Contribution à une meilleure compréhension du devenir des blessés de la route: évaluation à un an dans la cohorte ESPARR

Background: it is possible that victims can suffer from multiple problems after an accident, and this can be seen in the people with the most serious consequences. However, few studies allow us to know the profile and prognostic factors of severity of consequences after the accident in this population of victims. Moreover, there are few tools to predict 1-year post-traumatic sequelae in road crash victims. The thesis aims to determine subgroups of victims with similar outcomes 1 year after the crash and predictive factors for attribution to these subgroups and validate sequelae prediction by the Injury Impairment Score (IIS), in comparison with the one year outcomes. Methods: the thesis is a part of the broader ESPARR study based on the Rhône Registry of Road Traffic Casualties. The ESPARR cohort comprised 1,372 subjects, including 1,168 aged =16 years. Among 886 adult subjects who responded to a follow-up questionnaire one year later, the main analysis was carried out on 616 participants, who completed a self-report questionnaire on health, social, emotional and financial status 1 year after a crash. The multiple correspondence analysis and hierarchical clustering method was implemented to produce homogeneous road-crash victim subgroups according to differences in outcome. Baseline (time of accident) predictive factors for subgroup attribution were analysed on weighted multinomial logistic regression models. We used outcomes data at 1-year follow-up of road injury to validate the ability of IIS to predict sequelae. Results: there were 5 different victim subgroups in terms of consequences 1 year after the crash: the first presented few problems, the second had essentially physical sequelae, the next 2 subgroups presented many problems at various levels but with a lower proportion of psychological problems (the difference being due to financial repercussions), and the fifth showed a high proportion of psychological, physical, social and environment problems. As well as the known prognostic factors of age, initial injury severity and lesion type, socioeconomic fragility and the fact of a relative being involved in the accident emerged as being predictive of poor outcome one year later. IIS, in this injured population, failed to predict sequelae one year later as measured by real data. Conclusion: one year after a road accident, victims may still experience multiple problems in terms not only of physical health but also of mental health, social life and environment. Poor outcome may be predicted both from accident-related factors and from victims' socioeconomic fragility. These findings are useful in guiding prevention in terms not only of recovery of health status but also of recovery of social life in the best possible environment.

• Authors:
  • NHAC-VU, Hoang-Thy
• Publication Date: 2012

Language

• French

Media Info

• Media Type: Digital/other
• Pagination: 183 p

Subject/Index Terms

• TRT Terms: Postcrash phase
• ITRD Terms: 1613: Post accident
• Subject Areas: Safety and Human Factors;

Filing Info

• Accession Number: 01497678
• Record Type: Publication
• Source Agency: Institut Francais des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR)
• Files: ITRD
• Created Date: Nov 7 2013 11:49AM