After-effects and disabilities in traffic crash victims in northern Brazil

Objectives: The objective of this study was to identify the characteristics related to crash and victim, as well as the after-effects/disabilities and consequences arising from traffic crashes occurring in the city of Rio Branco–Acre. Methods: This is an analytical descriptive cross-sectional study conducted in the City of Rio Branco–Acre. The study population consisted of 405 residents of the city who were victims of traffic crashes, of all age groups and genders, who were hospitalized for the first time as a result of the crash in public hospitals and the health system network, as recorded in the Hospital Information System, and who were discharged between January 1 and December 31, 2010. The data sources included hospital record consultations and active searches for the victims. Hierarchical logistic regression was performed to evaluate the factors associated with the after-effects. Results: The majority of the study population was motorcycle victims (68.6%), male, and young (20–39 years). Concerning the after-effects, the following were significantly associated: factors related to the presence of a postcrash activity limitation (odds ratio [OR] = 2.39; 95% confidence interval [CI], 2.39–6.76), length of hospital stay in days (OR = 1 03; 95% CI, 1.01–1.06), and surgical treatment (OR = 1.82; 95% CI, 1.03–3.21). Those who suffered damage to soft tissue and nerves or facial injury showed an odds ratio of 2 to 4 times of having an after-effect/disability, independent of the victim's personal attributes. Conclusion: The mechanism, such as the origin of the pattern of injuries, explains the exposure factors shown by each attribute of the victim and their characteristics. Many of the injuries were precursors to after-effects/disabilities, which, due to their nature and extent, result in the modification of the apparently healthy living standards of young victims who are routinely injured in traffic crashes. Therefore, public policies for prevention should be formulated, reformulated, and implemented, taking into account each attribute of the victims and their social conditions, because these are closely related to their habits and customs. This is a starting point for promoting changes to the current reality that traffic crashes present in the morbidity and mortality of the population.

研究目的：本研究旨在识别巴西阿克里州里约布兰科市道路交通碰撞相关的碰撞与受害者特征，以及该类碰撞引发的后遗症/残疾与后续不良后果。
研究方法：本研究为在阿克里州里约布兰科市开展的分析性描述横断面研究（cross-sectional study）。研究对象为2010年1月1日至12月31日期间，因道路交通碰撞首次入住该市公立医院及卫生系统网络医院、并已出院的405名各年龄段、各性别的道路交通碰撞受害者居民，相关住院信息记录于医院信息系统（Hospital Information System）。本研究的数据来源包括病历查阅及对受害者的主动寻访。本研究采用分层逻辑回归（hierarchical logistic regression）分析，评估与后遗症发生相关的影响因素。
研究结果：研究对象中绝大多数为摩托车骑行受害者（68.6%），且以男性及青壮年（20~39岁）群体为主。关于后遗症发生的相关影响因素，分析结果显示以下因素与之存在显著关联：碰撞后活动受限相关因素（比值比（Odds Ratio, OR）=2.39；95%置信区间（Confidence Interval, CI）：2.39~6.76）、住院时长（以天计，OR=1.03；95%CI：1.01~1.06）以及手术治疗（OR=1.82；95%CI：1.03~3.21）。遭受软组织与神经损伤或面部损伤的受害者，其出现后遗症/残疾的风险为其他人群的2~4倍，且该关联不受受害者个人属性的影响。
研究结论：损伤机制（即损伤模式的成因）可解释受害者各项属性所体现的暴露因素特征。诸多损伤均为后遗症/残疾的前驱表现，此类损伤因其性质与严重程度，会改变本应健康的年轻受害者的生活状态——而这类年轻群体本就是道路交通碰撞的高发受伤人群。因此，公共预防政策的制定、修订与实施，应充分考虑受害者的各项属性及其社会境况，因其与受害者的行为习惯密切相关。本研究可为改善当前道路交通碰撞所带来的人群发病率与死亡率现状提供科学切入点。