Center for Health Systems Research, National Institute of Public Health, Universidad #655, Colonia Santa María Ahuacatitlán, Cerr los Pinos y Caminera, CP 62100, Cuernavaca, Morelos, Mexico.
Hospital General de León, León, Guanajuato, Mexico.
BMC Emerg Med. 2022 Feb 4;22(1):20. doi: 10.1186/s12873-022-00576-x.
Limited data from low- and middle-income countries (LMICs) on the severity of road traffic injuries (RTIs) and their relation to different variables of interest are routinely obtained. Knowledge on this subject relies on evidence from high-income countries, which might not be the same as in LMICs. This information is greatly needed to advance and inform local and regional efforts towards the United Nations' Decade of Action and the Sustainable Development Goals.
From May 2012 to November 2014, a RTI surveillance system was implemented in two referral hospitals in two Mexican cities, León and Guadalajara, with the objective of exploring the relationship between Injury Severity Score (ISS) and different sociodemographic characteristics of the injured as well as different variables related to the event and the environment. All individuals suffering RTIs who visited the Emergency Rooms (ER) were included after granting informed consent. A Zero-Truncated Negative Binomial Model was employed to explore the statistical association between ISS and variables of interest.
3024 individuals participated in the study: 2185 (72.3%) patients from León and 839 patients (27.7%) from Guadalajara. Being male, in the 20-59 age-group, having less schooling, events occurring in Guadalajara, on Sundays, at night, and arriving at ER via public/private ambulance were all associated with an increased log count of ISS. Found a significant interaction effect (p-value< 0.05) between type of road user and alcohol intake six hours before the accident on severity of the injury (ISS). The use of illicit drugs, cellphones and safety devices during the event showed no association to ISS.
Our study contributes to the statistical analysis of ISS obtained through RTI hospital surveillance systems. Findings might facilitate the development and evaluation of focused interventions to reduce RTIs in vulnerable users, to enhance ER services and prehospital care, and to reduce drink driving.
低中等收入国家（LMICs）常规获得关于道路交通伤害（RTIs）严重程度以及其与不同感兴趣变量关系的有限数据。关于这一主题的知识依赖于来自高收入国家的证据，而这些证据可能与 LMICs 不同。为了推进和为地方和区域努力提供信息，以实现联合国行动十年和可持续发展目标，非常需要这些信息。
2012 年 5 月至 2014 年 11 月，在墨西哥两个城市莱昂和瓜达拉哈拉的两家转诊医院实施了 RTI 监测系统，目的是探讨损伤严重程度评分（ISS）与受伤者不同社会人口特征以及与事件和环境相关的不同变量之间的关系。在获得知情同意后，所有因 RTIs 就诊急诊室（ER）的个体都被纳入研究。采用零截断负二项模型探索 ISS 与感兴趣变量之间的统计学关联。
共有 3024 人参与了这项研究：2185 人（72.3%）来自莱昂，839 人（27.7%）来自瓜达拉哈拉。男性、20-59 岁年龄段、受教育程度较低、事件发生在瓜达拉哈拉、周日、夜间、乘坐公共/私人救护车到达 ER，这些都与 ISS 的对数计数增加有关。在事故发生前六小时，道路交通参与者类型和酒精摄入与损伤严重程度（ISS）之间存在显著的交互作用效应（p 值<0.05）。在事件中使用非法药物、手机和安全设备与 ISS 无关。
本研究为通过 RTI 医院监测系统获得的 ISS 进行了统计分析。研究结果可能有助于制定和评估有针对性的干预措施，以减少弱势使用者的 RTIs，加强急诊室服务和院前护理，并减少酒后驾车。
