Abstract：
OBJECTIVE: Road traffic injuries (RTIs) pose a significant public health burden, and more than half of these fatalities are attributed to vulnerable road users (VRUs). This study aimed to evaluate the epidemiology and outcomes of severe RTIs in Korea by focusing on different types of road users.
METHODS: This is nationwide retrospective observational study. Using data from the Korean Nationwide Severe Trauma Registry, this study analyzed severe RTI cases from 2016 to 2020. The study included EMS-treated severe trauma patients, defining severe RTI as cases with an injury severity score (ISS) ≥16 or out-of-hospital cardiac arrest (OHCA). The main variable of interest was the road user type, classified as motor vehicle occupants (MVOs), pedestrians, motorcyclists, and bicyclists. Trends and injury characteristics by road user type were analyzed, and multivariate logistic regression was conducted to calculate the adjusted odds ratios (AORs) and 95 % confidence intervals (CIs) of road user type for in-hospital mortality.
RESULTS: Of the 143,021 EMS-treated severe trauma cases, 24,464 were included in this study. Pedestrians represented the largest group (n = 8,782; 35.9 %). More than half of the patients died (n = 12,620, 51.6 %), and a high proportion of patients had OHCA (n = 10,048, 41.1 %). There was no significant change in the overall severe RTI numbers from 2016 to 2020, but a decrease in pedestrian cases and an increase in motorcyclist cases were noted (both p for trend<0.05). Low usage of safety devices was observed (28.2 % of motor vehicle occupants used seat belts, 35.9 % of motorcyclists used helmets, and 9.6 % of bicyclists used helmets). Head injuries were most common, particularly among bicyclists (77.0 %) and motorcyclists (69.8 %). Compared to motor vehicle occupants, pedestrians (AOR [95 % CI] 1.12 [1.04-1.20]) and others (AOR [95 % CI] 1.30 [1.02-1.65]) had higher odds of mortality, while motorcyclists (AOR [95 % CI] 0.64 [0.59-0.69]) and bicyclists (AOR [95 % CI] 0.68 [0.60-0.76]) had lower odds of mortality.
CONCLUSIONS: We found varying trends and injury characteristics in severe RTIs according to road user type. Adapting prevention strategies for evolving road user patterns, with particular attention to increasing safety device usage and addressing the high mortality associated with severe RTIs are warranted.
METHODS: This is nationwide retrospective observational study. Using data from the Korean Nationwide Severe Trauma Registry, this study analyzed severe RTI cases from 2016 to 2020. The study included EMS-treated severe trauma patients, defining severe RTI as cases with an injury severity score (ISS) ≥16 or out-of-hospital cardiac arrest (OHCA). The main variable of interest was the road user type, classified as motor vehicle occupants (MVOs), pedestrians, motorcyclists, and bicyclists. Trends and injury characteristics by road user type were analyzed, and multivariate logistic regression was conducted to calculate the adjusted odds ratios (AORs) and 95 % confidence intervals (CIs) of road user type for in-hospital mortality.
RESULTS: Of the 143,021 EMS-treated severe trauma cases, 24,464 were included in this study. Pedestrians represented the largest group (n = 8,782; 35.9 %). More than half of the patients died (n = 12,620, 51.6 %), and a high proportion of patients had OHCA (n = 10,048, 41.1 %). There was no significant change in the overall severe RTI numbers from 2016 to 2020, but a decrease in pedestrian cases and an increase in motorcyclist cases were noted (both p for trend<0.05). Low usage of safety devices was observed (28.2 % of motor vehicle occupants used seat belts, 35.9 % of motorcyclists used helmets, and 9.6 % of bicyclists used helmets). Head injuries were most common, particularly among bicyclists (77.0 %) and motorcyclists (69.8 %). Compared to motor vehicle occupants, pedestrians (AOR [95 % CI] 1.12 [1.04-1.20]) and others (AOR [95 % CI] 1.30 [1.02-1.65]) had higher odds of mortality, while motorcyclists (AOR [95 % CI] 0.64 [0.59-0.69]) and bicyclists (AOR [95 % CI] 0.68 [0.60-0.76]) had lower odds of mortality.
CONCLUSIONS: We found varying trends and injury characteristics in severe RTIs according to road user type. Adapting prevention strategies for evolving road user patterns, with particular attention to increasing safety device usage and addressing the high mortality associated with severe RTIs are warranted.
摘要：
目标：道路交通伤害（RTIs）构成了重大的公共卫生负担，其中一半以上的死亡归因于弱势道路使用者(VRU)。本研究旨在通过关注不同类型的道路使用者来评估韩国严重RTI的流行病学和结果。
方法：这是一项全国性的回顾性观察研究。使用韩国全国严重创伤登记处的数据，本研究分析了2016年至2020年的严重RTI病例.这项研究包括EMS治疗的严重创伤患者，将严重RTI定义为损伤严重程度评分（ISS）≥16或院外心脏骤停（OHCA）的病例。感兴趣的主要变量是道路用户类型，分类为机动车乘员(MVOs)，行人,摩托车手,和骑自行车的人。分析了道路使用者类型的趋势和伤害特征，我们进行了多因素逻辑回归,以计算住院死亡率的道路使用者类型的校正比值比(AORs)和95%置信区间(CIs).
结果：在143,021例EMS治疗的严重创伤病例中，本研究包括24,464。行人占最大的群体(n=8,782;35.9%)。超过一半的患者死亡（n=12,620，51.6％），高比例的患者患有OHCA（n=10,048，41.1%）。从2016年到2020年，严重RTI的总体数量没有显着变化，但行人病例减少，摩托车手病例增加（趋势均<0.05）。观察到安全装置的使用率较低(28.2%的机动车乘员使用安全带，35.9%的电单车司机使用头盔,和9.6％的骑自行车的人使用头盔）。头部受伤最常见,特别是骑自行车的人(77.0%)和骑摩托车的人(69.8%)。与机动车乘员相比，行人（AOR[95%CI]1.12[1.04-1.20]）和其他人（AOR[95%CI]1.30[1.02-1.65]）的死亡率较高，而摩托车手(AOR[95%CI]0.64[0.59-0.69])和自行车手(AOR[95%CI]0.68[0.60-0.76])的死亡率较低.
结论：根据道路使用者类型，我们发现严重RTI的趋势和损伤特征各不相同。针对不断变化的道路使用者模式调整预防策略,特别注意增加安全装置的使用和解决与严重RTI相关的高死亡率是必要的。
方法：这是一项全国性的回顾性观察研究。使用韩国全国严重创伤登记处的数据，本研究分析了2016年至2020年的严重RTI病例.这项研究包括EMS治疗的严重创伤患者，将严重RTI定义为损伤严重程度评分（ISS）≥16或院外心脏骤停（OHCA）的病例。感兴趣的主要变量是道路用户类型，分类为机动车乘员(MVOs)，行人,摩托车手,和骑自行车的人。分析了道路使用者类型的趋势和伤害特征，我们进行了多因素逻辑回归,以计算住院死亡率的道路使用者类型的校正比值比(AORs)和95%置信区间(CIs).
结果：在143,021例EMS治疗的严重创伤病例中，本研究包括24,464。行人占最大的群体(n=8,782;35.9%)。超过一半的患者死亡（n=12,620，51.6％），高比例的患者患有OHCA（n=10,048，41.1%）。从2016年到2020年，严重RTI的总体数量没有显着变化，但行人病例减少，摩托车手病例增加（趋势均<0.05）。观察到安全装置的使用率较低(28.2%的机动车乘员使用安全带，35.9%的电单车司机使用头盔,和9.6％的骑自行车的人使用头盔）。头部受伤最常见,特别是骑自行车的人(77.0%)和骑摩托车的人(69.8%)。与机动车乘员相比，行人（AOR[95%CI]1.12[1.04-1.20]）和其他人（AOR[95%CI]1.30[1.02-1.65]）的死亡率较高，而摩托车手(AOR[95%CI]0.64[0.59-0.69])和自行车手(AOR[95%CI]0.68[0.60-0.76])的死亡率较低.
结论：根据道路使用者类型，我们发现严重RTI的趋势和损伤特征各不相同。针对不断变化的道路使用者模式调整预防策略,特别注意增加安全装置的使用和解决与严重RTI相关的高死亡率是必要的。
