Медицина неотложных состояний (Nov 2023)
Traffic injury as a medical and sanitary consequence of a man-made emergency in Ukraine. Report two: comparative characteristics of clinical and epidemiological signs (gender and age)
Abstract
Background. One of the main causes of death and disability of the population in Ukraine is traffic accidents. In addition, in 2022–2023, the number of fatal traffic accidents increased. The purpose was to determine the peculiarities of the clinical and epidemiological characteristics of traffic injuries as medical and sanitary consequences of emergencies in the components of the totality of the phenomenon (traffic accident). Materials and methods. The actual material of the study was 1,696 cases of traffic injuries, which were selected by the method of irreversible randomization. The study was conducted in 2019–2020. This array was distributed according to the conditions of an epidemiological experiment on natural models, which was formed in accordance with the requirements and criteria of the law of large numbers. Model 1 is a metropolis. This model includes victims who were injured and were treated in a metropolis (population of more than 1,000,000). Model 2 — rural area. This model includes victims who were injured in rural areas and were treated at a central district hospital. Model 3 is a regional city. This model includes victims who were injured in the city (population of 300,000–500,000). Results. As a result of the study, it was found that in all research models there was a significant advantage of injured men over women, but this indicator was the highest in model 2 (rural area) — 79.05 %. Indicators in model 1 (metropolis) and in model 3 (regional city) were practically equivalent to the indicator of the mixed regime (63.65, 66.12 and 66.86 %, respectively). The fact that the specific weight of those who survived prevails over that of the deceased in both gender groups in all research models is also noteworthy. The mortality was highest in men and women who were injured as a result of road accidents in rural areas (34.54 and 31.82 %, respectively), the lowest in men of model 2 (regional city; 3.75 %) and in women of model 1 (metropolis; 3.38 %). Also, the comparative analysis showed that the victims in the age group of 21–30 years rank first in all research models. People of working age (21–50 years old) among the victims of road accidents make up 66.81 % in model 1, 58.10 % in model 2, and 53.69 % in model 3. It was found that in almost all age groups, except for those older than 71 years, the highest mortality was observed in model 2 (rural area). The mortality in all study models was highest in the age group over 71 years: model 1 — 16.41 %, model 2 — 44.44 %, model 3 — 60.00 %. The lowest mortality was in model 1 in the age group of 21–30 years (2.17 %), in model 2 in the age group of 61–70 years (24.14 %), in model 3 in the age group of 21–30 years (7.02 %). Conclusions. The clinical and epidemiological characteristics of traffic injuries have specific features for metropolis, rural area, and regional city, which is a sign of certain differences in the infrastructure of models and the lifestyle of the population. All research models are characterized by the predominance of men, but this is especially pronounced in model 2 (rural area) — 79.05 %. The age factor has a significant influence on the formation of the array of victims in the research models, the largest specific weight in all models belongs to people of working age, which is most pronounced in the metropolis — 77.87 %. Age has a significant impact on the outcome of the traumatic process in all research models and is most pronounced in older age groups. The largest array of victims of working age with a negative course of the traumatic process was in rural areas — 75.70 %. Comparative clinical and epidemiological analysis of road traffic injuries in research models indicate the similarity of characteristics to developing countries.
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