OBJECTIVES: The aim of this study was to examine the frequency of fatalities in injuries in traffic accidents in Montenegro, identify contributing risk factors, and determine the most vulnerable participants in these accidents. METHODS: The research was designed as a retrospective descriptive study. Participants were people admitted to the Urgent Centre of Clinical Centre of Montenegro due to injuries in traffic accidents that resulted in serious bodily injury or death in the period from 2011-2020. We presented data using descriptive statistics. The square test was used to examine the association between the outcome of traffic injury with sex, age, category of injury, type of traffic participant, and injury localisation. Additionally, we used logistic regression to estimate the best predictor value of these variables for outcome. RESULTS: It was found that 44.7% of injured people died, the most frequent fatal outcome was registered in patients with central nervous system injuries (73.2%), then in patients with asphyxia (47.0%), and patients with bleeding (40.5%), χ2 = 27.530, p < 0.001. The most frequently injured traffic participants were drivers, but the highest number of deceased were among cyclists. Also, logistic regression showed that the category of injury was the most predictive impact on outcome in traffic-injured correspondents (p < 0.001). CONCLUSION: Among the injured, the highest number are drivers, and the fatal outcome mostly depends on the injury category. Nearly half of those injured in traffic accidents die, especially those with central nervous system injuries and cyclists. Therefore, special attention should be given during public health campaigns related to traffic accident prevention, focusing on this injury and this category of traffic participants.

Centre for Health System Evidence and Research in the Field of Public Health Institute of Public Health of Montenegro Podgorica Montenegro

Clinical Centre of Montenegro Podgorica Montenegro

Faculty of Medicine University of Montenegro Podgorica Montenegro

Zobrazit více v PubMed

Adeloye D, Thompson JY, Akanbi MA, Azuh D, Samuel V, Omoregbe N, et al. The burden of road traffic crashes, injuries and deaths in Africa: a systematic review and meta-analysis. Bull World Health Organ. 2016 Jul 1;94(7):510-21A.

Global status report on road safety 2013: supporting a decade of action [Internet]. Geneva: WHO; 2013 [cited 2022 Dec 12]. Available from: https://iris.who.int/handle/10665/78256.

Lukumay GG, Outwater AH, Mkoka DA, Ndile ML, Saveman BI. Traffic police officers' experience of post-crash care to road traffic injury victims: a qualitative study in Tanzania". BMC Emerg Med. 2019;19(1):51. doi: 10.1186/s12873-019-0274-x. DOI

Rosen HE, Bari I, Paichadze N, Peden M, Khayesi M, Monclús J, et al. Global road safety 2010-18: an analysis of Global Status Reports. Injury. 2022 Jul 20:S0020-1383(22)00504-6.

Nazir E, Nadeem F, Véronneau S. Road safety challenges in Pakistan: an overview. J Transp Secur. 2016;9:161-74.

Legome E, Shockley LW, editors. Trauma: a comprehensive emergency medicine approach. Cambridge: Cambridge University Press; 2011.

Forrester JD, August A, Cai LZ, Kushner AL, Wren SM. The golden hour after injury among civilians caught in conflict zones. Disaster Med Public Health Prep. 2019;13(5-6):1074-82.

Majdan M, Rusnák M, Bražinová A, Mauritz W. Severity, causes and outcomes of traumatic brain injuries occurring at different locations: implications for prevention and public health. Cent Eur J Public Health. 2015 Jun;23(2):142-8.

Khan AA, Fatmi Z. Strategies for prevention of road traffic injuries (RTIs) in Pakistan: situational analysis. J Coll Physicians Surg Pak. 2014;24(5):356-60.

Cheng P, Yin P, Ning P, Wang L, Cheng X, Liu Y, et al. Trends in traumatic brain injury mortality in China, 2006-2013: a population-based longitudinal study. PLoS Med. 2017;14:e1002332. doi: 10.1371/journal.pmed.1002332. DOI

Katayama Y, Kitamura T, Kiyohara K, Sado J, Hirose T, Matsuyama T, et al. Prehospital factors associated with death on hospital arrival after traffic crash in Japan: a national observational study. BMJ Open. 2019;9:e025350. doi: 10.1136/bmjopen-2018-025350. DOI

Association for Safe International Road Travel. Road safety facts [Internet]. Potomac: ASIRT [cited 2022 Dec 12]. Available from: https://www.asirt.org/safe-travel/road-safety-facts/.

AlAmmar HF, Jahan S. The prevalence of child restraint system use and pattern of child transportation in Buraidah City. J Family Med Prim Care. 2021 Aug;10(8):2810-5.

Zuraik C, Sampalis J. Epidemiology of traumatic injuries at an urban hospital in Port-au-Prince, Haiti. World J Surg, 2017;41(11):2674-80.

Genowska A, Jamiołkowski J, Szafraniec K, Fryc J, Pająk A. Health care resources and 24,910 deaths due to traffic accidents: an ecological mortality study in Poland. Int J Environ Res Public Health. 2021;18(11):5561. doi: 10.3390/ijerph18115561. DOI

Al Marzooqi AH, Badi M, El Jack A. Road traffic accidents in Dubai, 2002-2008. Asia Pac J Public Health. 2010;22(3Suppl):31S-9S.

Fernando DM, Tennakoon SU, Samaranayake AN. Wickramasinghe M. Characteristics of road traffic accident casualties admitted to a tertiary care hospital in Sri Lanka. Forensic Sci Med Pathol. 2017;13:44-51.

Rubinshteyn V, Giordano V, Cohen D, LeBaron J, Menon S, Demaree C. Multinomial estimations of predictive risk factors for traumatic brain injuries. Cureus. 2023;15(4):e37307. doi: 10.7759/cureus.37307. DOI

Shrivastava SR, Pandian P, Shrivastava PS. Pre-hospital care among victims of road traffic accident in a rural area of Tamil Nadu: a cross-sectional descriptive study. J Neurosci Rural Pract. 2014;5(Suppl 1):S33-8.

Ladeira RM, Malta DC, Morais OL Neto, Montenegro MMS, Soares AM Filho, Vasconcelos CH, et al. Road traffic accidents: Global Burden of Disease study, Brazil and federated units, 1990 and 2015. Rev Bras Epidemiol. 2017;20Suppl 01(Suppl 01):157-70.

Calosevic S, Lovric Z. Prognostic significance of specific injury patterns in casualties of traffic-related accidents. Injury. 2015;46 Suppl 6:S27-30.

Modarres SR, Shokrollahi MH, Yaserian M, Rahimi M, Amani N, Manouchehri A. Epidemiological characteristics of fatal traumatic accidents in Babol, Iran: a hospital-based survey. Bull Emerg Trauma. 2014;2(4):146-50.

Hatamabadi H, Vafaee R, Hadadi M, Abdalvand A, Esnaashari H, Soori H. Epidemiologic study of road traffic injuries by road user type characteristics and road environment in Iran: a community-based approach. Traffic Inj Prev. 2012;13(1):61-4.

Schöchl H, Schlimp CJ. Trauma bleeding management: the concept of goal-directed primary care. Anesth Analg. 2014;119(5):1064-73.

Cannon JW. Hemorrhagic shock. N Engl J Med. 2018 Jan 25;378(4):370-9.

Harbrecht BG. Is anything new in adult blunt splenic trauma? Am J Surg. 2005 Aug;190(2):273-8.

Van Winkle B, DiBrito SR, Amini N, Levy MJ, Haut ER. A survey of hospitalized trauma patients in hemorrhage control education: are trauma victims willing to stop the bleed? J Surg Res. 2021;264:469-73.

McCarty JC, Caterson EJ, Chaudhary MA, Herrera-Escobar JP, Hashmi ZG, Goldberg SA, et al. Can they stop the bleed? Evaluation of tourniquet application by individuals with varying levels of prior self-reported training. Injury. 2019 Jan;50(1):10-5.

Ried M, Bein T, Philipp A, Muller T, Graf B, Schmid C, et al. Extracorporeal lung support in trauma patients with severe chest injury and acute lung failure: a 10-year institutional experience. Crit Care. 2013 Jun 20;17(3):R110. doi: 10.1186/cc12782. DOI

Brekke IJ, Maidas P, Møller L. Delayed massive haemothorax following thoracic trauma. Tidsskr Nor Laegeforen. 2021 Feb 17;141(3). doi: 10.4045/tidsskr.20.0717. DOI

Pelicic D, Ristic B, Radojevic N, Djonovic N, Radevic S. Influence of spatial and temporal distance of the hospital on survival of patients with dangerous injuries sustained in traffic accidents. Iran J Public Health. 2022 Oct;51(10):2289-97.

Soori H, Khorasani-Zavareh D. Road traffic injuries measures in the Eastern Mediterranean Region: findings from the Global Status Report on Road Safety - 2015. J Inj Violence Res. 2019 Jul;11(2):149-58.

Ali D, Shahid MH, Khokhar MI, Alam MA, Kaiser A, Malik AA, et al. The spectrum of injuries from motorcycle induced road traffic accidents from level one trauma center: a prospective observational study. J Pak Med Assoc. 2020 Feb;70(Suppl 1)(2):S37-41.

Bekelis K, Missios S, Mackenzie TA. Prehospital helicopter transport and survival of patients with traumatic brain injury. Ann Surg. 2015 Mar;261(3):579-85.

Chong SL, Tyebally A, Chew SY, Lim YC, Feng XY, Chin ST, et al. Road traffic injuries among children and adolescents in Singapore - who is at greatest risk? Accid Anal Prev. 2017 Mar;100:59-64.