Comparison of the severity of traumatic brain injuries in pedestrians and occupants of motor vehicles admitted to Firat health center: a five-year series in an Eastern Turkish city

Abstract

Background: Traumatic brain injury is the leading cause of death of people in motor vehicle (MV) accidents, which have been increasing in number in developing countries. A retrospective study was undertaken to evaluate all cases admitted to the emergency department of the authors' institution with suspected injury after involvement in a MV-related accident between January 2000 and January 2005. Material and Method: During the study period a total of 2014 cases were admitted: 1258 were occupants of motor vehicles and 756 were pedestrians. Cases with traumatic brain injury were evaluated with respect to gender, age, Glasgow Coma Scales (GCS), and death. Results: Five hundred thirty-two of the cases (386 male, 146 female, mean age: 26.8+/-20.3 years) involved in MV accidents experienced traumatic brain injuries, of which 299 were MV occupants and 233 were pedestrians. The pediatric (< or =16 years: 65.4%) and elderly (> or =65 years: 64.7%) groups were frequently involved as pedestrians in MV accidents; adults 17-64 years of age were involved as pedestrians at a lower rate (25.4%, p<0.001). The GCS values of the pedestrian victims were significantly lower than those of the MV occupants on admission (p<0.001). Conclusions: The results show that improvements in car safety have reduced life-threatening conditions for occupants of motor vehicles, but this does not include pedestrian safety. There is great need for practical strategies to reduce or prevent MV accident-related injuries among pedestrians, especially for the pediatric and elderly groups who are most exposed to these injuries.