Objective: Though motor vehicle crashes (MVCs) were the main cause of head trauma from road traffic injuries (RTIs), motorcycle crashes (MCCs) are now a major cause of RTI-related head injury (HI) in many developing countries.
Methods: Using a prospective database of HIs from a neurosurgical practice in a sub-Saharan African developing country, a cross-sectional survey was conducted for the trauma demography and clinical epidemiology of this MCC-related HI.
Results: Motorcycle crashes accounted for 57% (473/833) of all RTI-related HIs in this registry. The victims, with a mean age of 33.1 years (SD = 18.3), consisted mainly of males (83.1%), those of low socioeconomic status (>90%), and those aged between 20 and 40 years old (56%). MCCs involved only riders in 114 cases (114/473, 32.1%), of which 69% were motorcycle–motorcycle crashes. The HI was moderate–severe in 50.8%; clinical symptomatology of significant HI included loss of consciousness (92%), anisocoria (35%), Abbreviated Injury Scale head (AIS–head) score > 3 (28%), and CT-Rotterdam score > 3 (30%). Extracranial systemic injury involved the limbs most frequently, with an Injury Severity Score (ISS) >25 in 49%. The fatality rate was 24%.
MCC-related HI among pedestrian victims involved more vulnerable age groups (the young and elderly) but have lower mean ISS compared to motorcycle passengers (mean ISS = 23.5 [11.6] vs. 27.4 [13.0]; 95% confidence interval [CI], 1.27–6.49; P = .004). In addition, compared to a contemporary cohort of MVC-related HIs in our registry, MCC victims were older (mean age 34.8 years [18.0] vs. 30.8 [18.4]; P = .002); had higher proportions of certain extracranial trauma like long bone fractures (71 vs. 29%; P = .02); and suffered fewer surgical brain lesions (25.5 vs. 17.2%; P = .004).
Conclusions: Motorcycle crashes are now a significant threat to the heads, limbs, and lives of vulnerable road users in developing countries. 相似文献
Abstract: The links between species–environment relations and species’ responses to protection are unclear, but the objectives of marine protected areas (MPAs) are most likely to be achieved when those relations are known and inform MPA design. The components of a species’ habitat vary with the spatial resolution of the area considered. We characterized areas at two resolutions: 250 m2 (transect) and approximately 30,000 m2 (seascape). We considered three categories of environmental variables: substrate type, bottom complexity, and depth. We sought to determine at which resolution habitat characteristics were a better predictor of abundance and species composition of fishes and whether the relations with environmental variables at either resolution affected species’ responses to protection. Habitat features accounted for a larger proportion of spatial variation in species composition and abundances than differences in protection status. This spatial variation was explained best by habitat characteristics at the seascape level than at the transect level. Species’ responses to protected areas were specific to particular seascape characteristics, primarily depth, and bottom complexity. Our method may be useful for prioritizing marine areas for protection, designing MPAs, and monitoring their effectiveness. It identified areas that provided natural shelter, areas acting as buffer zones, and areas where fish species were most responsive to protection. The identification of such areas is necessary for cost‐effective establishment and monitoring of MPAs. 相似文献