Neurologic injuries following road traffic accidents in the Dominican Republic: Examining causes and potential solutions

Sumanth P. Reddy, Maura S. Walsh, Robert Paulino-Ramirez, Jomar Florenzán, Jaime Fernández, Ohwofiemu E Nwariaku, Abier A Abdelnaby

Research output: Contribution to journalArticle

Abstract

Objective: Road traffic accidents (RTAs) are the number one cause of traumatic brain injuries (TBIs) worldwide. This study examines RTA-related TBIs in the Dominican Republic, a country in the Caribbean with the highest RTA fatality rate in the Western Hemisphere. Methods: We interviewed 117 adult patients or medical guardians of patients admitted to Hospital Traumatológico Dr. Ney Arias Lora in Santo Domingo following an RTA. Information regarding the type of accident, patient demographics, and injuries sustained was collected for each patient. Results: Most study participants were males (79.5%), and the most common method of transportation was motorized 2-wheeled vehicle (MTW; 74.4%). Of the 69 patients who suffered a TBI, 66.7% were classified as moderate–severe TBIs and 30.3% were classified as mild TBIs. The most common types of intracranial hemorrhage were subdural hemorrhage (12%) and subarachnoid hemorrhage (9.4%). Helmet use among admitted MTW riders was reported at 22.4%, and none of the 9 MTW riders who died in the hospital were wearing a helmet. Only 58.1% of patients lived in an area that offered 911 emergency response services at the time of the study. At 66.2%, the majority of people living within the 911 service area utilized emergency response services following an RTA. Multiple logistic regression determined that the utilization of 911 emergency response services was associated with a decrease in the likelihood of presenting with a moderate/severe TBI by a factor of 0.78 (adjusted odds ratio [OR]; P <.008; 95% confidence interval [CI], 0.65, 0.93). Nonuse of a helmet was associated with a 1.22 times increased risk of presenting with a moderate/severe TBI (adjusted OR; P <.04; 95% CI, 1.01, 1.61). Age and gender were not statistically significant in this model. Conclusions: The results of this study support 2 important avenues for reducing the burden of RTA-associated neurologic disease in the Dominican Republic. As with many other middle-income countries, MTWs represent an economical and efficient mode of transportation. Therefore, increasing helmet use may be the most effective way to reduce RTA-associated TBIs. In addition, continuing the expansion of postcrash emergency response services may mitigate the severity of RTA-associated neurologic disease.

Original languageEnglish (US)
JournalTraffic Injury Prevention
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Dominican Republic
Nervous System Trauma
Highway accidents
Traffic Accidents
traffic accident
road traffic
brain
Head Protective Devices
cause
Brain
Emergencies
Nervous System Diseases
confidence
Odds Ratio
Brain Concussion
Confidence Intervals
Disease
Subdural Hematoma
Time and Motion Studies
Intracranial Hemorrhages

Keywords

  • Dominican Republic
  • road traffic accidents
  • road traffic injuries
  • traumatic brain injuries

ASJC Scopus subject areas

  • Safety Research
  • Public Health, Environmental and Occupational Health

Cite this

Neurologic injuries following road traffic accidents in the Dominican Republic : Examining causes and potential solutions. / Reddy, Sumanth P.; Walsh, Maura S.; Paulino-Ramirez, Robert; Florenzán, Jomar; Fernández, Jaime; Nwariaku, Ohwofiemu E; Abdelnaby, Abier A.

In: Traffic Injury Prevention, 01.01.2019.

Research output: Contribution to journalArticle

@article{4b032a156b6542aaa58aefccfc08800c,
title = "Neurologic injuries following road traffic accidents in the Dominican Republic: Examining causes and potential solutions",
abstract = "Objective: Road traffic accidents (RTAs) are the number one cause of traumatic brain injuries (TBIs) worldwide. This study examines RTA-related TBIs in the Dominican Republic, a country in the Caribbean with the highest RTA fatality rate in the Western Hemisphere. Methods: We interviewed 117 adult patients or medical guardians of patients admitted to Hospital Traumatol{\'o}gico Dr. Ney Arias Lora in Santo Domingo following an RTA. Information regarding the type of accident, patient demographics, and injuries sustained was collected for each patient. Results: Most study participants were males (79.5{\%}), and the most common method of transportation was motorized 2-wheeled vehicle (MTW; 74.4{\%}). Of the 69 patients who suffered a TBI, 66.7{\%} were classified as moderate–severe TBIs and 30.3{\%} were classified as mild TBIs. The most common types of intracranial hemorrhage were subdural hemorrhage (12{\%}) and subarachnoid hemorrhage (9.4{\%}). Helmet use among admitted MTW riders was reported at 22.4{\%}, and none of the 9 MTW riders who died in the hospital were wearing a helmet. Only 58.1{\%} of patients lived in an area that offered 911 emergency response services at the time of the study. At 66.2{\%}, the majority of people living within the 911 service area utilized emergency response services following an RTA. Multiple logistic regression determined that the utilization of 911 emergency response services was associated with a decrease in the likelihood of presenting with a moderate/severe TBI by a factor of 0.78 (adjusted odds ratio [OR]; P <.008; 95{\%} confidence interval [CI], 0.65, 0.93). Nonuse of a helmet was associated with a 1.22 times increased risk of presenting with a moderate/severe TBI (adjusted OR; P <.04; 95{\%} CI, 1.01, 1.61). Age and gender were not statistically significant in this model. Conclusions: The results of this study support 2 important avenues for reducing the burden of RTA-associated neurologic disease in the Dominican Republic. As with many other middle-income countries, MTWs represent an economical and efficient mode of transportation. Therefore, increasing helmet use may be the most effective way to reduce RTA-associated TBIs. In addition, continuing the expansion of postcrash emergency response services may mitigate the severity of RTA-associated neurologic disease.",
keywords = "Dominican Republic, road traffic accidents, road traffic injuries, traumatic brain injuries",
author = "Reddy, {Sumanth P.} and Walsh, {Maura S.} and Robert Paulino-Ramirez and Jomar Florenz{\'a}n and Jaime Fern{\'a}ndez and Nwariaku, {Ohwofiemu E} and Abdelnaby, {Abier A}",
year = "2019",
month = "1",
day = "1",
doi = "10.1080/15389588.2019.1643016",
language = "English (US)",
journal = "Traffic Injury Prevention",
issn = "1538-9588",
publisher = "Taylor and Francis Ltd.",

}

TY - JOUR

T1 - Neurologic injuries following road traffic accidents in the Dominican Republic

T2 - Examining causes and potential solutions

AU - Reddy, Sumanth P.

AU - Walsh, Maura S.

AU - Paulino-Ramirez, Robert

AU - Florenzán, Jomar

AU - Fernández, Jaime

AU - Nwariaku, Ohwofiemu E

AU - Abdelnaby, Abier A

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Road traffic accidents (RTAs) are the number one cause of traumatic brain injuries (TBIs) worldwide. This study examines RTA-related TBIs in the Dominican Republic, a country in the Caribbean with the highest RTA fatality rate in the Western Hemisphere. Methods: We interviewed 117 adult patients or medical guardians of patients admitted to Hospital Traumatológico Dr. Ney Arias Lora in Santo Domingo following an RTA. Information regarding the type of accident, patient demographics, and injuries sustained was collected for each patient. Results: Most study participants were males (79.5%), and the most common method of transportation was motorized 2-wheeled vehicle (MTW; 74.4%). Of the 69 patients who suffered a TBI, 66.7% were classified as moderate–severe TBIs and 30.3% were classified as mild TBIs. The most common types of intracranial hemorrhage were subdural hemorrhage (12%) and subarachnoid hemorrhage (9.4%). Helmet use among admitted MTW riders was reported at 22.4%, and none of the 9 MTW riders who died in the hospital were wearing a helmet. Only 58.1% of patients lived in an area that offered 911 emergency response services at the time of the study. At 66.2%, the majority of people living within the 911 service area utilized emergency response services following an RTA. Multiple logistic regression determined that the utilization of 911 emergency response services was associated with a decrease in the likelihood of presenting with a moderate/severe TBI by a factor of 0.78 (adjusted odds ratio [OR]; P <.008; 95% confidence interval [CI], 0.65, 0.93). Nonuse of a helmet was associated with a 1.22 times increased risk of presenting with a moderate/severe TBI (adjusted OR; P <.04; 95% CI, 1.01, 1.61). Age and gender were not statistically significant in this model. Conclusions: The results of this study support 2 important avenues for reducing the burden of RTA-associated neurologic disease in the Dominican Republic. As with many other middle-income countries, MTWs represent an economical and efficient mode of transportation. Therefore, increasing helmet use may be the most effective way to reduce RTA-associated TBIs. In addition, continuing the expansion of postcrash emergency response services may mitigate the severity of RTA-associated neurologic disease.

AB - Objective: Road traffic accidents (RTAs) are the number one cause of traumatic brain injuries (TBIs) worldwide. This study examines RTA-related TBIs in the Dominican Republic, a country in the Caribbean with the highest RTA fatality rate in the Western Hemisphere. Methods: We interviewed 117 adult patients or medical guardians of patients admitted to Hospital Traumatológico Dr. Ney Arias Lora in Santo Domingo following an RTA. Information regarding the type of accident, patient demographics, and injuries sustained was collected for each patient. Results: Most study participants were males (79.5%), and the most common method of transportation was motorized 2-wheeled vehicle (MTW; 74.4%). Of the 69 patients who suffered a TBI, 66.7% were classified as moderate–severe TBIs and 30.3% were classified as mild TBIs. The most common types of intracranial hemorrhage were subdural hemorrhage (12%) and subarachnoid hemorrhage (9.4%). Helmet use among admitted MTW riders was reported at 22.4%, and none of the 9 MTW riders who died in the hospital were wearing a helmet. Only 58.1% of patients lived in an area that offered 911 emergency response services at the time of the study. At 66.2%, the majority of people living within the 911 service area utilized emergency response services following an RTA. Multiple logistic regression determined that the utilization of 911 emergency response services was associated with a decrease in the likelihood of presenting with a moderate/severe TBI by a factor of 0.78 (adjusted odds ratio [OR]; P <.008; 95% confidence interval [CI], 0.65, 0.93). Nonuse of a helmet was associated with a 1.22 times increased risk of presenting with a moderate/severe TBI (adjusted OR; P <.04; 95% CI, 1.01, 1.61). Age and gender were not statistically significant in this model. Conclusions: The results of this study support 2 important avenues for reducing the burden of RTA-associated neurologic disease in the Dominican Republic. As with many other middle-income countries, MTWs represent an economical and efficient mode of transportation. Therefore, increasing helmet use may be the most effective way to reduce RTA-associated TBIs. In addition, continuing the expansion of postcrash emergency response services may mitigate the severity of RTA-associated neurologic disease.

KW - Dominican Republic

KW - road traffic accidents

KW - road traffic injuries

KW - traumatic brain injuries

UR - http://www.scopus.com/inward/record.url?scp=85070487214&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070487214&partnerID=8YFLogxK

U2 - 10.1080/15389588.2019.1643016

DO - 10.1080/15389588.2019.1643016

M3 - Article

C2 - 31381379

AN - SCOPUS:85070487214

JO - Traffic Injury Prevention

JF - Traffic Injury Prevention

SN - 1538-9588

ER -