OBJETIVO: Caracterizar as diferenças das vítimas com diagnóstico de traumatismo crânio-encefálico envolvidas em diferentes condições, em acidentes de trânsito de veículo a motor e evidenciar indicadores para prevenção e seu atendimento. MÉTODO: Foram analisados os prontuários de todas as vítimas com diagnóstico de trauma crânio-encefálico, assistidas em hospital de referência para atendimento do trauma, entre março e junho de 1993. A população foi de 156 vítimas, sendo 80 pedestres, 50 ocupantes de veículos a motor, exceto de moto e, 26 motociclistas ou passageiros de motos. RESULTADOS E CONCLUSÕES: Os resultados mostraram que a mortalidade entre pedestres foi a mais alta entre os três grupos (25,0%). Os óbitos ocorrem em 19,2% dos ocupantes de motocicleta e 8,0% dos ocupantes de demais veículos a motor. Foram observadas diferenças estatísticas entre os grupos quando a variável gravidade do trauma crânio-encefálico foi analisado. Análise de certas variáveis mostraram importantes diferenças na distribuição dos três grupos.

OBJECTIVE: The purpose of this study was to discover the differences among victims who had traumatic brain injury due to traffic accidents. METHOD: Medical records of the head injury patients were analyzed according to their classification as traffic accident victims (pedestrian, motorcyclist or passenger and other motor vehicle driver or passenger), age, gender, admission type (admitted from scene of the injury or from another hospital), duration of hospitalization, type of head injury, types of lesions present in other body segments and mortality. Patient’s injury severity was measured by Injury Severity Score and head injury severity was analyzed using the ranking on the Glasgow Coma Scale, recorded by neurosurgeons during their first neuro assessment. All head injured patients admitted to a trauma center in S. Paulo city over a four-month period from March through June 1993, were included in the study. The sample was of 156 victims, with subsets of 80 pedestrians, 26 occupants of motorcycles and 50 occupants of other motor vehicles. RESULTS AND CONCLUSIONS: The results of this study showed that the mortality rate was higher in the pedestrian subset (25,0%) than among other victims and higher for motorcycle occupants (19,2%) than for motor vehicle victims (8,0%). Statistical differences between the subsets were established when the head injury severity variable was analyzed using the Glasgow Coma Scale. On the other hand, the differences between the three subsets was not statistically significant when the measurement used was the Injury Severity Score. Analyses of other variables showed important differences among subset distributions.

OBJETIVO: Caracterizar as diferenças das vítimas com diagnóstico de traumatismo crânio-encefálico envolvidas em diferentes condições, em acidentes de trânsito de veículo a motor e evidenciar indicadores para prevenção e seu atendimento. MÉTODO: Foram analisados os prontuários de todas as vítimas com diagnóstico de trauma crânio-encefálico, assistidas em hospital de referência para atendimento do trauma, entre março e junho de 1993. A população foi de 156 vítimas, sendo 80 pedestres, 50 ocupantes de veículos a motor, exceto de moto e, 26 motociclistas ou passageiros de motos. RESULTADOS E CONCLUSÕES: Os resultados mostraram que a mortalidade entre pedestres foi a mais alta entre os três grupos (25,0%). Os óbitos ocorrem em 19,2% dos ocupantes de motocicleta e 8,0% dos ocupantes de demais veículos a motor. Foram observadas diferenças estatísticas entre os grupos quando a variável gravidade do trauma crânio-encefálico foi analisado. Análise de certas variáveis mostraram importantes diferenças na distribuição dos três grupos.

OBJECTIVE: The purpose of this study was to discover the differences among victims who had traumatic brain injury due to traffic accidents. METHOD: Medical records of the head injury patients were analyzed according to their classification as traffic accident victims (pedestrian, motorcyclist or passenger and other motor vehicle driver or passenger), age, gender, admission type (admitted from scene of the injury or from another hospital), duration of hospitalization, type of head injury, types of lesions present in other body segments and mortality. Patient’s injury severity was measured by Injury Severity Score and head injury severity was analyzed using the ranking on the Glasgow Coma Scale, recorded by neurosurgeons during their first neuro assessment. All head injured patients admitted to a trauma center in S. Paulo city over a four-month period from March through June 1993, were included in the study. The sample was of 156 victims, with subsets of 80 pedestrians, 26 occupants of motorcycles and 50 occupants of other motor vehicles. RESULTS AND CONCLUSIONS: The results of this study showed that the mortality rate was higher in the pedestrian subset (25,0%) than among other victims and higher for motorcycle occupants (19,2%) than for motor vehicle victims (8,0%). Statistical differences between the subsets were established when the head injury severity variable was analyzed using the Glasgow Coma Scale. On the other hand, the differences between the three subsets was not statistically significant when the measurement used was the Injury Severity Score. Analyses of other variables showed important differences among subset distributions.

Trata-se de estudo prospectivo que teve por objetivo caracterizar a gravidade do trauma de pacientes hospitalizados, através do "Injury Severity Score" (ISS). Foram analisados 100 pacientes de trauma internados em uma instituição referência para trauma localizada em São Paulo, Brasil. Do total de pacientes, 68 sofreram trauma fechado e 32 trauma penetrante. Dentre os pacientes de trauma fechado, 53,0% sofreram trauma leve (ISS 1-15), 29,4% trauma moderado (ISS 16-24) e 17,6% trauma grave (ISS > 25) enquanto que 34,4% dos pacientes de trauma penetrante sofreram trauma leve, 18,7% trauma moderado e 46,9% trauma grave. A média e desvio-padrão dos ISSs dos pacientes de trauma fechado e penetrante foi, respectivamente, de 14,9 ± 8,1 e 20,8 ± 11,0, correspondendo a um percentual de mortos de 11,8% e 12,5%.

The severity of traumas in hospitalized patients was characterized by means of the Injury Severity Score (ISS) was studied prospectively. One hundred trauma patients hospitalized in a trauma referral health facility located in S. Paulo, Brazil, were analyzed. Of the total number of patients, 68 had blunt trauma and 32 penetrating trauma. As to ISS, it was discovered that 53.0% of the blunt trauma patients had mild trauma (ISS 1-15), 29,4% moderate trauma (ISS 16-24), and 17.6% showed severe trauma (ISS 25); 34.4% of the penetrating trauma patients had mild trauma, 18.7% moderate trauma and 46.9% severe trauma. The mean and standard deviations relationg to the ISS of blut and penetrating trauma patients were, respectively, 14.9 ± 8.1 and 20.8 ± 11.0; the respective mortality rates were of 11.8% and 12.5%

Trata-se de estudo prospectivo que teve por objetivo caracterizar a gravidade do trauma de pacientes hospitalizados, através do "Injury Severity Score" (ISS). Foram analisados 100 pacientes de trauma internados em uma instituição referência para trauma localizada em São Paulo, Brasil. Do total de pacientes, 68 sofreram trauma fechado e 32 trauma penetrante. Dentre os pacientes de trauma fechado, 53,0% sofreram trauma leve (ISS 1-15), 29,4% trauma moderado (ISS 16-24) e 17,6% trauma grave (ISS > 25) enquanto que 34,4% dos pacientes de trauma penetrante sofreram trauma leve, 18,7% trauma moderado e 46,9% trauma grave. A média e desvio-padrão dos ISSs dos pacientes de trauma fechado e penetrante foi, respectivamente, de 14,9 ± 8,1 e 20,8 ± 11,0, correspondendo a um percentual de mortos de 11,8% e 12,5%.

The severity of traumas in hospitalized patients was characterized by means of the Injury Severity Score (ISS) was studied prospectively. One hundred trauma patients hospitalized in a trauma referral health facility located in S. Paulo, Brazil, were analyzed. Of the total number of patients, 68 had blunt trauma and 32 penetrating trauma. As to ISS, it was discovered that 53.0% of the blunt trauma patients had mild trauma (ISS 1-15), 29,4% moderate trauma (ISS 16-24), and 17.6% showed severe trauma (ISS 25); 34.4% of the penetrating trauma patients had mild trauma, 18.7% moderate trauma and 46.9% severe trauma. The mean and standard deviations relationg to the ISS of blut and penetrating trauma patients were, respectively, 14.9 ± 8.1 and 20.8 ± 11.0; the respective mortality rates were of 11.8% and 12.5%

Apresenta-se uma análise do padrão das injúrias nas vítimas de acidentes de motocicleta internadas num hospital governamental de ensino, do Município de São Paulo, o qual conta com um serviço de emergência de referência. Ficou confirmado que nas vítimas internadas predominam os jovens, do sexo masculino e que a grande maioria recebe alta do hospital. Quanto às injúrias, verificou-se predomínio das classificadas no grau de intensidade leve (ISS de 1 a 9) e as lesões mais freqüentes foram as fraturas de membros e pelve, os ferimentos de superfície externa, os traumatismos crânio-encefálicos e as luxações de membros e pelve. Nas que faleceram, além das fraturas de membros e pelve, as lesões de órgãos abdominais e traumatismos crânio-encefálicos preponderaram e a ISS foi superior a 20. Nos pacientes com trauma de crânio, constatou-se relação direta entre escores altos da Escala de Coma de Glasgow e baixos da ISS e vice-versa.

An analysis of the injury patterns presented by inpatients of a government teaching hospital, known as one of the emergency centers of S. Paulo city, Brazil, is given the majority of victims are young, male adults and most of them were later discharged from the hospital. In relation to the injuries the majority of the patients were classified as being of minor injury grade (ISS between 1 and 9) and the most frequent injuries were extremity and pelvic fractures, surface trauma, traumatic brain injury and extremity and pelvic dislocations. Besides extremity and pelvic fractures, the victims who died showed abdominal organ injury and traumatic brain injury and the ISS was over 20. Head injury patients who had a high Glasgow Coma Scale score had a low ISS and vice-versa.

Apresenta-se uma análise do padrão das injúrias nas vítimas de acidentes de motocicleta internadas num hospital governamental de ensino, do Município de São Paulo, o qual conta com um serviço de emergência de referência. Ficou confirmado que nas vítimas internadas predominam os jovens, do sexo masculino e que a grande maioria recebe alta do hospital. Quanto às injúrias, verificou-se predomínio das classificadas no grau de intensidade leve (ISS de 1 a 9) e as lesões mais freqüentes foram as fraturas de membros e pelve, os ferimentos de superfície externa, os traumatismos crânio-encefálicos e as luxações de membros e pelve. Nas que faleceram, além das fraturas de membros e pelve, as lesões de órgãos abdominais e traumatismos crânio-encefálicos preponderaram e a ISS foi superior a 20. Nos pacientes com trauma de crânio, constatou-se relação direta entre escores altos da Escala de Coma de Glasgow e baixos da ISS e vice-versa.

An analysis of the injury patterns presented by inpatients of a government teaching hospital, known as one of the emergency centers of S. Paulo city, Brazil, is given the majority of victims are young, male adults and most of them were later discharged from the hospital. In relation to the injuries the majority of the patients were classified as being of minor injury grade (ISS between 1 and 9) and the most frequent injuries were extremity and pelvic fractures, surface trauma, traumatic brain injury and extremity and pelvic dislocations. Besides extremity and pelvic fractures, the victims who died showed abdominal organ injury and traumatic brain injury and the ISS was over 20. Head injury patients who had a high Glasgow Coma Scale score had a low ISS and vice-versa.

Estudo descritivo, feito por meio de dados oficiais, dos acidentes de motocicleta com vítimas (3.390), incluindo atropelamentos, ocorridos no Município de São Paulo, Brasil, em 1982, e que tiveram como conseqüência 4.480 vítimas, das quais, 166 faleceram dentro do período de até 180 dias após o evento. O coeficiente de mortalidade foi de aproximadamente 2/100.000 habitantes e a relação coeficiente masculino/feminino foi de 6:1. Na natureza das lesões verificou-se que os diagnósticos mais freqüentes foram as fraturas de crânio (27,96%), os traumatismos internos de tórax e de abdome (14,52%), e as fraturas dos membros inferiores (14,25%). Os óbitos no momento do acidente e nas primeiras 24 h perfizeram 62,35% do total. A morte ocorreu mais precocemente entre os motociclistas e passageiros do que entre os pedestres.

This is a descriptive study of official data on motorcycle accidents with victim (3,390) which occurred, during 1982, in S. Paulo city. There were 4,480 casualties and 166 of them died within 180 days of the event. The death rate was close to 2/100,000 inhabitants and the male/female ratio was 6:1. In relation to the kind of injury, the findings demonstrated the most frequent diagnoses were skull fracture, thoracic and abdominal injuries and leg fractures. Death on the scene of the accident or within twenty-four hours of the accident accounted for 62.35% of deaths. Motorcyclist and passenger deaths occurred more rapidly than those of the pedestrians.

Estudo descritivo, feito por meio de dados oficiais, dos acidentes de motocicleta com vítimas (3.390), incluindo atropelamentos, ocorridos no Município de São Paulo, Brasil, em 1982, e que tiveram como conseqüência 4.480 vítimas, das quais, 166 faleceram dentro do período de até 180 dias após o evento. O coeficiente de mortalidade foi de aproximadamente 2/100.000 habitantes e a relação coeficiente masculino/feminino foi de 6:1. Na natureza das lesões verificou-se que os diagnósticos mais freqüentes foram as fraturas de crânio (27,96%), os traumatismos internos de tórax e de abdome (14,52%), e as fraturas dos membros inferiores (14,25%). Os óbitos no momento do acidente e nas primeiras 24 h perfizeram 62,35% do total. A morte ocorreu mais precocemente entre os motociclistas e passageiros do que entre os pedestres.

This is a descriptive study of official data on motorcycle accidents with victim (3,390) which occurred, during 1982, in S. Paulo city. There were 4,480 casualties and 166 of them died within 180 days of the event. The death rate was close to 2/100,000 inhabitants and the male/female ratio was 6:1. In relation to the kind of injury, the findings demonstrated the most frequent diagnoses were skull fracture, thoracic and abdominal injuries and leg fractures. Death on the scene of the accident or within twenty-four hours of the accident accounted for 62.35% of deaths. Motorcyclist and passenger deaths occurred more rapidly than those of the pedestrians.

Estudo descritivo, feito por meio de dados oficiais, dos acidentes de motocicleta com vítimas (3.390), incluindo atropelamentos, ocorridos no município de São Paulo, SP (Brasil), em 1982, e que tiveram como conseqüência 4.480 vítimas. Destas, 166 faleceram dentro do período de até 180 dias após o evento. Esses acidentes foram mais freqüentes e mais graves do que aqueles relativos aos demais veículos a motor. Suas vítimas se caracterizaram como predominantemente do sexo masculino, das faixas etárias de 15 a 24 anos, e cerca de dois terços da população estudada foi de motociclistas. Em relação ao momento do acidente, constatou-se um pico nos fins de semana e uma distribuição não havendo diferenças significantes em relação aos meses e períodos do dia.

This is a descriptive study of official data on those motorcycle accidents with casualties riders and/or pedestrians (3,390) which occurred during 1,982 in S. Paulo city, Brazil. There were 4,480 casualties and 166 of these died within 180 days of the event. These accidents were more frequent and serious than those involving any other kind of motor vehicle. The casualties were, in their majority, males aged between 15 and 24, and two-thirds of this population were motorcyclists. The results of a study of the accidents themselves demonstrated that the peak occurred at weekends and there was no significant variations with regard to months or times of day.

Estudo descritivo, feito por meio de dados oficiais, dos acidentes de motocicleta com vítimas (3.390), incluindo atropelamentos, ocorridos no município de São Paulo, SP (Brasil), em 1982, e que tiveram como conseqüência 4.480 vítimas. Destas, 166 faleceram dentro do período de até 180 dias após o evento. Esses acidentes foram mais freqüentes e mais graves do que aqueles relativos aos demais veículos a motor. Suas vítimas se caracterizaram como predominantemente do sexo masculino, das faixas etárias de 15 a 24 anos, e cerca de dois terços da população estudada foi de motociclistas. Em relação ao momento do acidente, constatou-se um pico nos fins de semana e uma distribuição não havendo diferenças significantes em relação aos meses e períodos do dia.

This is a descriptive study of official data on those motorcycle accidents with casualties riders and/or pedestrians (3,390) which occurred during 1,982 in S. Paulo city, Brazil. There were 4,480 casualties and 166 of these died within 180 days of the event. These accidents were more frequent and serious than those involving any other kind of motor vehicle. The casualties were, in their majority, males aged between 15 and 24, and two-thirds of this population were motorcyclists. The results of a study of the accidents themselves demonstrated that the peak occurred at weekends and there was no significant variations with regard to months or times of day.