INF GR / PS / 16

Pedestrians injury profile evaluation in a hospital-based multicenter polytrauma survey

S. Prat-Fabregat

Trauma Unit

Multicenter survey

Variaciones en la práctica asistencial y en los resultados de la atención al paciente

traumático accidentado de tráfico en Catalunya

Dr. S. Prat Hospital Clínic

Dr. A. Plasència Institut Municipal SaludBarcelona

Agència Avaluació Tecnologia i Recerca Mèdiques

Inclusion criteria

Road traffic accident with:

ICU admission Surgical procedure ISS > 10

Exclusion: Not road traffic accident Dead before ED admission

Study population

Total cases:

508

Hospital distribution:– Bellvitge H1 87– Clínic H2 150– Girona H3 33– Parc Taulí H4 104– Vall d’Hebró H5 134

Bellvitge

Clìnic

Girona

Parc Tauli

Vall d'Hebró

020406080

100120140160

Type of accident (by hospital)

86150

33103 134

506

0

100

200

300

400

500

600

H1 H2 H3 H4 H5 Total

Pedestrian

Crash

Total x hosp

0

20

40

60

80

100

1 2 3 4 5 6

% Pedestrian

% Crash

ICD-9-CM

92 different diagnostic groups

Most frequent ICD codes:– Cranioenecephalic and craniofacial trauma(801-804 y 850)– Pelvic, upper and lower extremity fractures (810-816, 820-825, 808, 831-844)– Thoracic trauma (807, 860-862)

ICD-9-CM Diagnostic Groups

0 100 200 300 400

Other Injuries EE

Fx. EEII

Fx.EESS

Fx. Pelvis

Abdominal Trauma

Thorax Trauma

Thorax Trauma (osseus)

Fx. Cervical and dorsal

Craneoencephalic Trauma

Face Cranial Trauma

Injury pattern in collision with cranial trauma

0

2

4

6

8

10

12

14

H1 H2 H3 H4 H5

AIS 156

AIS 136

AIS 135

AIS 125

Injury patterns in pedestrians with cranial trauma

0

1

2

3

4

5

6

7

8

9

10

H1 H2 H3 H4 H5

AIS 156

AIS 135

AIS 134

Injury patterns in collision without cranial trauma

0

1

2

3

4

5

6

7

H1 H2 H3 H4 H5

AIS 345

AIS 356

AIS 456

Injury patterns in pedestrians without cranial trauma

0

0,5

1

1,5

2

2,5

3

3,5

4

4,5

H1 H2 H3 H4 H5

AIS 346

AIS 356

AIS 456

Injury patterns in motorcycle accident with cranial trauma

0

5

10

15

20

25

H1 H2 H3 H4 H5 Total

156

125

136

126

145

Injury patterns in motorcycle accident without cranial trauma

0

2

4

6

8

10

H1 H2 H3 H4 H5 Total

456

346

345

Max AIS in motorcycle accident with at least 3 AIS anatomic areas involvement

0 10 20 30

Max AIS 5

Max AIS 4

Max AIS 3 Extremities (5)

Abdominal (4)

Thoracic (3)

Cranial (1)

Max AIS in pedestrians with at least 3 AIS anatomic areas involvement

0 5 10 15 20

Max AIS 5

Max AIS 4

Max AIS 3 Extremities (5)

Abdominal (4)

Thoracic (3)

Cranial (1)

Vital status at hospital discharge: collisions

90%

10%

Alive

Dead

Overall mortality 10,2%

80%

20%

Alive

Dead

Overall mortality: 20,1%

The bigger the age, the bigger the pedestrians incidence (p< 0.01)

Vital status at hospital discharge: pedestrians

Conclusions:

From the 508 road traffic accidents studied (104 of which were pedestrian accidents), the mortality rate for the pedestrians is twice that for the car occupants

There is a clear relationship between increasing age and the risk of having a pedestrian accident (The average age of the injured pedestrian in this survey is 59 years)

The majority of the pedestrians were injured in two or more body regions; 60% of them required IC. The average time of hospitalization was 22 days, and an average of 8 days in the ICU