Clinical and nosological structure of disability among the victims of road accidents in Ukraine
The article deals with the problem of disability in the victims of road accidents, the structure of disability in the aspect of clinical and nosological characteristics of injuries. 219 cases of primary disability as a result of trauma occurred due to road accidents were analyzed. The distribution of the majority of victims depending on the clinical and nosological form of damage was studied, as well as the age in clinical and nosological groups. The clinical and nosological group of skeletal trauma (ST) made up 52 % by the specific gravity in the general array. In the clinical and nosological ST group with the first disability category, the indicator is 9.6 %, which is 42.4 % higher by the absolute value than the severity index of the general array. The second disability category in the clinical and nosological ST group has an index of 49.1 %, which is 2.9 % less by the absolute value than the severity index of the general array. The indicator of the third disability category in the clinical and nosological ST group is 41.2 %, which is 10.8 % less by the absolute value than the severity index. The foregoing points out that skeletal injury is a significant, common and disabling sign for victims of a road accident. The analysis of the data indicates that the distribution of patients in term of disability categories significantly depends on the age group. In the age group up to 30 years, the clinical and nosological ST group (67.3 %) is most common one. Among other clinical and nosological groups of this age, the most common were clinical and nosological groups of cranio-thoraco-abdomino-skeletal trauma (CTAST) (14.5 %), cranio-thoraco-skeletal trauma (CTST) (9.1 %), cranio-skeletal trauma (CST) (7.3 %), and thoraco-skeletal trauma (TST) (1.8 %). In the age group of up to 30 years, thoraco-abdomino-skeletal trauma (TAST) was not detected. The above shows that in the age group of up to 30 years, the skeletal component of injuries was found in 100 % of cases, the cranial component — in 30.9 %, the thoracic component — in 25.4 %, and the abdominal component — in 14.5 %. In the age group of 31–45 years, a skeletal injury was most common (45.1 %). The second common was the clinical and nosological group of CST (18.3 %), the third — CTAST (17.1 %), the fourth — TST (11 %), CTST is somewhat less common (6.1 %), and TAST was not detected at all. In this case, the skeletal component of injury was found in all cases of this age group (100 %), the cranial component — in 41.5 % of the victims; thoracic component — in 34.2 %; abdominal component — in 17.1 %. In the age group of 46–60 years, about half of the patients suffered from skeletal trauma (45.1 %). Among other injuries detected in persons disabled due to road accident in this age group, there were: CTST (21.6 %), CTAST (10.8 %), TST (9.5 %), CST (6.8 %), TAST (5.4 %). The age group of 61–75 years consists mainly of persons, who were disabled due to skeletal (75 %) and cranio-skeletal trauma (25 %) as a result of a road accident. Given that the overwhelming majority of this age group consists of pedestrians, it is likely that such a division is related to the neglec-ted traffic rules. The results of the study made it possible to conclude that clinical and nosological characteristics of people, who became disabled due to a car accident, are important risk factors affecting the nature and outcome of the traumatic process. In the clinical and nosological structure of victims, who became disabled due to a road accident, the damage of the locomotor system was most common — it was detected in 100 % of cases and accounts for 52 % of the total array of injuries, as well as the cranial component — 38.5 %. There is a certain differentiation in the clinical and nosological structure of patients depending on the disability category, primarily due to the damage of the locomotor system (it prevails in patients with the first disability category — 61.1 %), abdominal (15.4 % — second disability category) and thoracic (38.9 % — third disability category) components of injury. The nature and extent of the combination of polytrauma components are an important features that characterize the disability of the victims as a result of a road accident, so a combination with chest injuries has the greatest influence (other than damage to the locomotor system and cranial trauma) on the first and second disability categories, and on the third disability category — a combination with abdominal component. Most often, disability as a result of a road accident occurs among persons of the most productive age (18–60 years) due to the damage of the locomotor system.
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