León Alba Luz, Ascuntar-Tello Johana, Valderrama-Molina Carlos Oliver, Giraldo Nelson Darío, Constaín Alfredo, Puerta Andrés, Restrepo Camilo, Jaimes Fabián
Universidad de Antioquia, Medellín, Colombia.
Hospital Pablo Tobón Uribe, Medellín, Colombia.
J Clin Orthop Trauma. 2018 Mar;9(Suppl 1):S49-S55. doi: 10.1016/j.jcot.2017.11.012. Epub 2017 Nov 24.
Traffic accidents are considered a public health problem and, according to the World Health Organization, currently is the eighth cause of death in the world. Specifically, pedestrians, cyclists and motorcyclists contribute half of the fatalities. Adequate clinical management in accordance with aggregation patterns of the body areas involved, as well as the characteristics of the accident, will help to reduce mortality and disability in this population.
Secondary data analysis of a cohort of patients involved in traffic accidents and admitted to the emergency room (ER) of a high complexity hospital in Medellín, Colombia. They were over 15 years of age, had two or more injuries in different areas of the body and had a hospital stay of more than 24 h after admission. A cluster analysis was performed, using Ward's method and the similarity measure, to obtain clusters of body areas most commonly affected depending on the type of vehicle and the type of victim.
Among 2445 patients with traffic accidents, 34% (n = 836) were admitted into the Intensive Care Unit (ICU) and the overall hospital mortality rate was 8% (n = 201). More than 50% of the patients were motorcycle riders but mortality was higher in pedestrian-car accidents (16%, n = 34). The clusters show efficient performance to separate the population depending on the severity of their injuries. Pedestrians had the highest mortality after having accidents with cars and they also had the highest number of body parts clustered, mainly on head and abdomen areas.
Exploring the cluster patterns of injuries and body areas affected in traffic accidents allow to establish anatomical groups defined by the type of accident and the type of vehicle. This classification system will accelerate and prioritize ER-care for these population groups, helping to provide better health care services and to rationalize available resources.
交通事故被视为一个公共卫生问题，根据世界卫生组织的数据，目前是全球第八大致死原因。具体而言，行人、骑自行车的人和骑摩托车的人占死亡人数的一半。根据受伤身体部位的聚集模式以及事故特征进行适当的临床管理，将有助于降低该人群的死亡率和残疾率。
对哥伦比亚麦德林一家高复杂性医院急诊科收治的交通事故患者队列进行二次数据分析。他们年龄超过15岁，身体不同部位有两处或更多损伤，入院后住院时间超过24小时。使用沃德方法和相似性度量进行聚类分析，以根据车辆类型和受害者类型获得最常受影响的身体部位聚类。
在2445例交通事故患者中，34%（n = 836）被收入重症监护病房（ICU），总体医院死亡率为8%（n = 201）。超过50%的患者是摩托车骑手，但行人与汽车相撞事故中的死亡率更高（16%，n = 34）。聚类显示出根据受伤严重程度有效区分人群的性能。行人在与汽车发生事故后的死亡率最高，而且他们聚类的身体部位数量也最多，主要集中在头部和腹部区域。
探索交通事故中受伤部位和受影响身体区域的聚类模式，有助于建立由事故类型和车辆类型定义的解剖学分组。这种分类系统将加快对这些人群的急诊护理并确定其优先级，有助于提供更好的医疗服务并合理配置可用资源。
