Comparison of trauma severity in and out of the navigation ring around the metropolis: a case of Tabriz, Iran
-
Abazar Fathollahzadeh
,
Ali Ahmadinia
,
Reza Allahyari
,
Homayoun Sadeghi Bazargani
,
Haniyeh Ebrahimi Bakhtavar
,
Abdollah Moharamzadeh
,
Farzad Rahmani
Abstract
Objective: One of the causes of severe injuries in urban accidents is the occurrence of accidents on urban highways and city outskirts. The present study will determine the severity of accidents in the complete urban ring of Tabriz, including Shahid Kasaei highway, Pasdaran, Dizel Abad, Sento road, and Airport road in Tabriz during the years 2016-2022. Methods: In a cross-sectional descriptive study, the injuries from traffic accidents that were registered in the pre-hospital emergency center of Tabriz city were included. The study variables included all the information recorded in the pre-hospital emergency file between 2016 and 2022 and included 44,712 injured patients. Timing of the missions, variables related to the injured (demographics, vital signs), the accident's location, the injury's severity, and the accident's outcome were evaluated at the scene. Data were analyzed by SPSS 24 software. Results: Among 44,712 patients, 32,299 (72.2%) were men and the rest were women. Regarding the location of the accident, 34321 (76.8%) of the injured were inside the city, and 10391 (23.2%) had an accident in the city traffic ring. The most common accident site was in the traffic ring on Pasdaran highway, with 3179 injured (30.6%). The rate of on-scene death was higher in traffic accidents inside the traffic ring (1.3% vs. 0.9%). The severity of trauma was higher inside the traffic ring (P-value ˂0.001). Reaction and response time were higher in missions outside the traffic ring, leading to death at the scene (P value˂0.001). Conclusion: Based on the study results and the role of arrival time on the outcome of missions, it seems necessary to establish new pre-hospital emergency stations inside the city. It is necessary to pay more attention to education through the media and improve the general culture of society to reduce the accidents and injuries caused by it.
2. Vahdati SS, GhafarZad A, Rahmani F, Panahi F, Rad AO. Patterns of road traffic accidents in north west of Iran during 2013 New Year Holidays: complications and casualties. Bulletin of emergency & trauma. 2014;2(2):82.
3. Filipescu R, Powers C, Yu H, Yu J, Rothstein DH, Harmon CM, et al. Improving the performance of the Revised Trauma Score using Shock Index, Peripheral Oxygen Saturation, and Temperature–a National Trauma Database study 2011 to 2015. Surgery. 2020;167(5):821-8.
4. Watkins K. Safe and sustainable roads. Make roads safe the campaign for global road safety. 2012;1:40.
5. Yadollahi M. A study of mortality risk factors among trauma referrals to trauma center, Shiraz, Iran, 2017. Chinese journal of traumatology. 2019;22(4):212-8.
6. Greve JMDA, Resende MR, Carvalho HBd, Andreuccetti G, Bernini CO, Leyton V. Factors related to motorcycle accidents with victims: an epidemiological survey. MedicalExpress. 2018;5:mo18007.
7. Wang S, Dalal K. Road traffic injuries in Shanghai, China. HealthMed. 2012;6(1):74-80.
8. Anigh SG, Hajiloo Z, Bakhtavar HE, Paknejad SP, Rahmani F. Helmet: A device to reduce mortality and severity of trauma. 2022;3(1):93-100.
9. Bendak S. Seat belt utilization in Saudi Arabia and its impact on road accident injuries. Accident Analysis & Prevention. 2005;37(2):367-71.
10. Vorko-Jović A, Kern J, Biloglav Z. Risk factors in urban road traffic accidents. Journal of safety research. 2006;37(1):93-8.
11. Ashraf I, Hur S, Shafiq M, Park Y. Catastrophic factors involved in road accidents: Underlying causes and descriptive analysis. PLoS one. 2019;14(10):e0223473.
12. Sun L-L, Liu D, Chen T, He M-T. Road traffic safety: An analysis of the cross-effects of economic, road and population factors. Chinese journal of traumatology. 2019;22(05):290-5.
13. Zaloshnja E, Miller TR, Hendrie D. Effectiveness of child safety seats vs safety belts for children aged 2 to 3 years. Archives of pediatrics & adolescent medicine. 2007;161(1):65-8.
14. Sepehri Majd P, Alimohammadi Siyabani A, Ebrahimi Bakhtavar H, Rahmani F. A new method to predict the in-hospital outcome of multi-trauma patients: R-GAP. Journal of Emergency Practice and Trauma. 2022;8(2):128-33.
15. Fathi M, Ahmadinia A, Pourhassan N, Bakhtavar HE, Rahmani F. Road Safety as an Essential Need of Aged Population: A Case of Tabriz City, Iran. International Journal of Aging. 2023;1(1):e15-e.
16. Yazdani Charati J, Abbasi A, Fenderski A, Ali Pour N. Epidemiology of fatal traffic accidents in Sari, Iran in 2014. Journal of health research in community. 2016;2(3):61-8.
17. Golfiroozi S, Nikbakht HA, Fahim Yegane SA, Gholami Gharab S, Shojaie L, Ahmad Hosseini S, et al. Effective factors of severity of traffic accident traumas based on the Haddon matrix: a systematic review and meta-analysis. Annals of medicine and surgery (2012). 2024;86(3):1622-30.
18. Daily traffic of 160,000 cars from Kesai highway in Tabriz [Available from: https://www.mehrnews.com/news/5657645/.
19. Hajinabi K, Riahi L, Gholipour Varki H. The relationship between prehospital time indices and on-scene death rate in traffic accidents in the 22 regions of Tehran. Health Information Management. 2014;11(3):353-61.
20. Rezazadeh Z, Askarishahi M, Vakili M. Trend of Fetal Traffic injuries in Iran from 2009 to 2018. The Journal of Tolooebehdasht. 2020.
21. Jeong JH, Park YJ, Kim DH, Kim TY, Kang C, Lee SH, et al. The new trauma score (NTS): a modification of the revised trauma score for better trauma mortality prediction. BMC surgery. 2017;17:1-9.
22. Miller RT, Nazir N, McDonald T, Cannon CM. The modified rapid emergency medicine score: a novel trauma triage tool to predict in-hospital mortality. Injury. 2017;48(9):1870-7.
23. Sartorius D, Le Manach Y, David J-S, Rancurel E, Smail N, Thicoïpé M, et al. Mechanism, glasgow coma scale, age, and arterial pressure (MGAP): a new simple prehospital triage score to predict mortality in trauma patients. Critical care medicine. 2010;38(3):831-7.
24. Quirós AM, Pérez AB, Fernández AP, Perilla PP, Núñez AR, Martínez A, et al. Mortality in patients with potentially severe trauma in a tertiary care hospital emergency department and evaluation of risk prediction with the GAP prognostic scale. Emergencias. 2015;27:371-4.
25. Khajoei R, Abadi MZ, Dehesh T, Heydarpour N, Shokohian S, Rahmani F. Predictive value of the glasgow coma scale, age, and arterial blood pressure and the new trauma score indicators to determine the hospital mortality of multiple trauma patients. Archives of Trauma Research. 2021;10(2):86-91.
26. Manley G, Knudson MM, Morabito D, Damron S, Erickson V, Pitts L. Hypotension, hypoxia, and head injury: frequency, duration, and consequences. Archives of surgery. 2001;136(10):1118-23.
27. Spaite DW, Hu C, Bobrow BJ, Chikani V, Sherrill D, Barnhart B, et al. Mortality and prehospital blood pressure in patients with major traumatic brain injury: implications for the hypotension threshold. JAMA surgery. 2017;152(4):360-8.
28. Sittichanbuncha Y, Savatmongkorngul S, Jawroongrit P, Sawanyawisuth K. Low oxygen saturation is associated with pre-hospital mortality among non-traumatic patients using emergency medical services: A national database of Thailand. Turkish Journal of Emergency Medicine. 2015;15(3):113-5.
29. Lam SSW, Nguyen FNHL, Ng YY, Lee VP-X, Wong TH, Fook-Chong SMC, et al. Factors affecting the ambulance response times of trauma incidents in Singapore. Accident Analysis & Prevention. 2015;82:27-35.
30. Bigdeli M, Khorasani-Zavareh D, Mohammadi R. Pre-hospital care time intervals among victims of road traffic injuries in Iran. A cross-sectional study. BMC public health. 2010;10:1-7.
| Files | ||
| Issue | In press | |
| Section | Original article | |
| Keywords | ||
| Emergency Medical Services Mortality Trauma | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
