Dataset Information

Evaluation of a hospital-based injury surveillance system for monitoring road traffic deaths in Phuket, Thailand.

ABSTRACT: Objectives: The objective of this study was to evaluate and injury surveillance (IS) system's ability to monitor road traffic deaths and the coverage of road traffic injury and death surveillance in Phuket, Thailand. Methods: U.S. Centers for Disease Control and Prevention guidelines on surveillance system evaluation were used to qualitatively and quantitatively evaluate IS. Interviews with key stakeholders focused on IS's usefulness, simplicity, flexibility, acceptability, and stability. Active case finding of 2014 road traffic deaths in all paper and electronic hospital record systems was used to assess system sensitivity, positive predictive value, and data quality. Electronic data matching software was used to determine the implications of combining IS data with other provincial-level data sources (e.g., death certificates, electronic vehicle insurance claim system). Results: Evaluation results indicated that IS was useful, flexible, acceptable, and stable, with a high positive predictive value (99%). Simplicity was limited due to the burden of collecting data on all injuries and use of paper-based data collection forms. Sensitivity was low, with IS only identifying 55% of hospital road traffic death cases identified during active case finding; however, IS cases were representative of cases identified. Data accuracy and completeness varied across data fields. Combining IS with active case finding, death certificates, and the electronic vehicle insurance claim system more than doubled the number of road traffic death cases identified in Phuket. Conclusion: An efficient and comprehensive road traffic injury and death surveillance system is critical for monitoring Phuket's road traffic burden. The hospital-based IS system is a useful system for monitoring road traffic deaths and assessing risk behaviors. However, the complexity of data collection and limited coverage hinders the ability of IS to fully represent road traffic deaths in Phuket Province. Combining data sources could improve coverage and should be considered.

SUBMITTER: Nittayasoot N

PROVIDER: S-EPMC6584949 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Evaluation of a hospital-based injury surveillance system for monitoring road traffic deaths in Phuket, Thailand.

Nittayasoot Natthaprang N Peterson Alexis B AB Thammawijaya Panithee P Parker Erin M EM Sathawornwiwat Apichit A Boonthanapat Naris N Chantian Thanawadee T Voradetwitaya Lujisak L Jiraphongsa Chuleeporn C Sagarasaeranee Onpirun O Sansilapin Chalo C Rattanathamsakul Thanit T Ketgudee Lalida L Tantiworrawit Patcharin P

Traffic injury prevention 20190503 4

<b>Objectives:</b> The objective of this study was to evaluate and injury surveillance (IS) system's ability to monitor road traffic deaths and the coverage of road traffic injury and death surveillance in Phuket, Thailand. <b>Methods:</b> U.S. Centers for Disease Control and Prevention guidelines on surveillance system evaluation were used to qualitatively and quantitatively evaluate IS. Interviews with key stakeholders focused on IS's usefulness, simplicity, flexibility, acceptability, and sta ...[more]

PMID: 31050566

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Project description:ObjectiveThe objective of this study was to identify timing distribution and predictors of deaths following road traffic injuries among all age groups at Gondar Comprehensive specialised hospital.DesignA single-centre prospective cohort study.SettingThe study hospital is a tertiary hospital in North West Ethiopia.ParticipantsWe enrolled 454 participants who sustained road traffic injuries in to the current study. All age groups and injury severity were included except those who arrived dead, had no attendant and when the injury time was unknown.Primary and secondary outcome measuresThe primary outcome was time to death measured in hours from injury time up to the 30th day of the injuries. Secondary outcomes were prehospital first aid, length of hospital stay and hospital arrival time. The article has been registered, with a unique identification number of research registry 6556.ResultsA total of 454 victims were followed for 275 534 person hours. There were 80 deaths with an overall incidence of 2.90 deaths per 10 000 person hours of observation (95% CI 2.77 to 3.03). The significant predictors of time to death were being a driver (AHR=2.26; 95% CI 1.09 to 4.65, AR=14.8), accident at interurban roads ((AHR (Adjusted HAzard Ratio=1.98; 95% CI 1.02 to 3.82, AR (Attributable Risk)=21%)), time from injury to hospital arrival (AHR=0.41; 95% CI 0.16 to 0.63; AR=3%), systolic blood pressure on admission of <90 mm Hg (AHR=3.66; 95% CI 2.14 to 6.26; AR=57%), Glasgow Coma Scale of <8 (AHR=7.39; 95% CI 3.0819 to 17.74464; AR=75.7%), head injury with polytrauma (AHR=2.32 (1.12774 4.79; AR=37%) and interaction of distance from hospital with prehospital care.ConclusionThough the maturation of trauma centres in many developed countries has changed the temporal pattern of deaths following any trauma, our study demonstrated that trauma deaths follow the traditional trimodal pattern. That implies that potentially preventable causes of death continued in low-resource countries.

Project description:BackgroundGlobally, road traffic accidents are the leading causes of death among young people in general, and the main cause of death among young people aged 15-29 years. Recently, in Ethiopia, the number of road traffic accidents has been increasing. The study aimed to identify the potential factors associated with the number of human deaths by road traffic accidents in the Oromia Regional State, Ethiopia.MethodsWe used data obtained from the Oromia region traffic police office recorded on daily basis road traffic accidents from July 2016 up to July 2017. Count regression models were was used to analyses the factors associated with the number of human deaths from road traffic accidents.ResultsAge of the driver's 31-50 years (AOR = 0.289, 95%CI: 0.175, 0.479) and higher than 50 years old (AOR = 0.311, 95%CI: 0.129, 0.751), driver's years of experience 5-10 years (AOR = 0.014, 95%CI: 0.007, 0.027), and more than 10 years (AOR = 0.101, 95%CI: 0.057, 0.176), automobile vehicle type (AOR = 8.642, 95%CI: 2.7644, 27.023), vehicle years of service 5-10 years (AOR = 2.484, 95%CI: 1.194, 5.169), and more than 10 years (AOR = 2.639, 95%CI: 1.268, 5.497), vehicle upside down accidents (AOR = 5.560, 95%CI: 2.506, 12.336), turning illegal position (AOR = 0.454, 95%CI: 0.226, 0.913), residential areas (AOR = 108.506, 95%CI: 13.725, 857.798), and working areas (AOR = 129.606, 95%CI: 16.448, 1021.263) were significant associated number of human deaths per road traffic accident factors in the study area.ConclusionHuman deaths per road traffic accidents occurred due to the younger age of the driver, driver's lack of sufficient experience, vehicle serviced for long years, driving on a wet road, driving in the afternoon, driving near/around residential places and vehicle to driver's relation. Thus, the regional traffic police should give special attention to younger drivers, less experienced drivers, old vehicles, driving near residential areas, driving automobiles, and driving in the afternoon to control traffic system to reduce the number of human deaths pear road traffic accident.

Project description:ObjectivesAmid growing calls for police reform, it is imperative to reassess whether police actions designed to improve public safety are associated with injury prevention. This study aims to examine the relationship between the police traffic stops (PTSs) and motor vehicle crash (MVC) deaths at the state level. We hypothesize that increased PTSs would be associated with reduced MVC deaths.MethodsWe retrospectively analyzed PTSs and MVC deaths at the state level from 2004 to 2016. Police traffic stops data were from 33 state patrols from the Stanford Open Policing Project. The MVC deaths data were collected from the National Highway Traffic Safety Administration. The vehicle miles traveled data were from the Federal Highway Administration Office of Highway Policy Information. All data were adjusted per 100 million vehicle miles traveled (100MVMT) and were analyzed as state-level time series cross-sectional data. The dependent variable was MVC deaths per 100MVMT, and the independent variable was number of PTSs per 100MVMT. We performed panel data analysis accounting for random and fixed state effects and changes over time.ResultsThirty-three state patrols with 235 combined years were analyzed, with a total of 161,153,248 PTSs. The PTS rate varied by state and year. Nebraska had the highest PTS rate (3,637/100MVMT in 2004), while Arizona had the lowest (0.17/100MVMT in 2009). Motor vehicle crash deaths varied by state and year, with the highest death rate occurring in South Carolina in 2005 (2.2/100MVMT) and the lowest in Rhode Island in 2015 (0.57/100MVMT). After accounting for year and state-level variability, no association was found between PTS and the MVC death rates.ConclusionState patrol traffic stops are not associated with reduced MVC deaths. Strategies to reduce death from MVC should consider alternative strategies, such as motor vehicle modifications, community-based safety initiatives, improved access to health care, or prioritizing trauma system.Level of evidenceRetrospective epidemiological study, level IV.

Project description:Road traffic collisions are a major cause of traumatic brain injury. However, the relationship between road traffic collision dynamics and traumatic brain injury risk for different road users is unknown. We investigated 2065 collisions from Great Britain's Road Accident In-depth Studies collision database involving 5374 subjects (2013-20). Five hundred and ninety-five subjects sustained a traumatic brain injury (20.2% of 2940 casualties), including 315 moderate-severe and 133 mild-probable injuries. Key pathologies included skull fracture (179, 31.9%), subarachnoid haemorrhage (171, 30.5%), focal brain injury (168, 29.9%) and subdural haematoma (96, 17.1%). These results were extended nationally using >1 000 000 police-reported collision casualties. Extrapolating from the in-depth data we estimate that there are ∼20 000 traumatic brain injury casualties (∼5000 moderate-severe) annually on Great Britain's roads, accounting for severity differences. Detailed collision investigation allows vehicle collision dynamics to be understood and the change in velocity (known as delta-V) to be estimated for a subset of in-depth collision data. Higher delta-V increased the risk of moderate-severe brain injury for all road users. The four key pathologies were not observed below 8 km/h delta-V for pedestrians/cyclists and 19 km/h delta-V for car occupants (higher delta-V threshold for focal injury in both groups). Traumatic brain injury risk depended on road user type, delta-V and impact direction. Accounting for delta-V, pedestrians/cyclists had a 6-times higher likelihood of moderate-severe brain injury than car occupants. Wearing a cycle helmet during a collision was protective against overall and mild-to-moderate-to-severe brain injury, particularly skull fracture and subdural haematoma. Cycle helmet protection was not due to travel or impact speed differences between helmeted and non-helmeted cyclist groups. We additionally examined the influence of the delta-V direction. Car occupants exposed to a higher lateral delta-V component had a greater prevalence of moderate-severe brain injury, particularly subarachnoid haemorrhage. Multivariate logistic regression models created using total delta-V value and whether lateral delta-V was dominant had the best prediction capabilities (area under the receiver operator curve as high as 0.95). Collision notification systems are routinely fitted in new cars. These record delta-V and automatically alert emergency services to a collision in real-time. These risk relationships could, therefore, inform how routinely fitted automatic collision notification systems alert the emergency services to collisions with a high brain injury risk. Early notification of high-risk scenarios would enable quicker activation of the highest level of emergency service response. Identifying those that require neurosurgical care and ensuring they are transported directly to a centre with neuro-specialist provisions could improve patient outcomes.

Dataset Information

Evaluation of a hospital-based injury surveillance system for monitoring road traffic deaths in Phuket, Thailand.

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Evaluation of a hospital-based injury surveillance system for monitoring road traffic deaths in Phuket, Thailand.

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