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Factors associated with severity of motorcycle injuries among young adult riders

ANNALS OF EMERGENCY MEDICINE 2003年第6期41卷 783-791页

作者： Lin, MR Chang, SH Huang, WZ Hwang, HF Pai, L Taipei Med Univ Inst Injury Prevent & Control Taipei 110 Taiwan Natl Taiwan Univ Sch Publ Hlth Dept Publ Hlth Taipei 10764 Taiwan Harvard Univ Sch Publ Hlth Dept Biostat Boston MA 02115 USA Natl Taipei Coll Nursing Dept Nursing Taipei Taiwan Natl Def Med Ctr Dept Publ Hlth Taipei Taiwan

Study objective: A cohort of 4,729 junior college students in Taiwan was studied to determine risk factors for increased severity of motorcycle injuries. Methods: Crash characteristics were collected by using self-administered questionnaires soon after a student was involved in a motorcycle crash. The proportional odds model with generalized estimating equations, with correlated ordinal responses for collisions categorized into not injured, mildly injured, and severely injured categories, was used to determine the odds of injury severity. Results: A total of 1,889 motorcycle crashes involving 1,284 persons occurred over a 20-month period from November 1994 to June 1996. There were 1,339 noninjuries, 474 mild injuries, and 76 severe injuries. The adjusted odds ratio (OR) of rural to urban roads having a greater level of injury severity was 1.64. Compared with noncollisions, collisions with a moving car (adjusted 011=11.76), a parked car (adjusted OR 1.90), or another stationary object (adjusted OR=2.31) increased the odds for a greater level of injury severity. Riders using Sanyang (adjusted OR=1.63) and Yamaha (adjusted OR=1.39) motorcycles had greater odds of being involved in a crash with a greater level of injury compared with those riding Kymco motorcycles. Darkness (adjusted OR=1.65) and greater speeds (adjusted OR=1.63 to 4.69) also increased the odds of greater injury severity. Conclusion: At the time of motorcycle crashes, factors such as being on rural roads, collisions with a heavier object, some motorcycle makes, darkness, and greater speeds increased the severity of motorcycle injuries among these young adult riders.

关键词：事故交通/统计学和数值数据饮酒头部防护装置摩托车/统计学和数值数据危险因素台湾/流行病学创伤和损伤/流行病学青少年成年人女(雌)性人类男(雄)性

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Motorcycle casualties sustained during Daytona Beach bike week 2000: Lessons learned

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ANNALS OF EMERGENCY MEDICINE 2003年第6期41卷 792-797页

作者： Kanny, D Schieber, RA Jones, BH Ryan, GW Sorensen, BJ Dept Hlth & Human Serv US Publ Hlth Serv Ctr Dis Control & Prevent Epidemiol Program OffEpidem Intelligence Serv Atlanta GA USA Dept Hlth & Human Serv US Publ Hlth Serv Ctr Dis Control & Prevent Natl Ctr Injury Prevent & ControlDiv Unintent In Atlanta GA USA Dept Hlth & Human Serv US Publ Hlth Serv Ctr Dis Control & Prevent Natl Ctr Injury Prevent & ControlOff Stat & Prog Atlanta GA USA Volusia Cty Hlth Dept Daytona Beach FL USA

Study objective: In March 2000, an estimated 500,000 people attended an annual motorcycle rally in Daytona Beach, FL, where approximately 64,000 residents live year-round. The media reported 15 deaths during this 10-day event. To more, comprehensively assess the extent of trauma and need for emergency medical care we, investigated all motorcycle crashes, regardless of outcome. Methods: Motorcycle-related crash data from local medical examiner, hospital, emergency medical services (EMS), and police sources were linked. Frequencies of crashes, injuries, hospitalizations, and deaths were determined, and EMS use data were analyzed. Results: During Bike Week 2000, 570 people were involved in 281 motorcycle-related crashes. Two hundred thirty (40%) people were injured, of which 147 (64%) sought treatment in emergency departments, 72 (31%) were hospitalized, and 11 (5%) died. In crashes between motorcycles and passenger cars, individuals exposed as motorcycle Occupants were 8.7 times more likely to be injured than car occupants (95%, confidence limit 1.7, 15.7). Of 205 EMS dispatches for motorcycle-related crashes, two thirds resulted in transport to an ED. Data needed to assess known risk factors (eg, alcohol use, speed, lack of helmet use) were not routinely ascertained at either the Crash site or ED. Conclusion: Although fatalities first called attention to the problem, nonfatal injuries outnumbered deaths 20:1. The manpower resources of civil service and health resources could become overwhelmed or exhausted in circumstances in which many people are injured or killed throughout a relatively long period. The situation deserves future study. Better risk factor surveillance is needed to help prevent crashes.

关键词：事故交通/统计学和数值数据救护车/统计学和数值数据佛罗里达/流行病学摩托车/统计学和数值数据成年人女(雌)性人类男(雄)性中年人

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Reporting drivers with epilepsy

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ANNALS OF EMERGENCY MEDICINE 2003年第4期41卷 584-585页

作者： Krauss, G Krumholz, A Johns Hopkins Univ Dept Neurol Baltimore MD 21218 USA Univ Maryland Sch Med Dept Neurol Baltimore MD 21201 USA

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Commentary: Making progress... with a growing caution

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ANNALS OF EMERGENCY MEDICINE 2003年第2期41卷 272-275页

作者： Vaca, F

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Alcohol's contribution to fatal injuries: A report on public perceptions

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ANNALS OF EMERGENCY MEDICINE 2002年第6期39卷 622-630页

作者： Girasek, DC Gielen, AC Smith, GS Johns Hopkins Univ Sch Hyg & Publ Hlth Ctr Injury Res & Policy Baltimore MD USA

Study objective: We determine whether members of the public understand that alcohol contributes to each of the leading causes of unintentional-injury death in the United States and not just to motor vehicle-related fatalities Public opinions. of selected alcohol control policies were also assessed. Methods: We used a national telephone survey of 943 adults, who were selected by random-digit dialing techniques. Respondents' mean estimates of alcohol's involvement in fatal injuries were compared with published data from a meta-analysis of medical examiner data. Results: The study population accurately estimated the proportion of fatal fall, drowning, and poisoning victims who were legally drunk when they died. Respondents overestimated the proportion of drivers killed in motor vehicle crashes who were intoxicated and underestimated the proportion of fire/burn victims. Fifty-seven percent of participants endorsed the myth that alcohol intoxication is protective against injury in the event of a motor vehicle crash. Participants were divided over whether increasing the legal drinking age to 21 had resulted in fewer injury deaths, Seventy-eight percent of participants did not believe that raising alcohol taxes would reduce fatal injuries. A majority (58%) of respondents supported taking blood alcohol levels on all "seriously injured" patients brought to the hospital. Conclusion: This report suggests that public awareness of alcohol's contribution to the breadth of the injury problem in the United States is high. Conversely, public understanding of whether prevention strategies have proven to be effective is poor. Emergency medicine practitioners can serve as credible sources of more accurate information for patients and the community at large.

关键词：事故交通/统计学和数值数据数据收集教育程度乙醇/副作用乙醇/血液收入舆论电话美国创伤和损伤/化学诱导创伤和损伤/死亡率成年人老年人女(雌)性人类男(雄)性中年人

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Commentary: Screening and brief intervention for problem drinkers: Opportunities lost

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ANNALS OF EMERGENCY MEDICINE 2002年第6期39卷 686-687页

作者： Todd, KH RollinsSchoolofPublicHealth EmoryUniversityAtlantaGAUSA.

[Todd KH. Commentary: screening and brief intervention for problem drinkers: opportunities lost. Ann Emerg Med. June 2002;39;686-687.]

关键词：事故交通/死亡率事故交通/预防和控制事故交通/统计学和数值数据急性酒精中毒/经济学急性酒精中毒/治疗急诊室医院/经济学急诊室医院/统计学和数值数据美国/流行病学人类

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ANNALS OF EMERGENCY MEDICINE 2001年第4期38卷 415-422页

作者： McCammon, K United Hosp Ctr Dept Emergency Med Clarksburg WV 26301 USA

Impaired driving continues to be a major factor in many injuries and fatalities on our nation's highways. In 1998, alcohol was involved in 38% of all fatal crashes, contributing to 15,935 deaths. The combination of improved public awareness and strong legal sanctions for driving under the influence has been shown to reduce the incidence of impaired driving. A few states have instituted new statutes for mandatory health Care reporting of impaired drivers who have been involved in motor vehicle crashes. Current-research into establishing emergency department-based effective, efficient, and "user-friendly" methods for screening, intervention, and referral on behalf of the problem drinker offers promise for emergency physicians to become empowered to better manage this individual and public health problem. Emergency physicians may soon need to reassess their role in reducing the occurrence of alcohol-related motor vehicle crashes through widespread screening, intervention, and referral of these patients.

关键词：事故预防事故交通/预防和控制事故交通/统计学和数值数据年龄分布急诊室医院发病率一级预防/组织和管理规划制订危险因素存活率分析青少年成年人儿童儿童学龄前女(雌)性人类男(雄)性

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Fatality reduction by safety belts for front-seat occupants of cars and light trucks.

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Annals of emergency medicine 2001年第6期37卷 728-729页

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Maxillofacial injuries in the pediatric patient

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ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTICS 2000年第2期90卷 126-134页

作者： Haug, RH Foss, J Univ Kentucky Coll Dent Div Oral & Maxillofacial Surg Lexington KY 40536 USA Metrohlth Med Ctr Cleveland OH USA

Approximately 22 million children are injured in the United States annually. Children are uniquely susceptible to craniofacial trauma because of their greater cranial-mass-to-body ratio. The pediatric population sustains 1% to 14.7% of all Facial fractures. The majority of these injuries are encountered by boys (53.7% - 80%) who are involved in motor vehicle accidents (up to 80.2%). The incidence of other systemic injury concomitant to facial trauma is significant (10.4% - 88%). The management of the pediatric patient with maxillofacial injury should take into consideration the differences in anatomy and physiology between children and adults, the presence of concomitant injury, the particular stage in growth and development (anatomic, physiologic, and psychologic), and the specific injuries and anatomic sites that the injuries affect. This comprehensive review, based on the last 25 years of the world's English-speaking surgical literature, presents current thoughts on the anatomic and physiologic differences between adults and children, a synopsis of childhood growth and development, and an overview of state-of-the-art management of the pediatric patient who has sustained maxillofacial injury.

关键词：事故交通/统计学和数值数据虐待儿童/统计学和数值数据骨折固定术/方法生长上颌面部发育上颌面部损伤/流行病学上颌面部损伤/病因学上颌面部损伤/外科学参考值性别比率软组织损伤/流行病学软组织损伤/病因学软组织损伤/外科学牙损伤/流行病学牙损伤/病因学牙损伤/外科学美国/流行病学青少年儿童儿童学龄前女(雌)性人类婴儿男(雄)性

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Exploratory study of incident vehicle crashes among older drivers

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JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES 2000年第1期55卷 M22-M27页

作者： Sims, RV McGwin, G Allman, RM Ball, K Owsley, C Univ Alabama Div Gerontol & Geriat Med Birmingham AL USA Univ Alabama Dept Med Ctr Aging Birmingham AL 35294 USA Univ Alabama Sch Publ Hlth Dept Epidemiol Birmingham AL 35294 USA Univ Alabama Dept Surg Sect Trauma Burns & Surg Crit Care Birmingham AL 35294 USA Univ Alabama Dept Ophthalmol Birmingham AL 35294 USA Univ Alabama Dept Psychol Birmingham AL 35294 USA Birmingham Dept Vet Affairs Med Ctr Birmingham AL USA

Background, As the number of older adult drivers increases, distinguishing safe from unsafe older adult drivers will become an increasing public health concern. We report on the medical and functional factors associated with vehicle crashes in a cohort of Alabama drivers, 55 years old and older. Methods. This prospective study involved 174 older adults, on whom demographic, medical, functional, and physical performance data were collected in 1991. Subjects were then followed through 1996 for incident vehicle crashes. Results. Sixty-one subjects experienced between one and four police-reported vehicle crashes during the study period. Following adjustment for age, race, days driven per week, and gender, Cox proportional-hazards models showed the following variables to be associated with crash involvement: reported difficulty with yardwork or light housework (relative risk [RR] = 2.1;95% confidence interval [CI] 1.1,4.0;p = .02), or opening ajar(RR = 3.1;95% CI 1.4, 6.7;p = .004);at least one crash before 1991 (RR = 2.1;95% CI 1.2, 3.7;p = .008);using hypnotic medication (RR = 2.9;95% CI 1.3, 6.6;p = .0 1 );self-reported stroke or transient ischemic attack (RR = 2.7;95% CI 1.1, 6.6;p = .03);scoring within the depressed range on the Geriatric Depression Scale (RR = 2.5;95% CI 1.1, 6.0;p = .03), and failing the useful field-of-view test (RR = 1.9;95% CI 1.0, 3.5;p = .05). Conclusions, Variables related to function, medication use, affect, neurological disease, and visuocognitive skills were associated with vehicle crash involvement in this cohort. Our findings suggest that multifactorial assessments are warranted to identify at-risk older drivers.

关键词：事故交通/统计学和数值数据日常生活活动亚拉巴马/流行病学汽车驾驶卡方分布队列研究药物疗法老年人身心健康评价健康状况比例危险度模型前瞻性研究危险因素老年人老年人 80以上女(雌)性人类男(雄)性中年人

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