 ans victime de TCE. Les données ont été recueillies à partir d'un questionnaire préétabli, analysées par les logiciels SPSS 22.0, EXCEL et WORD 2010, les tests (chi-carré, Fisher) ont été utilisés pour l'analyse statistique, une valeur < à 0,05 considérée comme significative. RÉSULTATS: 19825 ont été admis au SAU dont 9912 victimes de traumatismes, parmi lesquelles 297 TCE ont été diagnostiqués chez l'enfant soit 1,5%. Le sexe masculin a été prédominant à 68%. La tranche d'âge 6-10 ans a été la plus représentée 39,4%. Les élèves étaient les plus représentés avec 58,9%. Les accidents de la Voie publique ont été le mécanisme lésionnel le plus fréquent 54,9%.La protection civile a transporté 29% des blessés. Le mécanisme moto-piéton a été plus fréquent à 27,6% (n=82). Le TC était grave chez 17.8% (n=53). Le reflexe photomoteur était anormal chez 29% (n=86). Le traumatisme du membre inferieur était associé dans 39,3%. Le taux de réalisation de la TDM cranioencephalique avec balayage cervical a été de 73,8% et a objectivé des lésions cérébrales dans 41,1%.Le délai d'admission au SAU était 31.6% (n=168) entre 24-48h. Le délai de prise en charge chirurgicale moyenne était de 9,82h chez 54.2%. Le traitement médical exclusif a été adopté dans 91,2% des cas. L'association tramadol et paracétamol a été la plus utilisée en analgésie avec 78,1% des cas. Le geste chirurgical a représenté 8,8% à type d'évacuation de l'hématome avec 65,4%. L'hyperthermie était l'agression cérébrale secondaire d'origine systémique (ACSOS) la plus représentée avec 6,7%. Le décès avant soins a représenté 5.4% (n=16), le décès hospitalier était de 12.8% (n=38). Les facteurs pronostiques étaient le réflexe photo moteur (p=0,002), le mécanisme (p=0,01), le score de Glasgow < à 9 (p=0,003), le délai de prise en charge (p=0,002) et l'association d'au moins deux ACSOS. CONCLUSION: le TCE chez l'enfant demeure un véritable problème de santé publique responsable d'une morbimortalité élevée, la prise en charge des ACSOS en pré hospitalier diminuerait significativement cette morbimortalité.
ABSTRACT
El trauma craneoencefálico es una causa frecuente de consulta en los servicios de urgencias, que conlleva un importante aumento en la morbimortalidad en toda la población, especialmente en los adultos jóvenes, con incremento en los costos en los sistemas de salud y en la salud pública con mayor frecuencia cuando hay secuelas. El diagnóstico temprano es vital para un tratamiento adecuado, especialmente quirúrgico, que puede cambiar y alterar el curso natural en la evolución del trauma con la disminución de secuelas. Por esta razón debemos conocer el uso racional y adecuado de las imágenes diagnósticas en el trauma craneoencefálico. [Ochoa SR. Uso de las imágenes diagnósticas en el trauma craneoencefálico. 62].
Traumatic brain injury (TBI) is a frequent cause of consultation in the emergency department, which carries a significant increase in morbidity and mortality of the population, especially young adults, with increased costs in health systems and public health , most often when there are sequels. The neuroimaging techniques can establish the injury presence and its extent, guide surgical planning and less invasive interventions, playing important roles in the acute therapy of TBI. The Imaging also can be important in the chronic therapy of TBI, identifying sequelae, determining prognosis, and guiding rehabilitation. [Ochoa SR. Use of diagnostic imaging in head trauma. MedUNAB 2012; 15:53-62].
Subject(s)
Brain Injuries, Traumatic , Brain Injuries , Diagnostic Imaging , Craniocerebral TraumaABSTRACT
Objetivo: analisar os pacientes submetidos à TC (tomografia computadorizada) em uma clínicaparticular em Manaus AM. Método: abordar pacientes atendidos na urgência que realizaram TCde crânio no horário de sobreaviso, período de outubro/2007 a setembro/2008. Resultados:foram 144 pacientes, 60 do sexo masculino e 84 feminino; 66 não apresentaram achados de TCEou AVC; os traumatizados foram 20. Em relação aos acidentes vasculares, 22 recentes, 15isquêmicos, 02 hemorrágicos e 56 tardios. Discussão: em função da TC de crânio estar disponívele relativa boa sensibilidade, tem se tornado a técnica de escolha para rastreamento de AVCs etraumatismos. Conclusão: os exames de imagem, incluindo a TC são de extrema importânciapara o auxílio na conduta.
Objective: neuroradiology urgencies and emergencies in a private clinic at Manaus, state ofAmazonas are common and include strokes, head trauma, infecctions diseases and less commontumoral processes. This study has the objective of analyse the patients that were submitted tocomputed tomography scan (CT) at Sensumed Clinic. Methods: there were realizedretrospectively every patient that made CT scan during extra time from October 2007 untilSeptember 2008. Results: there were 144 patients, 60 male and 84 female. 66 patients did nothave any radiologic finding for head trauma or stroke. The trauma patients were 20. The strokeswere 22 recent events, including 15 ischemic, 02 hemorragic and 56 late findings. Discussion: asCT scan is a disponible and with relatively good sensibility exam comparing to other exams, thisis the choice for screening at urgencies. Conclusion: we conclude that imaging findings areextremely important for medical conduct.
ABSTRACT
O estudo teve como objetivo identificar fatores desencadeantes, comprometimentos clínicos e/ou neurológicos de pacientes admitidos em um hospital público municipal. Optou-se pela abordagem quantitativa, retrospectiva de natureza documental, investigando uma amostra de 1.205 pacientes admitidos entre janeiro e dezembro de 2006. A coleta de dados deu-se combase em um formulário semiestruturado e estes foram organizados, codificados e analisados no Epi-Info. Os resultados evidenciaram a prevalência do sexo masculino 80,2 porcento, faixa etária entre 15 e 24 anos 23,2 porcento, procedência do interior 50,4 porcento, o acidente de trânsito 60,2 porcento como principais responsáveis pelo TCE, ocorrendo em via pública 45,1 porcento, nos horários de 12 as 18 34,3 porcento e aos domingos 24,9 porcento. Nestas casuísticas, o socorro foi realizado por leigos em 70,9 porcento,o tempo resposta para o atendimento foi superior a 3 horas em 39,4 porcento, e 53,4 porcento permaneceram inconscientes após o acidente. O tempo de permanência hospitalar foi menor que 24 horas em 25,6 porcento dos casos, a alta melhorada ocorreu em 85,6 porcento dessas admissões. O trabalho reafirma as ocorrências de acidentes de trânsito como a maior causa dos atendimentos internações no setor saúde. Aproximar-se da epidemiologia desse grave problema é imprescindível para a reformulação de políticas públicas com enfoque preventivo e educativo
The aim of the study is to identify the main triggering factors, clinical and or neurological complication of patients admitted in a municipal hospital. A quantitative approach, characterized as retrospective and documentary was chosen, investigating a sample of 1,205 patients admitted between January and December 2006. Data collection was carried out using a semi-structured form and it was organized, codified and analyzed in the Epi-Info analysis.The results show a male prevalence 80.2 porcent, aged 15 to 24 years 23.2 porcent, from the countryside50.4 porcent, whose main trauma etiologies were a traffic accident 60.2 porcent, occurring on public roads 45.1 porcent, from midday to six p.m. 34.3 porcent, and Sundays 24.9 porcent. They were helped by outsiders 70.9 porcent the response to the assistance was above 3 hours in 39.4 porcent of the cases, and 53.4 porcent of them remained unconscious after the accident. The time of permanence in the hospital was below 24 hours in 25.6 porcent and discharge due to improvement was given in 85.6 porcent of these admissions. This paper reasserts the occurrences of traffic accidents as the greates cause of attendances internments in the health sector. Take a closer look at the epidemiology of the serious problem is essential to reformulate public policies with a preventive and educational focus.
El estudio tiene como objetivo identificar factores desencadenantes, comprometimientos clínicos y o neurológicos de pacientes admitidos en un hospital público municipal. Se optó por un abordaje cuantitativo, retrospectivo de naturaleza documental, investigando una muestra de 1.205 pacientes admitidos entre enero y diciembre de 2006. La colecta de dados se dió con base en un formulario semiestructurado y estos fueron organizados, codificados y analisados en el Epi-Info. Los resultados evidenciaron el predominio del sexo masculino 80,2 por ciento, franja de edad entre 15 y 24 años 23,2 por ciento, procedencia de otras províncias 50,4 por ciento, el accidente de tránsito 60,2 por ciento como principales responsables por el TCE, ocurriendo en vía pública 45,1 por ciento, en los horarios de las 12 a las 18 horas 34,3 por ciento y a los domingos 24,9 por ciento. En estos casos, el socorro fue realizado por legos en 70,9 por ciento, en 39,4 por ciento, el tiempo derespuesta para el socorro fue superior a 3 horas y 53,4 por ciento permanecieron inconscientes después del accidente. El tiempo de permanencia hospitalario fue menor que 24 horas en 25,6 por ciento de los casos, la alta mejorada ocurrió en 85,6 por ciento de esas admisiones. El trabajo reafirma las ocurrencias de accidentes de tránsito como la mayor causa de los atendimientos internaciones en el sector de la salud. Aproximarse de la epidemiología de ese grave problema es imprescindible para la reformulación de políticas públicas con enfoque preventivo y educativo
