Search

Abstract: Powered two-wheelers (PTWs – mopeds, motorcycles, and scooters) remain the most dangerous form of travel on today''s roads. This study used hospital discharge data from eight European countries to examine the frequencies and patterns of injury among PTW users (age≥14 years), the predicted incidence of the loss of functional ability, and the mechanisms of the head injuries observed (all in light of increased helmet use). Of 977,557 injured patients discharged in 2004, 12,994 were identified as having been injured in PTW collisions. Lower extremity injuries accounted for 26% (25.6–26.7, 95% C.I.) of the total injuries, followed by upper extremity injuries (20.7%: 20.3–21.2), traumatic brain injuries (TBI) (18.5%: 18–19), and thoracic injuries (8.2%: 7.8–8.5). Approximately 80% of the lower extremity injury cases were expected to exhibit some functional disability one year following discharge (predicted Functional Capacity Index, pFCI-AIS98<100), compared to 47% of the upper extremity injury cases and 24% of the TBI cases. Although it occurred less frequently, patients that were expected to experience some functional limitation from TBI were predicted to fair worse on average (lose more functional ability) than patients expected to have functional limitations from extremity injuries. Cerebral concussion was the most common head injury observed (occurring in 56% of head injury cases), with most concussion cases (78%) exhibiting no other head injury. Among the AIS3+ head injuries that could be mapped to an injury mechanism, 48% of these were associated with a translational-impact mechanism, and 37% were associated with a rotational mechanism. The observation of high rates of expected long-term disability suggests that future efforts aim to mitigate lower and upper extremity injuries among PTW users. Likewise, the high rates of concussion and head injuries associated with a rotational mechanism provide goals for the next phase of PTW user head protection. [Copyright &y& Elsevier]

Abstract: Out of the 50,000 yearly road traffic deaths in the European Union (formed by 27 European countries and commonly designated as EU-27), some 8500 are pedestrians. While some studies focus on the increased risk for pedestrian mortality compared to other road users, there is a dearth of information on injury patterns that could be used to prioritize injury prevention measures. Hospital discharge data from eight European countries have been used in this study. Injury information from 10,341 pedestrians sustaining 19,424 injuries has been analyzed. Data have been augmented with Abbreviated Injury Scale, Functional Capacity Index and Injury Severity Score codes, and have been categorized into the Barell Matrix. Fractures (51.1%, 50.3–51.8) and internal injuries (21.3%, 20.7–21.9) are the most frequently found in the data; however, blood vessel injuries and internal injuries are the ones associated with the highest risk of death. Head and lower extremities account for 26% of the injuries each, being spinal and thoracic injuries those showing the highest threat to life risk. Hip and lower extremities injuries are the most frequent cause of functional limitation 1 year after discharge. Due to its intrinsic importance, different injury causation mechanisms for head injuries have been analyzed. Though current standards and regulations consider Head Injury Criterion (HIC) as the only tool to assess the risk of injuries to the head, real world injury data show that only 12.1% (11.0–13.2) of these injuries can be attributed to a pure translational mechanism and therefore susceptible to be predicted by HIC. Design of prevention strategies, particularly from the engineering point of view, should benefit from this information. [Copyright &y& Elsevier]