Bedingt durch ihre Definition - mindestens 24-stündiger Klinikaufenthalt - umfasst die Kategorie der Schwerverletzten in der amtlichen Verkehrsunfallstatistik eine große Breite tatsächlicher Verletzungsschweregrade. Durch das hohe persönliche Leid sowie die bedeutsamen volkswirtschaftlichen Kosten sind innerhalb dieser Gruppe die Schwerstverletzten von besonderem Interesse. Es werden drei Studien der Bundesanstalt für Straßenwesen (BASt) vorgestellt, in denen auf Grundlage verschiedener Datenquellen Verletzungsmuster und Verletzungsschwere in Zusammenhang mit Parametern des Unfallgeschehens gebracht wurden. Zusammengefasst zeigt sich, dass (a) die Zahl der Schwerstverletzten sich in den letzten Jahren nicht in gleichem Maße reduziert hat, wie die Zahlen Schwerverletzter und Getöteter; (b) sich über verschiedene Datenquellen (GIDAS, TraumaRegister DGU, Rettungsdienst, Polizei) ähnliche Verletzungsmuster in Abhängigkeit der Verkehrsteilnahme zeigen; (c) durch die Verbindung von medizinischen Daten des TraumaRegisters mit Daten der Polizei gute Voraussetzungen für eine umfangreiche Erfassung Schwerstverletzter in Deutschland geschaffen werden könnten.
In line with the new definition introduced by the European Commission (EC), the number of seriously injured road casualties in Germany for 2014 is assessed in this study. The number of MAIS3+ casualties is estimated by two different methodological approaches. The first approach is based on data from the German Inâ€Depth Accident Study (GIDAS), which is closely related to the German Road Traffic Accident Statistics. The second approach is based on data from the German TraumaRegister DGU-® (TRâ€DGU), which includes many more hospitals but not all MAIS3+ injuries.
Trauma management (TM) covers two types of medical treatment: the initial one provided by Emergency Medical Services (EMS) and a further one provided by permanent medical facilities. There is a consensus in the professional literature that to reduce the severity and the number of road crash victims, the TM system should provide rapid and adequate initial care of injury, combined with sufficient further treatment at a hospital or trauma centre. Recognizing the important role of TM for reducing road crash injury outcome, it was decided, within the EU funded SafetyNet project, to develop road safety performance indicators (SPIs) which would characterize the level of TM systems" performance in European countries and enable country comparisons. The concept of TM SPIs was developed based on a literature study of performance indicators in TM, a survey of available practices in Europe and data availability examinations. A set of TM SPIs was introduced including 14 indicators which characterize five issues such as: availability of EMS stations; availability and composition of EMS medical staff; availability and composition of EMS transportation units; characteristics of the EMS response time, and availability of trauma beds in permanent medical facilities. Basic information on the TM systems was collected in close cooperation with the national expert group. A dataset with TM SPIs for 21 countries was created. It was demonstrated that the countries can be compared using selected TM SPIs. Moreover, a more general comparison of the TM systems' performance in the countries is possible, using multiple ranking and statistical weighting techniques. By both methods, final estimates were received enabling the recognition of groups of countries with similar levels of the TM system's performance. The results of various trials were consistent as to the recognition of countries with high or low level of the TM systems" performance, where in grouping countries with intermediate levels of the TM system's performance some differences were observed. The SafetyNet project's practice demonstrated that data collection for estimating TM SPIs is not an easy task but is realizable for the majority of countries. The TM SPIs" message is currently limited to the availability of trauma care services. Further development of the TM SPIs should focus on characteristics of actual treatment supplied, based on combined police and medical road crash related databases.
Although the annual traffic accident statistics published by the national police is available in public, the detailed traffic accident data has not been released in Korea. Recently the Ministry of Land, Infrastructure and Transport recognized the importance of in-depth accident data to enhance road traffic safety and initiated a research project to establish a collection of the detailed accident data. The main objective of the project is a feasibility study to establish KIDAS (Korea In-Depth Accident Study). Within this project, three university hospitals which are located in mid-size cities have been selected to collect accident data. Annually, more than 500 cases of accidents have been collected from the in-patient's interviews and diagnosis. Unlike GIDAS (German In-Depth Accident Study), currently on-site investigation can"t be performed by the Korean police. The only available data is patient medical records, patient's description of accident circumstances and the damaged vehicle. Occasionally the police provide the accident investigation reports containing very brief information on accident causation and vehicle safety. In a first step, the concept of KIDAS is to adopt the format of iGLAD (Initiative for the Global Harmonization of Accident Data) for harmonization. Since the currently collected accident information is extremely limited compared with GIDAS, the other sources of data and calculations such as KNCAP vehicle data, pc-crash simulations, vehicle registration information, insurance company data are utilized to complete the iGLAD template. Results from KIDAS_iGLAD and the cases of assessment of active safety devices such as AEBS, ESC, and LDWS will be evaluated.
Ruptures and dissections of the thoracic and abdominal aortic vessel caused by traffic accidents are rare but potentially life-threatening injuries. They can occur by blunt trauma via seat belt or dashboard injury. The study aimed at evaluating the overall mortality, morbidity, neurological disorders, and differences in operative procedures of open repair and stenting. It shows that, with a change and improvement in diagnostic tools and surgical approach, mortality and morbidity of blunt aortic injuries were significantly reduced. Still an immediate life-threatening injury early diagnosis via multiple-slice and scans and surgical repair with minimally invasive stents showed excellent short-time results for selected patients.
Die Behandlungskosten von Unfallverletzten werden herkömmlich durch Multiplikation der durchschnittlichen Krankenhaus-Verweildauer mit dem vollpauschalierten und für alle Patienten gleichen Krankenhaus-Tagessatz ermittelt. Zielsetzung der vorliegenden Untersuchung ist es, den tatsächlichen Leistungsaufwand für die Gruppe der Unfallverletzten differenzierter zu erfassen, und zwar durch Addition von Einzelleistungen, die den Input für die stationäre Behandlung darstellen. Eine solche fallbezogene Kostenkalkulation wurde in ausgewählten Krankenhäusern für alle straßenverkehrsunfallverletzen Patienten des Jahres 1989 vorgenommen. Für Unfallverletzte in ambulanter Behandlung ergeben sich durchschnittliche Fallkosten in Höhe von 244 DM. Für die 5 häufigsten Einzeldiagnosen wurden folgende Werte ermittelt. 1. Prellungen der unteren Extremitäten: DM 287 je Patient. 2. Verstauchungen und Zerrungen im Rückenbereich: DM 149 je Patient. 3. Prellungen des Kopfes und des Halses: DM 326 je Patient. 4. Prellungen der oberen Extremitäten: DM 196 je Patient. Für Unfallverletzte in stationärer Behandlung ergeben sich durchschnittliche Fallkosten in Höhe von DM 4.824. Die Kosten liegen bei der Hälfte aller stationär behandelten Patienten unterhalb von DM 2.000. Bei 37 Prozent der Verletzten belaufen sie sich auf einen Betrag zwischen DM 2.000 und DM 7.000, wohingegen 13 Prozent der Fälle eine Behandlung benötigte die mehr als DM 10.000 an Kosten verursachte. Betrachtet man die Kosten der 10 häufigsten Einzeldiagnosen, so lassen sich zwei Gruppen bilden. Gehirnerschütterungen, Prellungen und Verstauchungen verursachten Kosten von weniger als der Hälfte des Durchschnittswertes von DM 4.824, wogegen für Frakturen als zweiter Gruppe weit darüber liegende Beträge errechnet wurden. Die Behandlungskosten von Unfallverletzungen mit Todesfolge liegen aufgrund der Verletzungsschwere bei DM 17.246 im Durchschnitt. Die Ergebnisse zeigen, dass die durchschnittlichen Behandlungskosten von Unfallverletzten in Akutkrankenhäusern in etwa den durchschnittlichen Behandlungskosten aller Patienten in Akutkrankenhäusern entsprechen.
Die Bundesanstalt für Straßenwesen hat eine Projektgruppe eingerichtet, deren Aufgabe es ist, die Erkenntnisse über Sachstand und Entwicklungen auf dem Gebiet des Rettungswesens zu systematisieren und zu interpretieren. Auf dieser Grundlage werden Problembereiche beschrieben und Vorschläge für Forschungsaktivitäten erarbeitet, die unter anderem im Rahmen der Forschungsplanung der BASt berücksichtigt werden sollten, beziehungsweise die von anderen Trägern mit Unterstützung durch die BASt durchgeführt werden sollten. Für den Projektgruppenbericht wurden folgende Themenschwerpunkte genannt: 1. Laienhilfe - ein problematischer Bereich des Rettungswesens, 2. Sind Notfallrettung und Krankentransport eine Einheit?, 3. Kommunikation und Kommunikationssysteme im Rettungswesen, 4. Notarztsysteme - Bestandsaufnahme und kritische Wertung, 5. Bewältigung eines Massenanfalls von Verletzten, 6. Die Verbindung von Rettungsdienst und Krankenhaus - eine Schwachstelle?, 7. Leistungsfähigkeit, Wirksamkeit und Effizienz von Rettungssystemen.
Powered Two Wheelers (PTWs) accidents constitute one of the road safety problems in Europe. PTWs fatalities represent 22% at EU level in 2006, having increased during last years, representing an opposite trend compared to other road users" figures. In order to reduce these figures it is necessary to investigate the accident causation mechanisms from different points of view (e.g.: human factor, vehicle characteristics, influence of the environment, type of accident). SAFERIDER project ("Advanced telematics for enhancing the SAFEty and comfort of motorcycle RIDERs", under the European Commission "7th Framework Program") has investigated PTW accident mechanisms through literature review and statistical analyses of National and In-depth accident databases; detecting and describing all the possible PTW's accident configurations where the implementation of ADAS (Advanced Driver Assistance Systems) and IVIS (In-Vehicle Information Systems) could contribute to avoid an accident or mitigate its severity. DIANA, the Spanish in-depth database developed by CIDAUT, has been analyzed for that purpose. DIANA comprises of accident investigation teams, in close cooperation with police forces, medical services, forensic surgeons, garages and scrap yards. An important innovation is the fact that before injured people arrive to hospitals, photographs and explanations about the possible accident injury mechanisms are sent to the respective hospitals (via 3G GPRS technology). By this, additional information to medical staff can be provided in order to predict in advance possible internal injuries and select the best medical treatment. This methodology is presented in this paper. On the other hand, the main results (corresponding to road, rider and PTW characteristics; pre and post-accident manoeuvres; road layout; rider behaviour; impact points; accident causations;...) from the analyses of the PTW accidents used for SAFERIDER are shown. Only accident types relevant to ADAS and IVIS devices have been considered.
Police records about traffic accidents like used by IRTAD (International Road Traffic and Accident Database) and CARE (Community Road Accident Database) do not represent all road injuries. For instance, road accidents of bicyclists without a counterpart are usually not reported. Furthermore, IRTAD-like data contains hardly any information on injury outcome and accident circumstances. This information gap leads to an under-representation of the safety concerns of the most vulnerable road users like children and the elderly both in accident research and safety promotion. Injury registration for the European Injury Database (IDB), in turn, combines details of accident causation with diagnostic information that can be used to assess injury severity and long term consequences. The IDB is collecting data from hospital emergency department patients and is being implemented in a growing number of countries. In this article IDB results on mode of transport and injury outcome are presented from a sample of nine EU member states.
To date, the Trauma Registry (TraumaRegister DGU-® contains data of approximately 100.000 severely injured patients, 65% of which suffered from a road traffic crash. Thus, it is the world's largest data base for severely injured patients. The article describes the development of the registry and explains how it was rolled out over Germany using the established structure of the German Trauma Network (TraumaNetzwerk DGU-®). In addition, this article presents three typical use cases from the fields of quality management, policy making and system-wide interventions, clinical research and injury prevention. In conclusion, the TraumaRegister DGU-® is a well-established tool for various purposes related to the control and reduction of the burden of road injury. Its ongoing expansion to other countries will support the goal of international benchmarking of hospitals and trauma systems.