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Objectives: A cross-sectional descriptive research aims to identify several characteristics in road traffic accident patients in need for emergency treatment in Mocchau District General Hospital.
JOURNAL OF MILITARY PHARMACO-MEDICINE No7-2015 SOME CHARACTERISTICS OF VICTIMS IN ROAD TRAFFIC ACCIDENTS TREATED AT MOCCHAU GENERAL HOSPITAL SONLA PROVINCE (2012 - 2013) Hoang Trung Khai*; Nguyen Thi Thinh* SUMMARY Objectives: A cross-sectional descriptive research aims to identify several characteristics in road traffic accident patients in need for emergency treatment in Mocchau District General Hospital Results and discussions: Men suffering from road traffic accidents are times as high as women (74.1% versus 25.9%) The victims in traffic accidents are mainly in the age group of 20 - 29, accounting for 30.0% These people come from Kinh and Thai ethnics (42.0% and 38.3%), whereas this rate is relatively low in other ethnic groups (the H’mong, Muong) Most victims are farmers (58.7%), victims with high literacy occupy 40.8% The timing of road traffic accidents occur mainly in the evening and at night higher than in the morning (41.5% versus 19.4%) In terms of weather factor, tracffic accidents often happen at the time of the sunshine rather than the time of shadow The flat road is the common cause of traffic accident Up to 19.1% of the accidents are due to no wearing helmets Situations leading to traffic accidents are: self-falling off motorcycles (35.6%), motorcycle - motorcycle collision (23.8%), automobile motorcycles collision (15.5%) * Key words: Road traffic accidents; Victims; Mocchau District; Sonla province INTRODUCTION Road traffic accident is the leading cause of death and disability in the world According to the WHO, every year there are 1.3 million deaths and 50 million injuries caused by road traffic accidents, causing great damage on economy and health In Vietnam, the overview report by the Ministry of Health in 2012 showed that the number of accidents, the number of injuries and deaths from accidents and injuries, especially road traffic accidents increased within 10 years Deaths from injuries and accidents of all kinds are leading cause of mortality in hospital There are on average day about 30 people deaths and 70 people injured Sonla is a mountainous province in the Northwest with high rate of accidents General Hospital of Mocchau district receives an annual average of more than 400 cases of injuries; in which, more than 50% is due to traffic accident This study aims to: Examine some factors related to patients with road traffic accidents in order to propose the appropriate measures in order for prevention or improvement in quality as well as give the first aid and emergency treatment for patients * Hadong Medical College Corresponding author: Nguyen Thi Thinh (ntthinhhd@gmail.com) 13 JOURNAL OF MILITARY PHARMACO-MEDICINE No7-2015 SUBJECTS AND METHODS Subjects 407 victims in road traffic accidents were treated at Emergency Department, General Hospital Mocchau district, Sonla in years between 2012 and 2013 Patients treated to stabilize and rehabilitate due to sequelae caused by traffic accidents were excluded Men with road traffic accidents are nearly times as high as women (74.2% vs 25.8%) Patients in the group of 20 - 29 years old with road traffic accidents account for the highest rate (30.0%), the age group under and over 60 years old has the low rate (3.4% vs 5.4%) H’Mong 9.1% Methods A cross-sectional and descriptive study was combined with analysis of secondary data Muong 7.6% The subjects of the study are patients who were treated at Emegency Department, Mocchau district, General Hospital within years Thai 7.6% Data collection Use the paper to record the cases of road traffic accidents based on Decision 1356/QD-BYT dated 18/4/2008 RESULTS Table 1: Distribution of patients in road traffic accidents according to gender and age (n = 407) PERSONAL CHARACTERISTICS NUMBER RATE (%) Male 301 74.1 Female 105 25.9 Age group: < years 14 3.4 - 15 32 7.9 16 - 19 65 20 - 29 Gender Others 2.9% Kinh 42.0% Chart 1: Distribution of patients with road traffic accidents according to ethnicity (n = 407) Patients with road traffic accidents treated in hospital are mainly from ethnic group of Kinh and Thai (occupying the highest rate 42.0% and 38.3%) Ethnic group of H’mong and Muong are 9.1% and 7.6%, respectively Other ethnic groups take up 2.9% Table 2: Distribution of traffic accident victims according to education level (n = 407) NUMBER RATE (%) Illiteracy 16 3.9 16.0 Literacy 59 14.5 122 30.0 Primary (level 1) 53 13.0 30 - 39 73 17.9 40 - 49 49 12.0 Lower secondary (level 2) 166 40.8 50 - 59 30 7.4 High School (level 3) 68 16.7 ≥ 60 22 5.4 Colleges and universities 45 11.1 14 EDUCATION LEVEL JOURNAL OF MILITARY PHARMACO-MEDICINE No7-2015 Patients with road traffic accidents treated in hospital are mostly at the secondary education level, which accounts for the highest rate (40.8%) Meanwhile the lowest rate is found in the illiterate patients (3.9%) Table 3: Distribution of traffic accidents according to occupation (n = 407) OCCUPATION NUMBER RATE (%) Students 68 16.7 Civil servants 34 8.4 Farmers 239 58.7 Workers and artisans 1.5 Traders, free labors 35 8.6 Others (retired people, children) 25 6.1 Victims as farmers constitute the highest rate (58.7%) In the morning 19.4% In the evening night 41.5% In the afternoon 39.1% Chart 2: The timing of occurrence of road traffic accidents (n = 407) 6h00 < 8h00 8h00 < 11h30 11h30 < 3h30 13h30 < 16h30 16h30 < 18h30 18h30 < 19h30 19h30 < 23h30 23h30 < 6h30 Chart 3: Rate of road traffic accidents victims according to the daytime (n = 407) 15 JOURNAL OF MILITARY PHARMACO-MEDICINE No7-2015 More than 80% of road traffic accidents Not occur from afternoon to evening and at night Not wearing In which, at the time between 13h30 wearing helmet < 16h30 and 19h30 - < 23h30 is the most helmet 19.1% frequent (26.1% vs 24.8%) and the lowest 19,1% number of traffic accidents happens in the morning from 6h30 to < 8h00 Entering a curve 9.9% Wearing Wearing helmet 80.9% helmet 80,9% Chart 6: Road traffic accidents caused by Uphill 5.7% motorcyclists’ wearing helmets (n = 340) Drunk 12.8% Downhill 15.1% In driving in the flat road 69.3% Not drunk 87.2% Chart 4: Status of movement on the road at the time of the accident (n = 407) Chart 7: Status of drinking wine or beer before occurring road traffic accidents 69.3% of patients in road traffic accidents is as a result of driving on the flat road Table 4: The situations responsible for road traffic accidents (n = 407) Others 25.3% Fog 13.0% Rainy 17.5% Sunny 44.2% Chart 5: Characteristics of weather when occurring road traffic accidents (n = 407) The road traffic accidents occurring on sunny weather take up the highest rate (44.2%), followed by rain (17.55 %), fog (13.0%) and others (25.3 %) 16 MECHANISM NUMBER % Motorcycles - motorcycles 97 23.8 Cars - motorcycles 63 15.5 Cars - walking 12 2.9 Motorcycles - walking 35 8.6 Self-falling motorcycles 145 35.6 Others 55 13.5 80.9% of patients with traffic accidents is due to motorcyclists’ wearing helmets, the rest (12.8%) lies in the group of no wearing helmets The victims driving under the influence of alcohol and self-falling off vehicles account for the highest rate (35.6%), following by collision between motorcycle - JOURNAL OF MILITARY PHARMACO-MEDICINE No7-2015 motorcycle (23.8%), car - motorcycle (15.5%), motorcycle - walking (8.6%), car - walking (2.9%) and other mechanisms (13.5%) DISCUSSION Our research findings in 407 patients with road traffic accidents is also consistent with that of several authors at home and in the world on patients’ characteristics, conditions and situations leading to road traffic accidents: - Characteristics of patients: Male drivers, especially young men from 20 - 29 years old at high risk of accidents are those who drive at high speed, overtake carelessly and drink wine/beer before Although Mocchau is the area with many ethnic groups, ethnic group of Kinh and Thai still account for over 50% of the population Therefore, the traffic frequency is also higher, but they are careless while joining in traffic Many reports or research results on road traffic accidents show that accidents happen to all the levels of education, people with higher education can be a better understanding of the harmful effects, consequences and precautious measures from traffic accidents The research results indicate that patients treated in hospital are chiefly farmers, taking up the highest rate in comparison with other professions - Characteristics of time, road and weather: Our research results show that 80.6% of traffic accidents occurs in the afternoon, evening and at night, in accordance with the research result of 3,411 victims of road traffic accident in Hanoi, and also similar to that in General Hospital of Bacgiang province and General Hospital of Bacgiang district in 2011 It can be explained that in the afternoon, after lunch time, especially on hot days, the victims drink wine/beer, whereas in the evening and at night, due to limited vision, the accident may happen In this study, traffic accidents occur in all types of roads and mainly on the flat road This result is consistent with that of the study on 1,193 emergency patients, who were treated in Khanhhoa General Hospital in months of 2011 with 79.18% traffic accidents occurring on flat road This is related to the victims’ subjectiveness and speeding Accidents often happen when it is sunny, this result is similar to the research by Le Trung Hai on road traffic accident in Khanhhoa General Hospital within six months in 2011: 94.31% of accidents occur in good weather - On situations causing accidents: In our research, motorcycle - related traffic accidents constitute 83.5%; of which, 1/3 of patients are self-falling (35.6%), nearly 1/4 is due to motorcycles - motorcycles collision (23.8%) and 1/6 is brought about by collision between cars and motorcycles (15.5%), motorcycle - walking (8.6%) This result corresponds with that on patients in traffic accidents in hospitals of Vietnam and consequently, accidents are very closely related to motor vehicles Particularly, the rate of head injuries and traumatic brain injury are associated very tightly with the rate of motorcyclists not wearing helmets 17 JOURNAL OF MILITARY PHARMACO-MEDICINE No7-2015 Our research results reveal that drunk drivers account for 12.8% This result is lower than that on 1,453 patients in road traffic accidents in need for emergency treatment in six provincial and district hospitals of three provinces: Hanam, Ninhbinh, Bacgiang This rate was 42.5% between 11 - 2010 and 03 - 2011 and 46.4% in 2011 in another study on 593 patients in two hospitals of Bacgiang province CONCLUSION car - motorbike: 15.5%, motorbike - walking: 8,6% and car - walking: 2.9% Driving under the influence of alcohol: 12.8% REFERENCES The Ministry of Health The situation of injuries in Vietnam for years (2006 - 2010) Proceedings of the Mid Term Review Conference of implementation of the Directive and Planning of Preventing Injury in community of health service in the period of 2011 - 2015 Hanoi 2011 Men at high risk of road traffic accidents are three times as high as women (74.1% versus 25.9%) The age group of 20 - 29 is predominant (30.0%) The victims are mainly from ethnic group of Kinh and Thai (42.0% and 38.3%), other ethnic groups such as Hmong, Muong have lower rate of accidents 58.7% of the patients are farmers Secondary high school students in traffic accident take up 40.8% The Ministry of Health Report on results of implementation of Decision No 1356/QDBYT dated on 18/04/2008 of the Ministry of Health on issuing forms of recording and reporting the cases of traffic accident with hospital admission 2011 The time of road accidents occurs mainly in the evening and at night, higher than in the morning (41.5% versus 19.4%) Moreover, accidents are attributable to the sunny condition rather than shady condition Flat road is responsible for traffic accidents, occupying high rate (69.3%) Up to 19.1% of the accidents are due to drivers not wearing helmets The Ministry of Health - Vietnam Administration of HIV/AIDS Control The global report on preventing injury of road traffic Medical Publisher 2004 Situations leading to the road traffic accidents: self-falling motorcycles: 35.6%, motorbike - motorbike collision: 23.8%, World Health Organization Global status report on alcohol and health World Health Organization Switzerland 2011, p.286 18 Vietnam Ministry of Health - Medical Publishing House Common Report on the health situation of Vietnam in 2012 Medical Publisher 2012, p.25 Tran Thi Ngoc Lan, Luong Mai Anh, Nguyen Thuy Linh et al Evaluation of alcohol usage in patients of traffic accidents in provinces of Hanam, Ninhbinh, Bacgiang 11/2010 - 3/2011 Journal of Medical Practice No 786/2011, 2011, p.45-51 ... 15.1% In driving in the flat road 69.3% Not drunk 87.2% Chart 4: Status of movement on the road at the time of the accident (n = 407) Chart 7: Status of drinking wine or beer before occurring road. .. with that of the study on 1,193 emergency patients, who were treated in Khanhhoa General Hospital in months of 2011 with 79.18% traffic accidents occurring on flat road This is related to the victims ... 80.6% of traffic accidents occurs in the afternoon, evening and at night, in accordance with the research result of 3,411 victims of road traffic accident in Hanoi, and also similar to that in General