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Road Traffic Injuries and Road Safety Measures – Can We Do Any Better?
Mariana Morgado, MD, Filipa Jalles, MD, Sara Lobo, MD, Francisco Abecasis, MD, Miroslava Gonçalves, MD. Hospital de Santa Maria, Lisbon, Portugal.

Road traffic injuries are the leading cause of death for people under 30 years, causing over a million deaths every year. Only 28 countries have adequate laws addressing individual risk factors prevention. Our purpose was to analyse how security measures (helmets, seat-belts, child restraints) relate to paediatric polytrauma severity in road traffic injury. Inpatient data from January 2011 to December 2015 was searched retrospectively. Patients under 18 years admitted after road traffic injury were included. Among 149 patients, 95 were male with a median age of 11 years. Median hospital stay was 8 days (range 1-420). Trauma mechanisms were vehicle associated pedestrian accidents (45%), motor vehicle collisions (39%) and bicycle accidents (16%). At the moment of trauma, 34% had no adult supervision. In 79% of bicycle/motorcycle accidents and in 26% of car collisions there was no protective equipment. Head trauma was present in 81,9%, associated with diffuse axonal injury in 22% and, with neurologic sequelae in 20%. Half had abdominal trauma and 42% needed surgery. Children perished in 5,4%. Absence of personal protective equipment was a significant predictor for head trauma (p<0.05), without abdominal injury increase. Diffuse axonal injury was a significant predictor for neurologic sequelae and death (p<0.01). Absence of adult supervision was a significant predictor of lack of security equipment (p<0.01), and was more common in older children (p<0.01). In the "Decade of Action for Road Safety", we still find important handicaps in road safety measures. This study corroborates that protective road equipment has a significant impact in the outcomes of road traffic injuries.


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