Dataset Information

Association of Cataract Surgery With Traffic Crashes.

ABSTRACT: Importance:Cataracts are the most common cause of impaired vision worldwide and may increase a driver's risk of a serious traffic crash. The potential benefits of cataract surgery for reducing a patient's subsequent risk of traffic crash are uncertain. Objective:To conduct a comprehensive longitudinal analysis testing whether cataract surgery is associated with a reduction in serious traffic crashes where the patient was the driver. Design, Setting, and Participants:Population-based individual-patient self-matching exposure-crossover design in Ontario, Canada, between April 1, 2006, and March 31, 2016. Consecutive patients 65 years and older undergoing cataract surgery (n?=?559?546). Interventions:First eye cataract extraction surgery (most patients received second eye soon after). Main Outcomes and Measures:Emergency department visit for a traffic crash as a driver. Results:Of the 559?546 patients, mean (SD) age was 76 (6) years, 58% were women (n?=?326?065), and 86% lived in a city (n?=?481?847). A total of 4680 traffic crashes (2.36 per 1000 patient-years) accrued during the 3.5-year baseline interval and 1200 traffic crashes (2.14 per 1000 patient-years) during the 1-year subsequent interval, representing 0.22 fewer crashes per 1000 patient-years following cataract surgery (odds ratio [OR], 0.91; 95% CI, 0.84-0.97; P?=?.004). The relative reduction included patients with diverse characteristics. No significant reduction was observed in other outcomes, such as traffic crashes where the patient was a passenger (OR, 1.03; 95% CI, 0.96-1.12) or pedestrian (OR, 1.02; 95% CI, 0.88-1.17), nor in other unrelated serious medical emergencies. Patients with younger age (OR, 1.27; 95% CI, 1.13-1.14), male sex (OR, 1.64; 95% CI, 1.46-1.85), a history of crash (baseline OR, 2.79; 95% CI, 1.94-4.02; induction OR, 4.26; 95% CI, 2.01-9.03), more emergency visits (OR, 1.34; 95% CI, 1.19-1.52), and frequent outpatient physician visits (OR, 1.17; 95% CI, 1.01-1.36) had higher risk of subsequent traffic crashes (multivariable model). Conclusions and Relevance:This study suggests that cataract surgery is associated with a modest decrease in a patient's subsequent risk of a serious traffic crash as a driver, which has potential implications for mortality, morbidity, and costs to society.

SUBMITTER: Schlenker MB

PROVIDER: S-EPMC6142973 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Association of Cataract Surgery With Traffic Crashes.

Schlenker Matthew B MB Thiruchelvam Deva D Redelmeier Donald A DA

JAMA ophthalmology 20180901 9

<h4>Importance</h4>Cataracts are the most common cause of impaired vision worldwide and may increase a driver's risk of a serious traffic crash. The potential benefits of cataract surgery for reducing a patient's subsequent risk of traffic crash are uncertain.<h4>Objective</h4>To conduct a comprehensive longitudinal analysis testing whether cataract surgery is associated with a reduction in serious traffic crashes where the patient was the driver.<h4>Design, setting, and participants</h4>Populat ...[more]

PMID: 29955857

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Project description:ImportanceThere is a paucity of data addressing the risk of cataract development in pediatric patients with atopic dermatitis (AD).ObjectiveTo investigate the association of AD with subsequent cataract development and cataract surgery in a Korean pediatric population.Design, setting, and participantsThis population-based retrospective longitudinal cohort study used nationally representative data from the Korean National Health Insurance Service database from 2002 to 2013. Incident AD cases, consisting of patients younger than 20 years with AD and severe AD and were matched to 4 controls each using propensity score derived from age, sex, residential area, and household income.Main outcomes and measuresIncidence probabilities of cataract development and cataract surgery between the AD group and controls were compared using Kaplan-Meier methods and log-rank tests. Cox proportional hazard models were fitted for cataract and cataract surgery to determine the risk factors in the matched cohort.ResultsOf 34 375 patients with incident AD (16 159 girls [47%]; mean [SD] age, 3.47 [4.96] years), there were 3734 severe AD cases (10.9%) with 137 500 matched controls. Development of cataracts was not different between the AD and control groups, (0.216% vs 0.227%; 95% CI, -0.041% to 0.063%; P = .32) or between the severe AD cohort and their controls (0.520% vs 0.276%; 95% CI, -0.073% to 0.561%; P = .06). Cataract surgery was performed more frequently in the AD cohort than in the control group (0.075% vs 0.041%; 95% CI, 0.017%-0.050%; P = .02) and in the severe AD cohort compared with their controls (0.221% vs 0.070%; 95% CI, 0.021%-0.279%; P = .03). Severe AD was associated with both development of cataract (adjusted hazard ratio, 1.94; 95% CI, 1.06-3.58, P = .03) and requirement for cataract surgery (adjusted hazard ratio, 5.48; 95% CI, 1.90-15.79, P = .002).Conclusions and relevanceAbsolute risk of cataract was rare, with or without AD, even after 10 years of observation. However, our results suggest that pediatric patients with AD have an increased risk for cataracts requiring surgery and that disease severity may increase the risk for cataract development and cataract surgery.

Project description:BackgroundAnti-lock Brake System (ABS) helps the equipped vehicles to stop under heavy braking, in a shorter distance and with a better control of direction. It was expected that this technology will reduce the rate of fatal road traffic crashes (RTC); however, the outcome is controversial in the real world. The aim of this study is to compare the claimed annual incidence rate and financial losses due to RTCs in ABS vs. non-ABS personal vehicles in Iran.MethodsA telephone survey among drivers of two similar models of personal vehicles was arranged. The studied vehicles were of the same brand and type; but only one of them was equipped with ABS. The number of RTCs, subsequent financial loss, and drivers' knowledge and perception about ABS were sought. The sample consisted of drivers of 1232 ABS and 3123 non-ABS vehicles.ResultsThe annual incidence rate of RTC involving another vehicle was 145.1 (134.8-155.9) per 1000 vehicle-years and there was not a statistically significant difference between study groups.The incidence of RTC with another vehicle due to brake failure was 50.3 (42.9-58.5) for 1000 non ABS vehicle-years and 30.0 (21.2-41.2) for 1000 ABS equipped vehicle-years. The difference was statistically significant after adjustment for the driver and vehicle's age and the daily driving time. The attributable risk of RTC for non-ABS vehicles was 20/1000 vehicles and the excess fraction was 39.8%. The mean financial loss due to reported RTCs was $987.9 ± $1547.3 US Dollars and there was not a statistically significant difference between study groups. While 61.1% of ABS vehicle drivers reported situations in which they believed the ABS had prevented a crash, 44.1% of them however, they did not know how to use ABS efficiently.ConclusionsLaw enforcement to maintain safe distance and adhere to speed limit while driving, is needed to raise the effectiveness of ABS. This is as necessary as considering mandatory outfitting of ABS. Safety authorities should first consider the global experience and local evidence, before adopting any specific policy in this regard. The drivers need to learn the right way to use ABS for maximum effectiveness.

Project description:BackgroundUndisputedly, traffic crashes constitute a public health concern whose impact and importance have been increasing during the past few decades. Specifically, road safety data have systematically shown how cyclists are highly vulnerable to suffering traffic crashes and severe injuries derived from them. Furthermore, although the empirical evidence is still very limited in this regard, in addition to other human factors involved in cycling crashes, distractions while cycling appear to be a major contributor to the road risk of cyclists.ObjectivesThe main objectives of this study were, first, to explore the prevalence and trends of cycling distractions within an international sample of bike users, and second, to determine the influence of such distractions on road crashes suffered by cyclists, simultaneously considering the explanatory role of risky behaviors (errors and traffic violations) as potentially mediating variables between cycling distractions and traffic crashes.MethodsFor this cross-sectional study, we analyzed the data obtained from 1,064 cyclists-61.2% male and 38.8% female-from 20 different countries, who answered an on-line questionnaire on cycling-related features, habits, behaviors and accidents.ResultsThe prevalence of different cycling distractions oscillated between 34.7% and 83.6%. The most common distractions were those related to the behavior of other users, physical elements of the road, weather conditions and phone calls. Age trends and differences were also found, thus establishing a positive association between age and distractibility during cycling. Furthermore, the effect of distractions on traffic crashes of cyclists was significant when tested together with age, risk perception and risky behaviors on the road.ConclusionThe results of this study support the hypotheses that distractions have a major prevalence among bike users, and that they play a significant role in the prediction of the traffic crash rates of cyclists, through the mediation of risky behaviors.

Project description:INTRODUCTION:Every year more than 1.2 million people worldwide die due to trauma sustained in road crashes, with an additional number of people injured exceeding 50 million. To a large extent, this applies to so called "unprotected road users", including pedestrians. The risk involved in a traffic crash for pedestrians can result from many factors, one of which is participation in road traffic when under the influence of alcohol. The aim of this study was to analyze the impact of alcohol use among pedestrians as unprotected road traffic participants, and the consequences of them being struck by motor vehicles. MATERIAL AND METHODS:The source of data was the medical documentation of the Department of Forensic Medicine at the Medical University of Warsaw. The sample for this research consisted of 313 pedestrians who were victims of fatal road crashes resulting from a collision with a mechanical vehicle. The obtained results were subjected to statistical analysis using the STATISTICA version 12.5 program (StatSoft Polska, Cracow, Poland). RESULTS:Male fatalities constituted the majority of the study sample. Nearly half of the fatal pedestrian victims were found to be under the influence of alcohol. The statistical analysis demonstrated a significant relationship between the gender and age of the victims, as well as between the place of the event, the place of death, the mechanism of the event, and the presence of alcohol in pedestrians. CONCLUSIONS:Among pedestrians, victims of road crashes who were under the influence of alcohol were predominantly drunk young males. Victims under the influence of alcohol were more likely to become fatalities in crashes where the mechanism of the incident was being struck by a passenger car, and when the place of the incident was a rural area, in these cases the rates of death directly at the scene were much more frequent. The eradication of alcohol consumption by all road users should be the overriding objective of all measures aimed at reducing the number of road crashes.

Dataset Information

Association of Cataract Surgery With Traffic Crashes.

Publications

Association of Cataract Surgery With Traffic Crashes.

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