Traffic injury prevention
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Traffic injury prevention · Sep 2016
Functional outcomes of motor vehicle crash head injuries in pediatric and adult occupants.
The objective of the study was to develop a disability-based metric for motor vehicle crash (MVC) injuries, with a focus on head injuries, and compare the functional outcomes between the pediatric and adult populations. ⋯ At-risk populations such as pediatric and older adult patients possessed higher DRMAIS values for different head injuries. Disability in pediatric patients is critical due to loss of quality life years. Disability risk can supplement severity metrics to improve the ability of such metrics to discriminate the severity of different injuries that do not lead to death. Understanding of age-related differences in injury outcomes when compared to adults could inform future age-specific modifications to the AIS.
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With the increasing popularity of cycling generally and availability of new bicycle child carriers, there is an emerging interest in the safety of child bicycle passengers and riders. However, very little is known about the nature and extent of injuries to child bicycle riders and passengers. The aim of this study was to enhance our understanding of child safety in bike transportation and to identify injury patterns and outcomes. ⋯ • Analyses of injury data to understand the nature and extent of injuries to children on bikes as passengers and riders. • Child cyclist injuries as a significant safety issue within Victoria, Australia. • Young children aged 0-3 years experienced significantly more head injuries compared to older children.
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Traffic injury prevention · Sep 2016
Development of an expert based ICD-9-CM and ICD-10-CM map to AIS 2005 update 2008.
This article describes how maps were developed from the clinical modifications of the 9th and 10th revisions of the International Classification of Diseases (ICD) to the Abbreviated Injury Scale 2005 Update 2008 (AIS08). The development of the mapping methodology is described, with discussion of the major assumptions used in the process to map ICD codes to AIS severities. There were many intricacies to developing the maps, because the 2 coding systems, ICD and AIS, were developed for different purposes and contain unique classification structures to meet these purposes. ⋯ This mapping between ICD and AIS provides a comprehensive, expert-designed solution for analysts to bridge the data gap between the injury descriptions provided in hospital codes (ICD-9-CM, ICD-10-CM) and injury severity codes (AIS08). By applying consistent rules from both the ICD and AIS taxonomies, the expert panel created these definitive maps, which are the only ones endorsed by the Association for the Advancement of Automotive Medicine (AAAM). Initial validation upheld the quality of these maps for the estimation of AIS severity, but future work should include verification of these maps for MAIS and ISS estimations with large data sets. These ICD-AIS maps will support data analysis from databases with injury information classified in these 2 different systems and open new doors for the investigation of injury from traumatic events using large injury data sets.
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Traffic injury prevention · Sep 2016
Prehospital transportation decisions for patients sustaining major trauma in road traffic crashes in Sweden.
The objective of this study was to evaluate the proportion and characteristics of patients sustaining major trauma in road traffic crashes (RTCs) who could benefit from direct transportation to a trauma center (TC). ⋯ Our results show that the majority of RTC major trauma patients are transported to a non-TC. This may cause unnecessary morbidity and mortality. These findings can guide the development of improved prehospital treatment guidelines, protocols and decision support systems.
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Traffic injury prevention · Sep 2016
Changing threshold for AIS scores of thoracolumbar compression fractures.
The Abbreviated Injury Scale (AIS) is an anatomical-based coding system created by the Association for the Advancement of Automotive Medicine, utilized to classify and code injuries resulting from trauma, in order of severity. According to the latest version, all Thoraco-Lumbar Compression Fractures (TLCF), even without injury to other spine components and with >20% loss of height, were branded AIS 3 injuries, reflecting a serious threat to life or permanent disability. Advances in spine imaging, recent biomechanical studies, and long-term outcomes research offer the opportunity to consider these injuries differently. ⋯ These results are consistent with evolving clinical thinking, resulting in decreasing surgical incidence and orthosis use. Our data strongly suggests that isolated compression fractures in the absence of neurologic deficit or severe cord compression due to retropulsed bone are self-limiting. Therefore, the AIS scores for these common injuries could be reconsidered and reflect their relatively benign outlook.