Akkaş Meltem, Ay Didem, Metin Aksu Nalan, Günalp Müge
Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, Ankara, Turkey.
Ulus Travma Acil Cerrahi Derg. 2011 Sep;17(5):440-4.
Although less frequent than automobile accidents, train accidents have a major impact on victims' lives.
Records of patients older than 16 years of age admitted to the Adult Emergency Department of Hacettepe University Medical Center due to train accidents were retrospectively evaluated.
44 patients (30 males, 14 females) with a mean age of 31.8±11.4 years were included in the study. The majority of the accidents occurred during commuting hours. 37 patients were discharged, 22 of them from the emergency department. The mortality rate was 7/44 (16%). Overall mean Revised Trauma Score (RTS) was 10.5 (3 in deaths and 11.9 in survivors). In 5 patients, the cause of death was pelvic trauma leading to major vascular injury and lower limb amputation. In 1 patient, thorax and abdomen trauma and in 1 patient head injury were the causes of mortality. Primary risk factors for mortality were alcohol intoxication (100%), cardiopulmonary resuscitation on admittance (100%), recurrent suicide attempt (75%), presence of psychiatric illness (60%), and low RTS.
In this study, most train accidents causing minor injuries were due to falling from the train prior to acceleration. Nevertheless, train accidents led to a mortality rate of 16% and morbidity rate of 37%. These findings draw attention to the importance of developing preventive strategies.
尽管火车事故不如汽车事故频繁，但对受害者的生活有重大影响。
回顾性评估因火车事故入住哈杰泰佩大学医学中心成人急诊科的16岁以上患者的记录。
44例患者（30例男性，14例女性）纳入研究，平均年龄31.8±11.4岁。大多数事故发生在通勤时间。37例患者出院，其中22例从急诊科出院。死亡率为7/44（16%）。总体平均修订创伤评分（RTS）为10.5（死亡患者为3分，存活患者为11.9分）。5例患者的死亡原因是骨盆创伤导致大血管损伤和下肢截肢。1例患者因胸部和腹部创伤，1例患者因头部受伤死亡。死亡的主要危险因素是酒精中毒（100%）、入院时心肺复苏（100%）、反复自杀未遂（75%）、精神疾病（60%）和低RTS。
在本研究中，大多数造成轻伤的火车事故是由于在火车加速前从火车上坠落。然而，火车事故导致死亡率为16%，发病率为37%。这些发现凸显了制定预防策略的重要性。
