Patterns of Motorbike Accidents Related Head Injuries in Patients Presenting to a Tertiary Care Hospital of Peshawar
Keywords:
Road Traffic Accidents, Head Injury, Motorbike AccidentAbstract
Objective: To determine the different patterns of motorbike related head injuries in patients presenting to a tertiary care hospital of Peshawar.
Materials and Methods: It was a prospective (observational) study, which was conducted at the Neurotrauma ward of Neurosurgery department, Lady Reading Hospital, Peshawar from January 2016 to June 2016. Total number of patients were 246. We included those patients who were having impaired Glasgow Coma Scale (GCS), danger signs and having some abnormal findings on CT brain. We excluded those patients who were having GCS 15/15 and those patients of head injury having associated co-morbid conditions.
Results: There were 230 (93.49%) males and 16 (6.5%) females. Age range was 1 to 80 years. Majority of pati-ents were drivers (55.28%). Only 6 (2.43%) drivers used helmet. Ninety patients (36.58%) had an ICU stay of more than one week. Seventy six (30.89%) patients were operated and 170 (69.1%) patients were treated con-servatively. Mortality was 14.63% in our study.
Conclusion: Majority were males in our study, most of the patients who sustained head injury in motorbike accidents were drivers. Thirty six percent of the patients needed ICU stay of more than 1 week. Maximum of the patients needed conservative treatment.
References
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48. Kidwell CS et al: Comparison of MRI and CT for dete-ction of acute intracerebral hemorrhage. JAMA. 2004; 292 (15): 1823-1830.
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50. Stippler M,et al. Utility of routine follow-up head CT scanning after mild traumatic brain injury: A systematic review of the literature. Emerg Med J. 2012; 29 (7): 528-532.
51. Bainbridge J, Khirwadkar H, Hourihan MD: Vomiting - is this a good indication for CT head scans in patients with minor head injury? Br J Radiol. 2012; 85 (1010): 183-186.
52. Sharif-Alhoseini M, Khodadadi H, Chardoli M, Rahi-mi-Movaghar V: Indications for brain computed tomo-graphy scan after minor head injury. J Emerg Trauma Shock, 2011; 4 (4): 472-476.
53. Leong LB, Sukarom S, Vasu A, Hian LG: Identifying predictors of an abnormal computed tomographic scan among patients with a head injury and a Glasgow Coma Scale of 15. Eur J Emerg Med Epub ahead of print, 2012. 54. J. Hitimana, M. Perez, A. Kinasha, and I. Kakande, “Clinical presentation and outcome of neurosurgical
2. Mohan D. Road safety in less-motorized environments: future concerns. Int. J. Epidemiol. 2002; 31: 527–32.
3. Nantulya VM RM. The neglected epidemic: road traffic injuries in developing countries. BMJ. 2002; 324: 1139-41.
4. Peden M mK, Krug E. Injury: a leading cause of the global burden of disease, 2000. Geneva: WHO; 2002. The injury chart book 2000 (2002).
5. Peden MM, McGee K, Krug E, Injuries WHO, Dept VP. Injury: a leading cause of the global burden of disease, 2000: Dept. of Injuries and Violence Prevent-ion, Noncommunicable Diseases and Mental Health Cluster, WHO; 2002.
6. Odero W GP, Zwi A. Road traffic injuries in develop-
ing countries: a comprehensive review of epidemiolo-gical studies. Trop Med Int Health, 1997; 2 (5): 445–60.
7. Jacobs G AA, Astrop A. Estimating global road fata-lities. London: Transport Research Laboratory. 2000 (TRL Report 445).
8. Murray CJ LA. The global burden of disease: a com-prehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. (Global burden of disease and injury series). Boston: Harvard School of Public Health; 1996: 1.
9. Bazarian JJ, Blyth B, Mookerjee S, He H, McDermott MP: Sex differences in outcome after mild traumatic brain injury. J Neurotrauma, 2010; 27: 527–539.
10. Bell RS, Mossop CM, Dirks MS, Stephens FL, Mulli-gan L, Ecker R, Neal CJ, Kumar A, Tigno T, Armonda RA: Early decompressive craniectomy for severe pene-trating and closed head injury during wartime. Neuro-surg Focus, 2010; 28: E1.
11. Nantulya VM RM. Equity dimensions of road traffic injuries in low and middle-income countries. lnj Con-trol Saf Promot. 2003; 10 (1-2): 13-20.
12. Madubueze CC, Chukwu CO, Omoke NI, Oyakhilome OP, Ozo C. Road traffic injuries as seen in a Nigerian teaching hospital. Int Orthop. Jul 11. Pub Med PMID: 20623283.
13. Tham KY, Seow E, Lau G. Pattern of injuries in hel-meted motorcyclists in Singapore. Emergency medicine journal: EMJ. 2004 Jul; 21 (4): 478-82.
14. Labinjo M, Juillard C, Kobusingye OC, Hyder AA. The burden of road traffic injuries in Nigeria: results of a population-based survey. Inj Prev. 2009 Jun; 15 (3): 157-62.
15. Ghaffar A, Hyder A, Mastoor M, Shaikh I. Injuries in Pakistan: directions for future health policy. Health pol-icy and planning, 1999; 14: 11.
16. Mayou R, Tyndel S, Bryant B. Long-term outcome of motor vehicle accident injury. Am Psychosomatic Soc 1997: 578-84.
17. Peden M, Scurfield R, Sleet D, Mohan D, Hyder AA, Jarawan E, et al. World report on road traffic injury prevention. World Health Organization Geneva; 2004.
18. Hyder AA, Morrow RH. Applying burden of disease methods to developing countries: case study from Paki-stan. Am J Public Health, 2000; 90: 1235-40.
19. A, Rehman. The Burden of Road Traffic Injuries in South Asia: A Commentary. JCPSP. 2004; 14: 707-8.
20. Razzak JA, Luby SP. Estimating deaths and injuries due to road traffic accident in Karachi, Pakistan, thro-ugh the capture-recapture method. Int J Epidemiol. 1998; 27: 866-70.
21. Hyder AA, Ghaffar A, M asood TI. Motor Vehicle cra-shes in Pakistan: the emerging epidemic. Injury pre-vention, 2006; 6: 199-202.
22. Sexton B, Baughan C, Elliott M, Maycock G. The acci-dent risk of motorcyclists. Crowthorne: Transport Rese-arch Laboratory, 2004.23. K enneth S. O benski P. M otorcycle A ccident Recon-struction and Litigation, 3rd Ed. Lawyers & Judges Publishing, 2002.
24. Tham KY, Seow E, Lau G. Pattern of injuries in hel-meted motorcyclists in Singapore. Emerg Med J. 2004: 478-82.
25. Skalkidou A, Petridou E, Papadopoulos FC, Dessypris N, Trichopoulos D. Factors affecting motorcycle helmet use in the population of Greater Athens, Greece. Injury Prevention, 1999: 264-7.
26. larke DD, Ward P, Bartle C, Truman W. In-depth Study of Motorcycle Accidents. Road Safety Research Report, 2004: 54.
27. Christian WJ, Carroll M, Meyer K, Vitaz TW, Franklin GA. Motorcycle helmets and head injuries in Kentucky, 1995-2000. J Ky Med Assoc. 2003; 101: 21.
28. Van HT, S in g h asiv an o n P, K aew kungw al J, Suri-yawongpaisal P, Khai LH. Estimation of non-fatal road traffic injuries in Thai Nguyen, Vietnam using capture-recapture method. Southeast Asian J Trop Med Public Health, 2006; 37: 405.
29. Shukla D, Devi BI: Mild traumatic brain injuries in adults. J Neurosci Rural Pract. 2010; 1 (2): 82-88.
30. Lee B, Newberg A: Neuroimaging in Traumatic Brain Imaging. Neuro Rx. 2005; 2 (2): 372-83.
31. Servadei F, Teasdale G, Merry G: Neurotraumatology Committee of the World Federation of Neurosurgical Societies. Defining acute mild head injury in adults: A proposal based on prognostic factors, diagnosis, and management. J Neurotrauma, 2001; 18: 657–664.
32. Masson F et al.: Epidemiology of severe brain injuries: A prospective population-based study. J Trauma, 2001; 51 (3): 481-489.
33. Stevens JA, Dellinger AM: Motor vehicle and fall rela-ted deaths among older Americans 1990–98: Sex, race, and ethnic disparities. Inj Prev. 2002; 8 (4): 272-275. 34. Umerani MS1, Abbas A, Sharif S. Traumatic brain inju-ries: experience from a tertiary care centre in Pakistan. Turk Neurosurg. 2014; 24 (1): 19-24.
35. Thurman D: Head Trauma: Basic, preclinical, and clini-cal directions. In: Miller L, Ayes R (ed). Head Trauma: Basic, Preclinical, and Clinical Directions. New York: John Wiley and Sons, 2001: 327–347.
36. Jooma R, Ahmed S, Zarden AM: Comparison of Two Surveys of head injured patients presenting during a calendar year to an Urban Medical Centre 32 years apart. J Pak Med Ass. 2005; 55 (12): 630-632.
37. Raja IA, Vohra AH, Ahmed M: Neurotrauma in Pakis-tan. World J Surg. 2001; 25: 1230–1237.
38. Jinnah Postgraduate Medical Centre, Half Yearly Rep-ort Jan to Jun & Half Yearly Comparison of 2008 to 2011. Road Traffic Injury Research & Prevention Cen-tre; 2011 Aug.
39. Hyder AA, Ghaffar A, Masood TI: Motor vehicle cra-shes in Pakistan: The emerging epidemic. Inj Prev. 2000; 6: 199-202.
40. Naddumba, E.K. A cross sectional retrospective study of boda injuries at Mulago Hospital in Kampala, Uga-nda. ECAJS. 2004; 9: 44-47.
41. Okeniyi, J.A. et al. Motorcycle injury: an emerging menace to child health in Nigeria. Internet J Pediatr Neonatol. 2005; 5 (1).
42. J. Mayrose, “The effects of a mandatory motorcycle helmet law on helmet use and injury patterns among motorcyclist fatalities,” J Safety Res. 2008; Vol. 39, No. 4: pp. 429–432.
43. P. F. Umebese and S. U. Okukpo, “Motorcycle acci-dents in a Nigeria University campus: a one year study of pattern of trauma sustained in the University of Ben-in,” Niger J Clin Pract. 2001; Vol. 10: pp. 33–36.
44. P. Siviroj, K. Peltzer, S. Pengpid, and S. Morarit, “Hel-met use and associated factors among thai motorcyclists during Songkran festival,” Int J Environ Res Public Health, 2012; Vol. 9, No. 9: pp. 3286–3297.
45. B. A. Solagberu, C. K. P. Ofoegbu, A. A. Nasir, O. K. Ogundipe, A.O. Adekanye, and L.O. Abdur-Rahman, “Motorcycle injuries in a developing country and the vulnerability of riders, passengers, and pedestrian,” Inj Prev. 2006; Vol. 12, No. 4: pp. 266–268.
46. Raja IA, Vohra AH, Ahmed M: Neurotrauma in Pakis-tan. World J Surg. 2001; 25: 1230–1237.
47. M. Richter, D. Otte, U. Lehmann et al., “Head injury mechanisms in helmet-protected motorcyclists: pros-pective multicenter study,” J Trauma —Injury, Infection and Critical Care, 2001; Vol. 51, No. 5: pp. 949–958.
48. Kidwell CS et al: Comparison of MRI and CT for dete-ction of acute intracerebral hemorrhage. JAMA. 2004; 292 (15): 1823-1830.
49. Papa L, et al: Performance of the Canadian CT Head Rule and the New Orleans Criteria for predicting any traumatic intracranial injury on computed tomography in a United States Level I trauma center. Acad Emerg Med. 2012; 19 (1): 2-10.
50. Stippler M,et al. Utility of routine follow-up head CT scanning after mild traumatic brain injury: A systematic review of the literature. Emerg Med J. 2012; 29 (7): 528-532.
51. Bainbridge J, Khirwadkar H, Hourihan MD: Vomiting - is this a good indication for CT head scans in patients with minor head injury? Br J Radiol. 2012; 85 (1010): 183-186.
52. Sharif-Alhoseini M, Khodadadi H, Chardoli M, Rahi-mi-Movaghar V: Indications for brain computed tomo-graphy scan after minor head injury. J Emerg Trauma Shock, 2011; 4 (4): 472-476.
53. Leong LB, Sukarom S, Vasu A, Hian LG: Identifying predictors of an abnormal computed tomographic scan among patients with a head injury and a Glasgow Coma Scale of 15. Eur J Emerg Med Epub ahead of print, 2012. 54. J. Hitimana, M. Perez, A. Kinasha, and I. Kakande, “Clinical presentation and outcome of neurosurgical
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