Citation

Adeleye AO, Clark DJ, Malomo TA. Traffic Injury Prev. 2019; 20(2): 211-215.

Affiliation

Department of Neurological Surgery , University College Hospital , UCH, Ibadan , Nigeria.

Copyright

(Copyright © 2019, Informa - Taylor and Francis Group)

DOI

10.1080/15389588.2018.1553085

PMID

30946601

Abstract

OBJECTIVE: Though motor vehicle crashes (MVCs) were the main cause of head trauma from road traffic injuries (RTIs), motorcycle crashes (MCCs) are now a major cause of RTI-related head injury (HI) in many developing countries.

METHODS: Using a prospective database of HIs from a neurosurgical practice in a sub-Saharan African developing country, a cross-sectional survey was conducted for the trauma demography and clinical epidemiology of this MCC-related HI.

RESULTS: Motorcycle crashes accounted for 57% (473/833) of all RTI-related HIs in this registry. The victims, with a mean age of 33.1 years (SD = 18.3), consisted mainly of males (83.1%), those of low socioeconomic status (>90%), and those aged between 20 and 40 years old (56%). MCCs involved only riders in 114 cases (114/473, 32.1%), of which 69% were motorcycle-motorcycle crashes. The HI was moderate-severe in 50.8%; clinical symptomatology of significant HI included loss of consciousness (92%), anisocoria (35%), Abbreviated Injury Scale head (AIS-head) score > 3 (28%), and CT-Rotterdam score > 3 (30%). Extracranial systemic injury involved the limbs most frequently, with an Injury Severity Score (ISS) >25 in 49%. The fatality rate was 24%. MCC-related HI among pedestrian victims involved more vulnerable age groups (the young and elderly) but have lower mean ISS compared to motorcycle passengers (mean ISS = 23.5 [11.6] vs. 27.4 [13.0]; 95% confidence interval [CI], 1.27-6.49; P =.004). In addition, compared to a contemporary cohort of MVC-related HIs in our registry, MCC victims were older (mean age 34.8 years [18.0] vs. 30.8 [18.4]; P =.002); had higher proportions of certain extracranial trauma like long bone fractures (71 vs. 29%; P =.02); and suffered fewer surgical brain lesions (25.5 vs. 17.2%; P =.004).

CONCLUSIONS: Motorcycle crashes are now a significant threat to the heads, limbs, and lives of vulnerable road users in developing countries.

Language: en

Keywords

Head injury; developing countries; motorcycle crash