Fatores determinantes da gravidade de lesões em vítimas de trauma por acidentes envolvendo motocicletas

Abstract

Morbidity and mortality from accidents involving motorcycles have assumed alarming levels, especially in low- and middle-income. In Brazil, most studies that emphasize this problem, use a secondary data source, which makes the assessment of cause and effect. This study aims to analyze factors determining the severity of injuries in victims of accidents involving motorcycles. This is a cohort study composed of victims of accidents involving motorcycles. Those people were included, regardless of the position occupied. This time all road users who required hospital care because of injuries resulting secondary trauma to this type of accidents were included, whether biker, cyclist, pedestrian or vehicle occupant. The site was selected from the study of the epidemiological behavior of the endpoints in the last 30 years where the highest mortality rates were observed in the macro-region of Sobral, justifying the collection in this region. 10 field researchers were trained. The collection began in October 1, 2013 and continued until it was complete the sample of 1,043 individuals. Conducted pilot to adjust the instrument. The main outcomes were: hospitalization and death. The univariate analysis was initially, with analysis of frequency, means, medians and normality tests. Then the bivariate and stratified analysis took account of the relationship between exposure factors and selected outcomes. Both outcomes were analyzed by Kaplan-Meier curves and Cox bivariate analysis. The variables associated with the outcome considering pvalor <0.25 were considered eligible to enter the multivariate model, but in the final model remained those in the 0.05 level. Approved by the Ethics Committee of the State University Valley Acaraú (UVA) through the opinion 408039. The main results pointed to the relationship between variables related to characteristics of the person, human behavior and characteristics of the lesions and the outcomes. There was no difference between the sexes. In survival analysis, appeared as predictor variables related to individual characteristics, clinics and trauma arising from the impact. In the final model the outcome of death was identified that the abdominal trauma, speed and age were instrumental in the survival time, determining early death. Scores higher on the RTS were related with longer survival. We conclude that the factors related to the behavior, characteristics of the person and related injuries contribute significantly to the severity of outcomes in motorcycle accidents, raising strategies for preventive measures and strengthening of prehospital care and rapid transportation to specialized center trauma as crucial factors to reduce morbidity and mortality by that injury.