Comparative analysis of the frequency and the severity of diagnosed lesions between pedestrians struck by motor vehicles and other blunt trauma mechanisms victims

ABSTRACTObjective:to compare the frequency and the severity of diagnosed injuries between pedestrians struck by motor vehicles and victims of other blunt trauma mechanisms.Methods:retrospective analysis of data from the Trauma Registry, including adult blunt trauma patients admitted from 2008 to 2010. We reviewed the mechanism of trauma, vital signs on admission and the injuries identified. Severity stratification was carried using RTS, AIS-90, ISS e TRISS. Patients were assigned into group A (pedestrians struck by motor vehicle) or B (victims of other mechanisms of blunt trauma). Variables were compared between groups. We considered p<0.05 as significant.Results:a total of 5785 cases were included, and 1217 (21,0%) of which were in group A. Pedestrians struck by vehicles presented (p<0.05) higher mean age, mean heart rate upon admission, mean ISS and mean AIS in head, thorax, abdomen and extremities, as well as lower mean Glasgow coma scale, arterial blood pressure upon admission, RTS and TRISS. They also had a higher frequency of epidural hematomas, subdural hematomas, subarachnoid hemorrhage, brain swelling, cerebral contusions, costal fractures, pneumothorax, flail chest, pulmonary contusions, as well as pelvic, superior limbs and inferior limbs fractures.Conclusion:pedestrian struck by vehicles sustained intracranial, thoracic, abdominal and extremity injuries more frequently than victims of other blunt trauma mechanism as a group. They also presented worse physiologic and anatomic severity of the trauma.

摘要
目的：本研究旨在对比机动车撞击行人与其他钝性创伤致伤者的确诊损伤发生频率与严重程度。
方法：本研究对创伤登记系统的数据进行回顾性分析，研究对象为2008至2010年收治的成年钝性创伤患者。我们回顾了创伤致伤机制、入院时的生命体征及确诊的损伤情况，并采用修正创伤评分（Revised Trauma Score, RTS）、简明损伤定级标准90版（AIS-90）、损伤严重度评分（Injury Severity Score, ISS）及创伤严重度评分法（Trauma Injury Severity Score, TRISS）进行严重程度分层。将患者分为A组（机动车撞击行人）与B组（其他钝性创伤致伤者），对两组间的变量进行比较，以p<0.05为差异具有统计学意义。
结果：本研究共纳入5785例患者，其中1217例（21.0%）属于A组。与B组相比，机动车撞击行人组的平均年龄、入院平均心率、平均损伤严重度评分（ISS）及头部、胸部、腹部与四肢的简明损伤定级评分（AIS）均显著更高（p<0.05）；而入院时的平均格拉斯哥昏迷量表（Glasgow Coma Scale, GCS）评分、平均动脉血压、修正创伤评分（RTS）及创伤严重度评分法（TRISS）均显著更低。此外，该组患者硬膜外血肿、硬膜下血肿、蛛网膜下腔出血、脑肿胀、脑挫伤、肋骨骨折、气胸、连枷胸、肺挫伤以及骨盆、上肢与下肢骨折的发生率均更高。
结论：整体而言，机动车撞击行人相较于其他钝性创伤致伤者，更易发生颅内、胸部、腹部及四肢损伤，且创伤的生理与解剖严重程度更差。