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

Published online by Cambridge University Press:  28 June 2012

Adeleke O. Ifesanya ,
Dolapo Afuwape ,
Victoria N. Okoje ,
Atinuke Agunloye ,
Olusola Odole ,
Clement A. Okolo  and
Temitope O. Alonge
Adeleke O. Ifesanya*
Affiliation:
Department of Orthopaedics & Trauma, University College Hospital, Ibadan, Nigeria and College of Medicine, University of Ibadan, Ibadan, Nigeria
Dolapo Afuwape
Affiliation:
Department of Surgery, University College Hospital, Ibadan, Nigeria and College of Medicine, University of Ibadan, Ibadan, Nigeria
Victoria N. Okoje
Affiliation:
Department of Oral and Maxillofacial Surgery, University College Hospital, Ibadan, Nigeria and College of Medicine, University of Ibadan, Ibadan, Nigeria
Atinuke Agunloye
Affiliation:
Department of Radiology, University College Hospital, Ibadan, Nigeria and College of Medicine, University of Ibadan, Ibadan, Nigeria
Olusola Odole
Affiliation:
Department of Physiotherapy, University College Hospital, Ibadan, Nigeria and College of Medicine, University of Ibadan, Ibadan, Nigeria
Clement A. Okolo
Affiliation:
Department of Pathology, University College Hospital, Ibadan, Nigeria and College of Medicine, University of Ibadan, Ibadan, Nigeria
Temitope O. Alonge
Affiliation:
Department of Orthopaedics & Trauma, University College Hospital, Ibadan, Nigeria and College of Medicine, University of Ibadan, Ibadan, Nigeria
*
Department of Orthopaedics and Trauma, University College Hospital, Ibadan, Nigeria E-mail: lekeifesanya@yahoo.com
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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.

Keywords

injurymortalitymotorcycleNigeriapedestrianroad crash
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 5 , October 2009 , pp. 443 - 446
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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