Unintentional Injury Outcomes Secondary to Pedestrian Traffic Crashes: A Descriptive Analysis from a Major Medical Center

Abstract

Introduction:An environment in which traffic regulations are not strictly enforced often is characterized by carnage from motor vehicular crashes resulting in severe injuries with unacceptably high mortality. The descriptive demographics and injury characteristics of pedestrian road crash victims presenting to a tertiary medical center in southwestern Nigeria are presented in order to provide baseline epidemiology as a first step in determining areas of potential mitigation for care of unintentional injuries.Methods:Consecutive pedestrian road traffic crash patients treated in the Accident and Emergency Department of a tertiary hospital were prospective-ly reviewed from March 2007 to February 2008 to determine baseline demo-graphics and clinical outcomes.Results:A total of 184 patients with a mean value of the ages of 31.4 years were studied; 27% of the patients were <11 years of age. The male to female ratio was 1.6:1. Fifty-four percent of the victims were struck by automobiles and 29% were struck by motorcycles. Sixty-five percent were struck while crossing common thoroughfares. Head injury was sustained in 61% of patients. The mortality rate was 31.0% (n = 57). The clinical course leading to death showed 22.8% of the patients who died initially experienced hemorrhagic shock, 17.5% suffered a severe head injury, and 17.5% suffered aspiration. Autopsy confirmed brainstem herniation in 28.1% of the patients who died. The average interval between injury and death was 5.5 ±13.6 days (range: 0–77 days). In this setting, three out of every ten patients experienc-ing pedestrian vehicular trauma will die before leaving the hospital.The elder-ly are most at risk, with two-thirds of victims dying from injuries sustained.Conclusions:This raises serious questions about the prehospitaland hospi-tal-based emergency services for vehicular road crash victims in this environ-ment, and confirms the World Health Organization findings that Africa has the highest rate overall for unintentional injury deaths. A system-wide program must be put in place that addresses proven prevention measures across all sectors of the community.

Is the pedestrian an endangered group of road users? A descriptive account of pedestrian injuries

“…A study of RTC fatalities in Mexico showed that there was an increased incidence in patients over 55 years (8). This is in contrast to what we found and what was found by several other authors using fatalities, community or hospital data (9)(10)(11)(12). The average age of male pedestrians injured was significantly lower than that of female pedestrians in a study in South Africa that collected data from adults above the age of 15 years (13).…”

“…In urban Kampala there is also a large number of injuries involving bicycles although the majority of these are not serious enough to warrant medical attention (7). In parts of Nigeria, more pedestrians were injured by motor vehicles than motorcycles (12) while in other parts of Nigeria motorcycles were the commonest cause of pedestrian injuries (14). In Thailand, motorcycles are responsible for a majority of pedestrian injuries (15).…”

Neighbourhood characteristics and under-five mortality in Nigeria

“…; (Ekenze et al, 2009;Ifesanya et al, 2009;Melliez et al, 2007;Okafor et al, 2009;Okoro et al, 2009). Many other studies that are not hospital-based, but population-based failed to consider the influence of contextual situation where children are raised on their survival chances.…”