Comparing alertness and injury severity following motor vehicular accidents at a Nigerian tertiary hospital

Abstract

Background: From casual observation of injury patterns in Motor Vehicular Accidents (MVAs), it was sometimes observed that if the victim had been more alert and reacts protectively, injury severity might be reduced. Protective response is often expected to minimize the severity of injuries.
Objective: To determine the relationship between alertness and Injury Severity Score (ISS) in MVA victims.
Design: Prospective hospital based cross sectional study.
Setting: Adult Emergency Department of Obafemi: Awolowe University Teaching Hospital.
Subjects: Adults presenting at the emergency room (ER) following MVAs.
Interventions :Advanced Trauma Life Support(ATLS) protocol for accident victims.
Main Outcome Measures: Injury Severity.
Results: A total of 90 adults had MVAs representing 20% of ER attendances during the period. Young males accounted for 53% of the victims, seated in the middle seats of commercial buses moving at moderate speed, awake and saw the accident coming. Seat belts were used in 30% of patients and 43% had ISS scores > 15. There was no statistically significant association between alertness and ISS.
Conclusion: Victims of MVAs are majorly travellers in our community. We observed that the level of alertness prior to the accident has no significant association with the ISS. Other factors such as seatbelts, state of vehicles and speed limits contribute to the ISS. The calculation of ISS should be done routinely for objective assessment of patients.