Morbidity and Mortality among the Motor Vehicle Accident patients
Authors: Elena Lacramioara Boeras , Tudor Ghira (students/paramedics, Emergency Department, SMURD Sibiu, Romania)
Co-Authors: Virgiliu Cezar Bologa (MD, Emercency Specialist, Emergency Department, UPU-SMURD Sibiu, Romania), Alexandra Crisu Bota
(MD, Forensics Department, Clinical Emergency Hospital, Sibiu, Romania)
BACKGROUND
In the European Union (EU), every two minutes a person dies secondary to
motor vehicle accidents (MVA), 73 are treated outside the hospital, 136
are treated in emergency units and 28 are hospitalized. Trauma ranks as
the 4th most common cause of death after cardiovascular diseases, cancer
and respiratory diseases.
Among the EU states, the United Kingdom has the lowest MVA mortality
rate. In 2012, 28 per million inhabitants died in MVA in the UK, compared
to 95 per million in Romania. According to statistics, Romania has the
highest mortality rates due to MVA in the European Union. The county of
Sibiu ranks among the highest places in Romania with 93 per million MVA
deaths in 2012.
The purpose of this study is to analyze the dynamics and characteristics of
traumatic mortality and morbidity among the trauma victims presented to
the Sibiu County Clinical Emergency Hospital between 01.01.2010 and
31.12.2013.
MATERIALS AND METHODS
Trauma records of MVA victims presented to the Sibiu
County Clinical Emergency Hospital between 01.01.2010
and 31.12.2013 were retrospectively reviewed. The data
was obtained from the case report forms, the full
medical charts and discharge notes of 2269 patients,
from 16 to 98 years old.
The data was collected from the Emergency Care Unit
(ECU) clinical records and the Forensics Department
records of the Sibiu County Clinical Emergency Hospital.
RESULTS & DISCUSSIONS
Out of the total 2269 MVA victims, 2160 (95.1%) were admitted to the Emergency Care Unit of the
Sibiu County Clinical Emergency Hospital, 109 (4.8%) died at the scene of the crash, and 3 (0.1%)
died during transfer to the hospital. From the 2160 victims admitted to the ECU, 1436 (66.4%) had
left the hospital the same day with minor injuries, 688 (31.8%) required surgical intervention and
further care, and 36 (1.6%) died during the hospitalization.
In the 4-year study period 684 MVA victims were admitted to the surgical units of the Sibiu County
Hospital. In 2010, 36 patients required general surgery, 54 patients needed neurosurgery and 70
had orthopedic treatments. In 2011, 38 victims had general surgery, 49 neurosurgery and 91
orthopedic treatments. In 2012, 44 patients needed general surgery, 37 neurosurgery and 72
orthopedic treatments while in 2013, 43 victims had general surgery, 40 neurosurgery, 68
orthopedic treatments.
Between the years of 2010 and 2013 the majority of deaths registered in the Forensics Department
of Sibiu County were due to poly-trauma. In 2010 there were 24 poly-trauma cases, followed by 13
head injury cases. In 2011 there were 31 poly-trauma deaths and 9 head injury deaths recorded.
In 2012 records show 25 poly-trauma cases and 10 head injury cases, while in 2013 there were 24
polytrauma and 11 head injury deaths recorded.
CONCLUSIONS & PERSPECTIVES
Between the years of 2010 and 2013 the number of deaths
caused by MVA in the Sibiu County are decreasing gradually,
similar to trends noted in the European Union.
Even though the number MVA induced deaths between 2010 and
2013 decreased slowly from 38 deaths in 2010 to 35 in 2013,
there is a greater decrease noted when we compare MVA deaths
to the 2006-2009 period when the average was 65 per year.
In our study period the most common cause of death secondary
to MVA was poly-trauma followed by head injuries. The number of
cases remained constant across the time period, with a slight
peak in poly-trauma patients in 2011.