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Abstract Background For real-time assessment of the probability of survival (Ps) of blunt trauma victims at emergency centers, this study aimed to establish regression models for estimating Ps using simplified coefficients. Methods The data of 10,210 blunt trauma patients not missing both the binary outcome data about survival and the data necessary for Ps calculation by The Trauma and Injury Severity Score (TRISS) method were extracted from the Japan Trauma Data Bank (2004-2007) and analyzed. Half (5,113) of the data was allocated to a derivation data set, with the other half (5,097) allocated to a validation data set. The data of 6,407 blunt trauma victims from the trauma registry of Khon Kaen Regional Hospital in Thailand were analyzed for validation. The logistic regression models included age, the Injury Severity Score (ISS), the Glasgow Coma Scale score (GCS), systolic blood pressure (SBP), respiratory rate (RR), and their coded values (cAGE, 0-1; cISS, 0-4; cSBP, 0-4; cGCS, 0-4; cRR, 0-4) as predictor variables. The coefficients were simplified by rounding off after the decimal point or choosing 0.5 if the coefficients varied across 0.5. The area under the receiver-operating characteristic curve (AUROCC) was calculated for each model to measure discriminant ability. Results A group of formulas (log (Ps/1-Ps) = logit (Ps) = -9 + cISS - cAGE + cSBP + cGCS + cRR/2, where -9 becomes -7 if the predictor variable of cRR or cISS is missing) was developed. Using these formulas, the AUROCCs were between 0.950 and 0.964. When these models were applied to the Khon Kean data, their AUROCCs were greater than 0.91. Conclusion: These equations allow physicians to perform real-time assessments of survival by easy mental calculations at Asian emergency centers, which are overcrowded with blunt injury victims of traffic accidents.

Thailand faces road safety challenges. The country has a high rate of road traffic deaths, with 36.2 deaths per 100 000 population per year according to the World Health Organization [...]

Background: The aims of care for victims of accident and emergency are to avoid preventable death and disabilities. Studies worldwide have shown that death could be prevented in many cases that die before reaching the hospital. Many complications resulting in disabilities could be also be prevented with good pre hospital care. Pre hospital care system are much well developed in all developed countries but much less developed in Thailand. Objectives: To development an effective pilot model of pre hospital care system in Khon Kaen Province and to advocate the necessity of pre hospital care system in Thailand. Materials and Methods: Model development by setting up organization structure, provincial wide command control center in Khon Kaen hospital together with extensive campaign through public media, recruiting and developing qualified personnel. Setting up ambulance standard, pre hospital care network and zoning, setting up rules and regulations and software program to monitor the system. Multiple seminars, lecturers were held. Results: A well developed pre hospital care model has been established in Khon Kaen province. In the year 2003, 28 ambulance stations had been set up provincial wide. 140 pre hospital care nurses had been trained, 98 EMT had been produced, and thousands of volunteers had been trained. Ambulance missions had been progressively increased every year. In 2003, there were more than 7,000 missions. 89% of the ambulance missions left the hospital within 1 minute after the call and 80% of the ambulance missions reached the scene within 10 minutes. The quality of critical care run by personnel had progressively improved. Four National Seminars were held in 1999, 2000, 2001, and 2002. Conclusions: Pre hospital care system is one of the major components in inclusive trauma care system. This system is still much less developed in Thailand. Khon Kaen province has developed the pilot project of pre hospital care model since 1994 and has resulted in well developed system provincial wide and it is promising that all accident and emergency in the province would be well covered and people in Khon Kaen are well accessible to this system. The next step of countrywide generalization required more complicated, multisector collaboration, master plan establishment, financial consideration and strong political commitment. [ABSTRACT FROM AUTHOR]

Young motorcycle drivers in Thailand are at high risk for road traffic accidents. We conducted this study to identify factors associated with motorcycle accident risk behavior (MARB). We studied 372 randomly selected university students aged 18-22 years (mean 20.2 years; women comprised 68.0% of our participants), who attend a government university in northeastern Thailand. Each student was asked to fill out a questionnaire asking about MARB and factors associated with this behavior. The respondents had an average of 6.2 years (SD+3.09) motorcycle driving experience, 72.3% had a motorcycle driver's license and 83.0% had accident insurance. The prevalence of self-reported motorcycle accident injuries was 42.7%. Their major MARB were using a telephone while driving (69.3%), speeding (45.4%), driving with more than one passenger (40.1%), drunk driving (22.1%), and not wearing a helmet (23.3%). Factors related to MARB were: gender, with men engaged in risky behavior more often than women (p < 0.05); duration of motorcycle driving--drivers with > 5 years experience were more likely to engage in risky behavior (p < 0.05); and knowledge of safe driving, those with a greater knowledge of safe driving were more likely to drive safely (p < 0.001). Having a greater awareness of MARB was associated with lower risk of engaging in risky behavior (p < 0.001). Students who engaged in risky behavior were more likely to view it as normal behavior (p < 0.001) and less likely to have adequate self-control (p < 0.001). Our findings indicate a need to strengthen accident prevention programs for university students in northeastern Thailand.

Background: Road traffic injuries are a major public health problem in Thailand. The number of mortalities, morbidities and disabilities are huge, greatly affecting the individual victims, the families, society and the nation as a whole., Objective: To study the current situation regarding traffic injuries in Thailand., Material and Method: Retrospective study from multiple national data sources, Results: For over ten years, the annual death toll due to road accidents has been more than ten thousand Thais. The situation remains critical with a higher mortality and morbidity than many other low or middle income countries. Two-thirds of the victims were males: 80% were under 40 years of age. Most (80%) of the injured and dead were motorcyclists. The large number of traffic crashes, injuries, disabilities and deaths resulted in more than 168 thousand million Baht in economic losses in 2002. These losses are trending to increase., Conclusion: Traffic injuries are a persistent major public health concern primarily because of a lack of adherence to the use of safety restraints and obedience of traffic laws. The nation must not hesitate to increase efforts to address these problems, as they are costing life and limb of Thais every hour of every day, as well as adding a huge economic burden.

This study was conducted in 2000-2001 in order to improve the quality of trauma care by establishing the Key Performance Indicators (KPIs) as a guideline in providing trauma care service and to study the personnel's performance following 27 indexes of KPIs for trauma care in Khon Kaen Hospital. After the implementation of the KPIs by the method of participatory action research (PAR), the trauma preventable death rate was decreased to 1.3 per cent which was statistically different from the preventable death rate in 1997 (2.0%).