Hostname: page-component-848d4c4894-8bljj Total loading time: 0 Render date: 2024-06-19T06:07:45.505Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Downing, AJ: Pedestrian Safety in Developing Countries. In: Proceedings of the Vulnerable Road User: International Conference on Traffic Safety. New Delhi, 27–30.January 1991. New Delhi: McMillan India Ltd, 1991.Google Scholar
2.Dessie, T, Larson, CP: The occurrence and driver characteristics associated with motor vehicle injuries in Addis Ababa, Ethiopia. J Trop Med Hyg 1991;94:395–400.Google ScholarPubMed
3.Berger, LR, Mohan, D: Injury Control: A Global View. Oxford: Oxford University Press, 1996.Google Scholar
4.World Health Organization: The World Report on Child Injury Prevention. News Release World Health Organization/46, available at http://www.who.int/violence_injury_prevention/child/injury/world_report/en/. Accessed 10 December 2008.Google Scholar
5.Hamilton-Wentworth Department of Public Health Services: Community Mobilization on Prevention of Child Pedestrian Injuries. Hamilton: Hamilton-Wentworth Department of Public Health Services, 1993.Google Scholar
6.Barton, BK, Schwebel, DC: The roles of age, gender, inhibitory control, and parental supervision in children's pedestrian safety. J Pediatr Psychol 2007;32(5):517–526.Google Scholar
7.Assailly, JP: Characterization and prevention of child pedestrian accidents: An overview. J App Dev Psychol 1997;18:257–262.CrossRefGoogle Scholar
8.Keall, MD: Pedestrian exposure to risk of road accident in New Zealand. Accid Anal Prev 1995;27:729–740.Google Scholar
9.Hoxie, RE, Rubenstein, LZ: Are older pedestrians allowed enough time to cross intersections safely? J Am Geriatr Soc 1994;3:241–244.CrossRefGoogle Scholar
10.McKay, MP, Vaca, F: Commentary: Pedestrian roadway fatalities: Profiling the problem. Ann Emerg Med 2003;42:480–482.CrossRefGoogle ScholarPubMed
11.Schwebel, DC, Barton, BK: Temperament and Children. In: Vollrath, M (ed): Handbook of Personality and Health. New York: Wiley, 2006, pp 51–71.Google Scholar
12.Morrongiello, BA: Children's perspectives on injury and close-call experi-ences: Sex differences in injury-outcome processes. J Ped Psychol 1997;22:499–512.CrossRefGoogle Scholar
13.Olson, LM, Sklar, DP, Cobb, LC, et al. : Analysis of childhood pedestrian deaths in New Mexico 1986–1990. Ann Emerg Med 1993;22:512–516.Google Scholar
14.Sethi, D, Zwi, AB: Accidents and Other Injuries. In: Chamie, J, Cliquet, RL (eds), Health and Mortality Issues of Global Concern. Proceedings of Symposium on Health and Mortality, Brussels, 19–22. November 1997. Brussels: Population Division United Nations and CBGS, 1999, pp 412–441.Google Scholar
15.Pedestrian accidents (editorial). Br Med J 1979;1(6156):101–104.Google Scholar
16.Crandall, JR, Bhalla, KS, Madeley, NJ: Designing road vehicles for pedestrian protection. BMJ 2002;324(7346):1109–1110.CrossRefGoogle ScholarPubMed
17.Ashton, SJ: Vehicle Design and Pedestrian Injuries. In: Chapman, AJ, Wide, FM, Foot, HC (eds), Pedestrian Accidents. New York: John Wiley & Sons, 1982, pp 169–202.Google Scholar
18.Brainard, B: Injury profiles in pedestrian motor vehicle trauma. Ann Emerg Med 1986;18:881–883.CrossRefGoogle Scholar
19.Parmet, S, Lynm, C., Glass, R: Pedestrian safety. JAMA 2002;288:2212.Google Scholar
20.Weis, EB, Pritz, HB, Hassler, CR: Experimental automobile-pedestrian injuries. J Trauma 1977;17:823–828.Google Scholar
21.Tester, JM, Rutherford, GW, Wald, Z, Rutherford, MW: A matched case-con-trol study evaluating the effectiveness of speed humps in reducing child pedestrian injuries. Am J Public Health 2004;94(4):646–650.Google Scholar
22.Howarth, CI, Repetto-Wright, R: The measurement of risk and the attribu-tion of responsibility for child pedestrian accidents. Safety Education 1978;144:10–13.Google Scholar