Analysis On Epidemiological Characteristics Of Trauma And Road Traffic Injuries In Guangzhou City

1 ObjectiveThis study aimed to understand the epidemiological characteristics of pre-hospital trauma patients and road traffic injuries,and further analyze influence factors of road traffic injuries and death in Guangzhou city so as to clarify epidemiological regularity of trauma and road traffic injuries,as well as the risk factors of road traffic injuries casualties.To make scientific and reasonable prevention,control measures and treatment strategy,providing reference for the further construction and improvement of pre-hospital emergency trauma treatment system.2 Methods?1?All the electronic medical records of pre-hospital trauma patients from 2008 to 2017 in Guangzhou were collected form the dispatching command platform database of Guangzhou emergency medical command center.R language and Arc Gis 10.2 were used to establish the database and conduct statistical analysis.?2?All the cases of road traffic injures form 2013 to 2017 in Guangzhou were sorted from the road traffic accident registration database of traffic police detachment of Guangzhou public security bureau.Spss 20.0 and Arc Gis 10.2 were used to establish the database and conduct statistical analysis.?3?The 18,513 cases of road traffic injury and casualty events in Guangzhou from 2013 to2017 were gathered to retrospective analysis,and the multivariate logistic analysis was conducted to explore the influencing factors of road traffic injury and casualty events.?4?Statistical analysis methods:descriptive statistical analysis,circular distribution analysis,spatial autocorrelation and hot spot analysis,multivariate logistic regression analysis.3 Results?1?During the past decade,there were 439,596 pre-hospital trauma patients,showing the fluctuating trend in first increased and then decreased.The pre-hospital trauma rate slightly decreased,which were higher than 30%??²=2524.38,P<0.01?.The incidence rate of trauma was23.97/10,000?47.88/10,000,showing a decreasing trend??²=533.64,P<0.01?.The trauma patients average age were?44.97±22.68?years old.The main population was 21 to 50 years old.The male-female ratio was 1.80:1.Circular distribution analysis and seasonal index suggested that the time of trauma occurred was aggregated.In a year,June to August and October to November were the periods of high incidence of trauma?P<0.01?,while February was the period of low incidence.In a day,the traumatic peak period was 10 to 11 am and 17 to 18 pm?P<0.01?,while the trough period was 3 to 6 am.Spatial autocorrelation analysis showed that the spatial distribution of trauma patients was clustered.Except for 2014,the global Moran's I index were>0?Z>1.96,P<0.05?.The hot pot analysis showed that hot pots and cold pots were existed.The hot pots mainly distributed in Baiyun,Tianhe and Huangpu Districts.Particularly obvious hot spots include Zhongluotan Town,Renhe Town,Jianggao Town,Taihe Town,Yongping Street,Junhe Street,Jingxi Street,Longdong Street,Fenghuang Street,Changxing Street,Xintang Street,Tangxia Street,Yuangang Street,Huangcun Street,Zhuji Street,Chebei Street,Dasha Street,Lianhe Street,Yuzhu Street,Yonghe Street,Hongshan Street,Wenchong Street,Changzhou Street in above three regions district?Z>2.58,P<0.01?,the cold pots were mainly in Liwan,Yuexiu and Haizhu Districts.The top three trauma types were road traffic injuries?40.93%?,fall injuries?25.54%?,and impact injuries?11.59%?,the proportion of falls injuries increases with age,and the proportion of women in falls injuries higher than men,the top four positions of traumatic injury were craniocerebral?31.23%?,face?19.04%?,lower extremity?17.13%?and upper extremity?11.66%?,the proportion of lower extremity trauma varies with age at age Increased and increased,women accounted for a higher proportion of limb trauma than men,the proportion of upper limb trauma decreased with age.?2?There were 13,245 cases of road traffic injuries happened in Guangzhou,causing 14,415injuries and 4,098 deaths over the past five years.The casualty ratio was 3.52:1,and the direct economic loss was 4,278,300 yuan.The degree of motorization reached 174.41 to 192.59vehicles per thousand people.The fatality rate ranged from 20.80%to 22.38%.The circular distribution analysis showed that the temporal distribution among road traffic injury occurrence,injuries and death presented central tendency,overlapping with the trauma.Second half of the year was the peak period(Z_occurrence=8.32,Z_injuries=8.41,Z_death=5.08,P<0.01).First half of the day in 8?9 am was the peak hours(Z_occurrence=35.36,Z_injuries=19.05,Z_death=19.74,P<0.01),while20?21 pm in the second half(Z_occurrence=46.79,Z_injuries=81.11,Z_death=13.74,P<0.01),the special fatality peak time was 3?4am.According to global spatial autocorrelation analysis,all Moran's I index of road traffic injury occurrences,injuries and deaths were>0,and there was a positive spatial correlation(Z_occurrence=13.55,Z_injuries=12.28,Z_death=19.73,P<0.01),which indicated that the three were clustered in space.After hot pot analysis,there were hot pots in road traffic injury occurrence,injury,and death(Z_occurrence?Z_injuries?Z_death>1.96,P<0.05).The hot spots mainly include Baiyun,Huadu,Conghua and Zengcheng Districts,especially Renhe Town,Shiling Town,Tiamen Town,Tanhuo Town,Huahu Town,Huadong Town,Yayao Town,and Xinhua Street,Zhongxin Town,Shitan Town,and Zhucun Street are the most obvious in above three districts.Hot spots of road traffic injuries include Jiulong Town in Zengcheng District,and deaths include Aotou Town,Chengjiao Street,and Jiekou Street in Conghua District.(Z_occurrence?Z_injuries?Z_death>2.58,P<0.01).The cold pots area were similar to trauma,mainly distributed in Liwan,Yuexiu and Haizhu Districts.?3?The single-factor screened of influencing factors for road traffic injuries and deaths.Among the spatial factors,the fatality rate in Conghua District was higher?37.03%???²=525.05,P<0.01?.In the time factor,the fatality rate was higher?50.93%?in half of day??²=52.24,P<0.01?.Among road factors,when the pavement condition was not intact?34.29%?,the road surface was under construction,bumps,roadblocks,subsidence and other conditions?31.07%?,the pavement structure was dirt road or other conditions?28.07%?,terrain was mountainous?28.92%?,road grade was national road and county road?23.42%and 24.30%?,road type was highway?33.54%?,the road alignment was a general curved slope?40.18%?,the intersection section was a narrow road?39.39%?,its fatality rate was higher?P<0.05?.In the environmental factors,when it's cloudy and rainy?32.04%and 31.80%?,visibility was less than 50 meters?25.26%?,no lighting at night?33.06%?,four traffic control methods?26.45%?,road physical barriers were the center with non-blocking?25.51%?,the central protective facility was a movable guardrail?30.43%?,and the roadside protective facility was a protective pier/pillar?33.38%?,its fatality rate was higher?P<0.05?.It was prompted that time period,pavement conditions,terrain,road grade,road type,road alignment,lighting conditions,traffic control methods,road physical barriers and roadside protection facilities were influencing factor for road traffic injuries and deaths by using the multiple logistic regression model?P<0.05?.4 Conclusion?1?The trauma situation in Guangzhou is still grim,with its own epidemiological characteristics.Paying attention to the high-risk and special populations,peak times and time points,key areas,common types and location values of trauma are crucial for prevention,control and treatment.At the same time,it has a reference value for the construction and improvement of the trauma treatment system.?2?The primary type of trauma was road traffic injuries.Due to the high degree of motorization,the fatality rate of it remain at a high level.The time distribution showed a correlation with social production and activities,while road traffic injuries were more when work and entertainment activities were active.The spatial distribution was correlated with the social economic conditions and geographical location,while the road traffic injuries in urban and rural areas were more.?3?Through a single factor analysis of road traffic injuries and fatalities,clarify the situation of road traffic injuries caused by large number injuries,deaths and high mortality rate in road traffic.In addition,the multiple logistic regression model fitted well,displayed the influencing factors of road traffic casualties include 10 factors such as time,space,road and environment.