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
INTRODUCTION: Although the LATCH System (Lower Anchors and Tethers for Children) holds the promise of simplifying the installation of a child restraint system (CRS) to the vehicle's seat, many drivers transporting young children have difficulties using this technology. This paper reports on an observation study of LATCH use and misuse. METHOD: Observations of approximately 1,000 children less than 5 years of age in CRSs, in the back seats of vehicles that were equipped with tether and lower anchors, in seven states. RESULTS: Tethers were used for 51% of the children when the forward-facing CRS had tether straps and the vehicle had tether anchors. Lower anchors were used for 58% of the children when the CRS had lower attachments and the vehicle had lower anchors. The most common tether and lower attachment misuses were loose tether straps (18% of cases) and loose lower attachment installation (30% of the cases), respectively. Vehicle safety belts were used in combination with lower attachments in 20% of all lower anchor installations. CONCLUSION: As more caregivers of young children drive vehicles equipped with LATCH, it will be important to promote the proper installation of CRSs using this technology. LATCH education messages must also emphasize that the lower anchors may not always be the safest choice for CRS attachment -- the safest attachment is the one that results in a tight fit and will be used correctly consistently. 相似文献