Degree of injury severity of the traffic accident autopsy cases.
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概要
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In order to evaluate the degree of injury severity in traffic accident autopsy cases, 171 cases were analyzed according to the abbreviated injury scale, 1985 revision (AIS) and injury severity score (ISS). ISS was derived from the sum of squares of the highest scores on the AIS in each of the three body parts most severely injured. Regarding the interval between accident and death, half of the cases were distributed in prehospital death and 21% died within 6 hours of hospitalization. Fifty percent of all deaths were attributed to thoracoabdominal injury, and 30% were attributed to head injury. The mean ISS in all cases was 43.9±19.8 (min. 5, max 97) and in regard to the relationship between the ISS level and survival interval, our results suggested "The higher ISS, the shorter the survival period". Among the hospitalized patient except for the prehospital death, the mean ISS was 32.8±13.0 (min. 5, max 66). In various injury types of the hospitalized patients, thoracoabdominal injury cases had the highest mean ISS (34.9±14.8), followed by head injury cases (33.7±6.6), secondary infection cases (30.1±11.6). Concerning the relationship between the mean ISS and age distribution, the elderly group above 65-years significantly had the lowest mean ISS (27.1±10.1). As for mode of accident, bicycle accidents had the highest ISS (51.4±25.0) and head AIS (3.3±1.9), and the automobile accident had the significantly lowest ISS (21.1±12.5). On the other hand, the extremities AIS was the highest in pedestrian accident. Sixty percent of cases (mean ISS: 30.2±11.2) were treated symptomatically. Among these cases, we found three outpatients who had low mean ISS (12.7±3.5) but later died from pulmonary thromboembolism or general fatty embolism. Concerning treatment in which emergency abdominal operation was performed, these cases had the highest ISS (50.4±12.1). At present there is a relative low rate of autopsies being performed in cases of trauma caused by traffic accidents. Our data indicate that AIS and ISS, usually used in the clinical field, can be applied to autopsy cases of traffic accidents, and can be used as the basic data for epidemiological, medical, economical and legal analysis of traffic accident cases in the future.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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