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BMC Public Health

, 9:11

First Online: 12 January 2009Received: 28 July 2008Accepted: 12 January 2009DOI: 10.1186-1471-2458-9-11

Cite this article as: Fitzharris, M., Dandona, R., Kumar, G.A. et al. BMC Public Health 2009 9: 11. doi:10.1186-1471-2458-9-11


BackgroundTraffic crashes and consequent injuries represent a growing public health concern in India, particularly in light of increasing motorization. Motorised two-wheeled vehicles MTV constitute a large portion of the vehicle fleet in India. We report the crash characteristics and injury patterns among a cohort of MTV riders and pillions presenting to hospital post-crash.

MethodsConsecutive MTV riders and pillions, whether alive or dead, injured in a road traffic crash presenting to the emergency departments of two government hospitals and three branches of a private hospital in urban Hyderabad, India, were recruited to this study.

Results378 MTV users were enrolled to the study of whom 333 88.1% were male, 252 66.7% were riders and median age was 31.3 years. A total of 223 59% MTV users were injured in multi-vehicle crashes while one-third had a frontal impact. The majority 77% were assessed as having a Glasgow coma score GCS of 13–15, 12% a GCS of 9–12 and 11% a GCS of 3–8. No difference was seen in the severity distribution of injuries based on GCS among riders and pillions. Open wounds and superficial injuries to the head 69.3% and upper extremity 27% and lower extremity 24% were the most common injuries. 43 11% sustained an intracranial injury, including 12 28% with associated fracture of the bones of the head. There were few differences in types of injuries sustained by riders and pillions though riders had a significantly lower risk of crush injuries of the lower extremity than pillions relative risk, RR 0.25, 95% CI 0.08–0.81 and female pillions were at a significantly lower risk of sustaining fractures of the lower extremity than male pillions RR 0.30, 95% CI 0.09 – 0.94. Overall, 42 11% MTV users died, of which 42.8% died before reaching the hospital. Only 74 19.6% MTV users had worn a helmet correctly and failure to wear a helmet was associated with a five times greater risk of intracranial injury RR 4.99, 95% CI 1.23–20.1. Of the 19 pre-hospital deaths, 16 84% had not worn a helmet.

ConclusionHead injuries accounted for the major proportion of injuries sustained in MTV users. Non-helmet use was associated with increased risk of serious head injuries. The data presented on the nature and severity of injuries sustained by MTV users can assist with planning to deal with these consequences as well as prevention of these injuries given the high use of MTV in India.

AbbreviationsCIConfidence interval

EDemergency department

GCSglasgow coma scale

LOCloss of consciousness

ISSinjury severity score

MAIShighest AIS severity for each region

MTVmotorised two-wheeled vehicles

MVCmultiple vehicle crash

RRrelative risk

RTIroad traffic injury

SVCsingle vehicle crash

ICD-10The International Statistical Classification of Diseases and Related Health Problems 10th Revision.

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Autor: Michael Fitzharris - Rakhi Dandona - G Anil Kumar - Lalit Dandona


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