Sonstige
[Introduction:] A large number of road users involved in road traffic crashes recover from their injuries, but some of them never recover fully and suffer from some kind of permanent disability. In addition to loss of life or reduced quality of life, road accidents carry many and diverse consequences to the survivors such as legal implications, economic burden, job absences, need of care from a third person, home and vehicle adaptations as well as psychological consequences. Within an EU funded project MOVE/C4/SUB/2011-294/SI2.628846 (REHABIL AID) these consequences were analyzed more detailed.
A total survey of road traffic accidents involving most severely injured, defined as sustaining a polytrauma or severe monotrauma (ISS > 15) or being killed, was conducted over 14 months in a large study region in Germany. Data on injuries, pre-clinical and clinical care, crash circumstances and vehicle damage were obtained both prospectively and retrospectively from trauma centers, dispatch centers, police and fire departments. 149 patients with a polytrauma and eight with a severe monotrauma were recorded altogether. 22 patients died in hospital. Another 76 victims had deceased at the accident scene. In 2008, 49 % of patients treated with life-threatening injuries were car or van occupants, 21 % motorcyclists, 18 % cyclists and 10 % pedestrians. Among fatalities at the scene, vehicle occupants constituted an even larger portion. The number of road users with life-threatening trauma in the region was extrapolated to the German situation. It suggests that 10 % among the "seriously injured" as defined in national accident statistics are surviving accident victims with a polytrauma or severe monotrauma.
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.