Cranial and spinal injuries in motorcycle accidents: A hospital-based study
Yıl: 2019 Cilt: 25 Sayı: 2 Sayfa Aralığı: 167 - 171 Metin Dili: İngilizce DOI: 10.14744/tjtes.2019.46116 İndeks Tarihi: 10-06-2020
Cranial and spinal injuries in motorcycle accidents: A hospital-based study
Öz: BACKGROUND: Injuries caused by motorcycle accidents have been reported in several studies with an examination from a generaltrauma point of view. However, to our knowledge, there is no detailed study specific to central nervous system injuries. This researchwas focused on central nervous system injuries associated with motorcycle accidents.METHODS: The medical records of 540 patients who were admitted to the emergency department between 2008 and 2016 as theresult of a motorcycle accident were retrospectively evaluated. Data were collected from electronic medical records, follow-up forms,and radiological images. Information on patient age, gender, type and site of injury, helmet use, alcohol level, Glasgow Coma Scalescore on admission, length of stay in the intensive care unit and hospital, neurological status on discharge, and follow-up was collectedand analyzed.RESULTS: A total of 486 of 540 patients (90%) were male, 54 (10%) were female, and the mean age was 31±18 years (range: 2–85years, median: 25 years). Cranial injuries were detected in 320 cases (59%). The distribution of cranial injuries was: epidural hemorrhage (12.6%), subdural hemorrhage (15.2%), depressed fracture (10.4%), linear fracture (23%), skull base fracture (5.5%), diffuseaxonal injury (9.3%), subarachnoid hemorrhage (25.2%), intracerebral hemorrhage (13.5%), and contusion (26.3%). Spinal fractureswere detected in 52 cases (9.6%). Twenty-two (4.07%) of the spinal fractures were observed in the cervical region, 10 (1.85%) in thethoracic region, and 20 (3.7%) in the lumbar region. The mean length of stay in the hospital was 8.2±4 days and 7 days in the intensivecare unit. Sixty-eight patients (12.6%) died. Traumatic cranial entities other than linear fracture were associated with an elevated levelof mortality. A Glasgow Coma Scale score of 6 or less was associated with significant mortality (68%).CONCLUSION: A detailed report of motorcycle accident-associated central nervous system injuries is provided. The use of protective equipment, such as helmets, significantly reduced the rate of cerebral injury and death.
Anahtar Kelime: Motosiklet kazalarında kafa ve omurga yaralanmaları: Hastane tabanlı bir çalışma
Öz: AMAÇ: Motosiklet kazalarına bağlı yaralanmalar, genel travma açısından çeşitli çalışmalarda incelenmiştir. Bununla birlikte, merkezi sinir sistemi yaralanmalarına ilişkin ayrıntılı bir çalışma yoktur. Bu çalışma motosiklet kazaları ile ilişkili merkezi sinir sistemi yaralanmalarına odaklanmıştır. GEREÇ VE YÖNTEM: 2008 ile 2016 yılları arasında motosiklet kazası nedeniyle acil servise başvuran 540 hastanın tıbbi kayıtları geriye dönük olarak değerlendirildi. Veriler elektronik tıbbi kayıtlardan, takip formlarından ve radyolojik görüntülerden elde edildi. Hastaların yaşı, cinsiyeti, yaralanma tipi ve yeri, kask kullanımı, alkol düzeyleri, Glasgow Koma Skorları, yoğun bakım ünitesinde kalış süreleri, taburcu olurken ve takiplerde nörolojik durumları gibi bilgiler toplanmıştır. BULGULAR: Çalışmaya alınan 540 olgunun 486’sı (%90) erkek, 54’ü (%10) kadın, yaş ortalaması 31±18 (dağılım 2–85, medyan 25) idi. Kraniyal yaralanmalar 320 olguda (%59) saptandı. Kraniyal yaralanmaların dağılımı şöyledir: Epidural kanama (%12.6), subdural hemoraji (%15.2), deprese kırık (%10.4), lineer kırık (%23), kafa tabanı kırığı (%5.5), diffüz aksonal yaralanma (%9.3), subaraknoid kanama (%25.2), intraserebral hemoraji (%13.5), kontüzyon (%26.3). Spinal kırıklar 52 olguda (%9.6) tespit edildi. Servikal bölgede 22 (%4.07) omurga kırığı, torasik bölgede 10 (%1.85) ve lomber bölgede 20 (%3.7) gözlendi. Hastanede kalış süresi yoğun bakımda ortalama 8.2±4 gün, ortalama yedi gündü. Altmış sekiz hasta (%12.6) hayatını kaybetti. Lineer kırık hariç diğer tüm kraniyal yaralanmalar yüksek mortalite ile ilşkiliydi. Ayrıca, 6 veya daha düşük Glasgow Koma Skorları, önemli mortalite (%68) ile ilişkilendirildi. TARTIŞMA: Motosiklet kazalarının neden olduğu merkezi sinir sistemi yaralanmalarının ayrıntılı bir raporu verilmiştir. Kask gibi koruyucu ekipmanların kullanılması, beyin hasarı ve ölüm oranını önemli ölçüde azaltır
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Bambach MR, Mitchell RJ. The rising burden of serious thoracic trauma sustained by motorcyclists in road traffic crashes. Accid Anal Prev 2014;62:248–58.
- 2. Solagberu BA, Ofoegbu CK, Nasir AA, Ogundipe OK, Adekanye AO, Abdur-Rahman LO. Motorcycle injuries in a developing country and the vulnerability of riders, passengers, and pedestrians. Inj Prev 2006;12:266–8.
- 3. United States. National Highway Traffic Safety Administration, University of North Carolina (System). Highway Safety Research Center. Countermeasures that work a highway safety countermeasure guide for state highway safety offices. 4th ed. Washington, D.C.: U.S. National Highway Traffic Safety Administration; 2009. 1 online resource (301 p.) ill.
- 4. Clarke DD, Ward P, Bartle C, Truman W. The role of motorcyclist and other driver behaviour in two types of serious accident in the UK. Accid Anal Prev 2007;39:974–81.
- 5. De Silva MJ, Roberts I, Perel P, Edwards P, Kenward MG, Fernandes J, et al; CRASH Trial Collaborators. Patient outcome after traumatic brain injury in high-, middle- and low-income countries: analysis of data on 8927 patients in 46 countries. Int J Epidemiol 2009;38:452–8.
- 6. Gorski TF, Gorski YC, McLeod G, Suh D, Cordero R, Essien F, et al. Patterns of injury and outcomes associated with motocross accidents. Am Surg 2003;69:895–8.
- 7. Gorios C, Armond Jde E, Rodrigues CL, Pernambuco H, Iporre RO, Colombo-Souza P. Analysis of hospitalization occurred due to motorcycles accidents in São Paulo city. Acta Ortop Bras 2015;23:212–4.
- 8. Gupta A, Jaipuria J, Bagdia A, Kumar S, Sagar S, Misra MC. Motorised two-wheeler crash and helmets: injury patterns, severity, mortality and the consequence of gender bias. World J Surg 2014;38:215–21.
- 9. Ozkan S, Kiliç S, Durukan P, Akdur O, Vardar A, Geyik S,et al. Occupational injuries admitted to the Emergency Department. Ulus Travma Acil Cerrahi Derg 2010;16:241–7.
- 10. Zettas JP, Zettas P, Thanasophon B. Injury patterns in motorcycle accidents. J Trauma 1979;19:833–6.
- 11. Lin MR, Kraus JF. A review of risk factors and patterns of motorcycle injuries. Accid Anal Prev 2009;41:710–22.
- 12. Leong QM, Tsung Shyen KG, Appasamy V, Chiu MT. Young adults and riding position: factors that affect mortality among inpatient adult motorcycle casualties: a major trauma center experience. World J Surg 2009;33:870–3.
- 13. Murphy RK, McEvoy L, Kelleher MO, Bolger C, Phillips J. The burden of motorcycle-related neuro-trauma in Ireland and associated helmet usage. Br J Neurosurg 2009;23:162–4.
- 14. Coben JH, Steiner CA, Owens P. Motorcycle-related hospitalizations in the United States, 2001. Am J Prev Med 2004;27:355–62.
- 15. Silva LOJE, Fernanda Bellolio M, Smith EM, Daniels DJ, Lohse CM, Campbell RL. Motocross-associated head and spine injuries in adult patients evaluatedin an emergency department. Am J Emerg Med 2017;35:1485–9.
- 16. Doyle D, Muir M, Chinn B. Motorcycle accidents in Strathclyde Region, Scotland during 1992: a study of the injuries sustained. Health Bull (Edinb) 1995;53:386–94.
- 17. Ankarath S, Giannoudis PV, Barlow I, Bellamy MC, Matthews SJ, Smith RM. Injury patterns associated with mortality following motorcycle crashes. Injury 2002;33:473–7.
- 18. Ji M, Gilchick RA, Bender SJ. Trends in helmet use and head injuries in San Diego County: the effect of bicycle helmet legislation. Accid Anal Prev 2006;38:128–34.
- 19. Keng SH. Helmet use and motorcycle fatalities in Taiwan. Accid Anal Prev 2005;37:349–55.
- 20. Auman KM, Kufera JA, Ballesteros MF, Smialek JE, Dischinger PC. Autopsy study of motorcyclist fatalities: the effect of the 1992 Maryland motorcycle helmet use law. Am J Public Health 2002;92:1352–5.
- 21. Sauter C, Zhu S, Allen S, Hargarten S, Layde PM. Increased risk of death or disability in unhelmeted Wisconsin motorcyclists. WMJ 2005;104:39–44.
- 22. Hundley JC, Kilgo PD, Miller PR, Chang MC, Hensberry RA, Meredith JW, et al. Non-helmeted motorcyclists: a burden to society? A study using the National Trauma Data Bank. J Trauma 2004;57:944–9.
- 23. Peeters S, Blaine C, Vycheth I, Nang S, Vuthy D, Park KB. Epidemiology of Traumatic Brain Injuries at a Major Government Hospitalin Cambodia. World Neurosurg 2017;97:580–9. 24. Lateef F. Riding motorcycles: is it a lower limb hazard? Singapore Med J 2002;43:566–9.
- 25. Eastridge BJ, Shafi S, Minei JP, Culica D, McConnel C, Gentilello L. Economic impact of motorcycle helmets: from impact to discharge. J Trauma 2006;60:978–83.
- 26. Khor D, Inaba K, Aiolfi A, Delapena S, Benjamin E, Matsushima K, et al. The impact of helmet use on outcomes after a motorcycle crash. Injury 2017;48:1093–7.
- 27. Page PS, Wei Z, Brooks NP. Motorcycle helmets and cervical spine injuries: a 5-year experience at a Level 1 trauma center. J Neurosurg Spine 2018;28:607–11.
- 28. Hooten KG, Murad GJ. Helmet use and cervical spine injury: a review of motorcycle, moped, and bicycle accidents at a level 1 trauma center. J Neurotrauma 2014;31:1329–33.
- 29. Ooi SS, Wong SV, Yeap JS, Umar R. Relationship between cervical spine injury and helmet use in motorcycle road crashes. Asia Pac J Public Health 2011;23:608–19.
| APA | ÖZDÖL Ç, GEDİZ T, AGHAYEV K (2019). Cranial and spinal injuries in motorcycle accidents: A hospital-based study. , 167 - 171. 10.14744/tjtes.2019.46116 |
| Chicago | ÖZDÖL Çağatay,GEDİZ Tolga,AGHAYEV Kamran Cranial and spinal injuries in motorcycle accidents: A hospital-based study. (2019): 167 - 171. 10.14744/tjtes.2019.46116 |
| MLA | ÖZDÖL Çağatay,GEDİZ Tolga,AGHAYEV Kamran Cranial and spinal injuries in motorcycle accidents: A hospital-based study. , 2019, ss.167 - 171. 10.14744/tjtes.2019.46116 |
| AMA | ÖZDÖL Ç,GEDİZ T,AGHAYEV K Cranial and spinal injuries in motorcycle accidents: A hospital-based study. . 2019; 167 - 171. 10.14744/tjtes.2019.46116 |
| Vancouver | ÖZDÖL Ç,GEDİZ T,AGHAYEV K Cranial and spinal injuries in motorcycle accidents: A hospital-based study. . 2019; 167 - 171. 10.14744/tjtes.2019.46116 |
| IEEE | ÖZDÖL Ç,GEDİZ T,AGHAYEV K "Cranial and spinal injuries in motorcycle accidents: A hospital-based study." , ss.167 - 171, 2019. 10.14744/tjtes.2019.46116 |
| ISNAD | ÖZDÖL, Çağatay vd. "Cranial and spinal injuries in motorcycle accidents: A hospital-based study". (2019), 167-171. https://doi.org/10.14744/tjtes.2019.46116 |
| APA | ÖZDÖL Ç, GEDİZ T, AGHAYEV K (2019). Cranial and spinal injuries in motorcycle accidents: A hospital-based study. Ulusal Travma ve Acil Cerrahi Dergisi, 25(2), 167 - 171. 10.14744/tjtes.2019.46116 |
| Chicago | ÖZDÖL Çağatay,GEDİZ Tolga,AGHAYEV Kamran Cranial and spinal injuries in motorcycle accidents: A hospital-based study. Ulusal Travma ve Acil Cerrahi Dergisi 25, no.2 (2019): 167 - 171. 10.14744/tjtes.2019.46116 |
| MLA | ÖZDÖL Çağatay,GEDİZ Tolga,AGHAYEV Kamran Cranial and spinal injuries in motorcycle accidents: A hospital-based study. Ulusal Travma ve Acil Cerrahi Dergisi, vol.25, no.2, 2019, ss.167 - 171. 10.14744/tjtes.2019.46116 |
| AMA | ÖZDÖL Ç,GEDİZ T,AGHAYEV K Cranial and spinal injuries in motorcycle accidents: A hospital-based study. Ulusal Travma ve Acil Cerrahi Dergisi. 2019; 25(2): 167 - 171. 10.14744/tjtes.2019.46116 |
| Vancouver | ÖZDÖL Ç,GEDİZ T,AGHAYEV K Cranial and spinal injuries in motorcycle accidents: A hospital-based study. Ulusal Travma ve Acil Cerrahi Dergisi. 2019; 25(2): 167 - 171. 10.14744/tjtes.2019.46116 |
| IEEE | ÖZDÖL Ç,GEDİZ T,AGHAYEV K "Cranial and spinal injuries in motorcycle accidents: A hospital-based study." Ulusal Travma ve Acil Cerrahi Dergisi, 25, ss.167 - 171, 2019. 10.14744/tjtes.2019.46116 |
| ISNAD | ÖZDÖL, Çağatay vd. "Cranial and spinal injuries in motorcycle accidents: A hospital-based study". Ulusal Travma ve Acil Cerrahi Dergisi 25/2 (2019), 167-171. https://doi.org/10.14744/tjtes.2019.46116 |
