10 year evaluation of train accidents

BACKGROUND
Although less frequent than automobile accidents, train accidents have a major impact on victims’ lives.
METHODS
Records of patients older than 16 years of age admitted to the Adult Emergency Department of Hacettepe University Medical Center due to train accidents were retrospectively evaluated.
RESULTS
44 patients (30 males, 14 females) with a mean age of 31.8±11.4 years were included in the study. The majority of the accidents occurred during commuting hours. 37 patients were discharged, 22 of them from the emergency department. The mortality rate was 7/44 (16%). Overall mean Revised Trauma Score (RTS) was 10.5 (3 in deaths and 11.9 in survivors). In 5 patients, the cause of death was pelvic trauma leading to major vascular injury and lower limb amputation. In 1 patient, thorax and abdomen trauma and in 1 patient head injury were the causes of mortality. Primary risk factors for mortality were alcohol intoxication (100%), cardiopulmonary resuscitation on admittance (100%), recurrent suicide attempt (75%), presence of psychiatric illness (60%), and low RTS.
CONCLUSION
In this study, most train accidents causing minor injuries were due to falling from the train prior to acceleration. Nevertheless, train accidents led to a mortality rate of 16% and morbidity rate of 37%. These findings draw attention to the importance of developing preventive strategies.

10-year evaluation of train accidents

AMAÇ
Otomobil kazalarý ile karþýlaþtýrýldýðýnda tren kazalarý daha az görülmekle beraber, kazazedelerin hayatlarý üzerinde ciddi etkisi vardýr.
GEREÇ VE YÖNTEM
Hacettepe Üniversitesi Týp Fakültesi Hastanesi Acil Kliniðine baþvuran 16 yaþ üzerinde, tren kazasýna maruz hastalarýn dosyalarý geriye dönük olarak incelendi.
BULGULAR
30 erkek, 14 kadýn toplam 44 hastanýn yaþ ortalamasý 31,8±14,3 idi. Yaralanmalarýn çoðu iþe gidiþ-çýkýþ saatlerindeydi. Yirmi ikisi acil servisten olmak üzere toplam 37 hasta taburcu edildi. Mortalite 7/44 (%16) saptandý. Revize travma skoru (RTS) ortalama 10,5 olup, ölenlerde 3, yaþayanlarda 11,9 idi. Ölüm nedeni 5 hastada majör vasküler hasar ve alt ekstremite amputasyonuna yol açan pelvik travma, 1 hastada torakal ve abdominal travma, 1 hastada kafa travmasý idi. Mortalite için primer risk faktörleri; alkollü olmak (%100), baþvuru anýnda kardiyopulmoner resüsitasyon yapýlmasý (%100), tekrarlayan intihar giriþimi (%75), psikiyatrik hastalýk öyküsü (%60) ve düþük RTS puaný idi.
SONUÇ
Tren kazalarýnýn çoðunluðunu, yeterince hýz kazanmamýþ trenden kaza ile düþmeye baðlý oluþmuþ minör yaralanmalar oluþturmaktadýr. Buna raðmen tren kazalarý %16 mortalite ve %37 morbiditeye neden olmuþtur. Bu bulgular yaralanmalarý önleyici tedbirlerin geliþtirilmesinin önemine dikkat çekmektedir.