Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.
Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, VIC 3162, Australia.
Int J Environ Res Public Health. 2021 Oct 29;18(21):11380. doi: 10.3390/ijerph182111380.
Road trauma remains a significant public health problem. We aimed to identify sub-groups of motor vehicle collisions in Victoria, Australia, and the association between collision characteristics and outcomes up to 24 months post-injury. Data were extracted from the Victorian State Trauma Registry for injured drivers aged ≥16 years, from 2010 to 2016, with a compensation claim who survived ≥12 months post-injury. People with intentional or severe head injury were excluded, resulting in 2735 cases. Latent class analysis was used to identify collision classes for driver fault and blood alcohol concentration (BAC), day and time of collision, weather conditions, single vs. multi-vehicle and regional vs. metropolitan injury location. Five classes were identified: (1) daytime multi-vehicle collisions, no other at fault; (2) daytime single-vehicle predominantly weekday collisions; (3) evening single-vehicle collisions, no other at fault, 36% with BAC ≥ 0.05; (4) sunrise or sunset weekday collisions; and (5) dusk and evening multi-vehicle in metropolitan areas with BAC < 0.05. Mixed linear and logistic regression analyses examined associations between collision class and return to work, health (EQ-5D-3L summary score) and independent function Glasgow Outcome Scale - Extended at 6, 12 and 24 months. After adjusting for demographic, health and injury characteristics, collision class was not associated with outcomes. Rather, risk of poor outcomes was associated with age, sex and socioeconomic disadvantage, education, pre-injury health and injury severity. People at risk of poor recovery may be identified from factors available during the hospital admission and may benefit from clinical assessment and targeted referrals and treatments.
道路创伤仍然是一个重大的公共卫生问题。我们旨在确定澳大利亚维多利亚州机动车碰撞的亚组，并确定碰撞特征与受伤后 24 个月内结果之间的关系。从 2010 年至 2016 年，从维多利亚州创伤登记处提取了数据，涉及年龄≥16 岁的受伤驾驶员，有赔偿要求，且在受伤后≥12 个月存活。排除了故意或严重头部受伤的人，共纳入 2735 例患者。使用潜在类别分析来确定驾驶员过失和血液酒精浓度（BAC）、碰撞时间和日期、天气条件、单辆车与多辆车以及受伤地点的区域与城市之间的碰撞类别。确定了五个类别：（1）白天多辆车碰撞，无其他过错；（2）白天单辆车为主、工作日碰撞；（3）晚上单辆车碰撞，无其他过错，36%的 BAC≥0.05；（4）工作日日出或日落碰撞；（5）黄昏和晚上多辆车在城市地区，BAC<0.05。混合线性和逻辑回归分析检查了碰撞类别与重返工作、健康（EQ-5D-3L 综合评分）和受伤后 6、12 和 24 个月独立功能格拉斯哥结局扩展量表之间的关联。在调整了人口统计学、健康和受伤特征后，碰撞类别与结果无关。相反，不良结果的风险与年龄、性别和社会经济劣势、教育、受伤前健康和受伤严重程度有关。可根据住院期间的可用因素识别出恢复不佳的风险人群，并可通过临床评估和有针对性的转诊和治疗获益。
