Study of pattern of injuries sustained by two-wheeler drivers in a tertiary care hospital of Bhopal city

Background: Road Traffic Accident (RTA) is one of the major causes of death and disability in India, especially among two-wheeler drivers due to over speeding, carelessness, stunts on road, ignorance of safety measures and alcohol. It accounts for considerable loss of the nation in terms of life and property. Objectives: To study the pattern of injuries among two-wheeler drivers in relation to different parameters in a Tertiary Care Hospital of Bhopal City. Material and Methods: The present study was carried out at a tertiary care hospital of Bhopal city. All the 2-wheeler drivers who were victims of Road traffic accidents & who reported to the emergency department of the study place during study period (from 1st January to 31st December 2017) were included in the study. Various parameters like age, gender of the victims, time of accident, seasonal variations, factor responsible for accident, types of injury sustained by the victims in relation to the use of helmet while driving and consumption of alcohol, duration of stay in the hospital and outcome of different injuries were considered. Results: There was a clear-cut male preponderance (85.21%) with maximum involvement of younger age groups (2130 Years). Most of the accidents have been taken place in evening hours (6 pm to 12 midnight). The type of injury sustained in majority of cases was multiple injuries followed by head injury, among them most of the victims (79.68%) were not wearing the helmet. The most common factor responsible for the accidents (34.25%) was Rash Driving. Conclusion: Due to increasing population, increasing number of vehicles and over-burdened traffic, the incidence of RTA is rising especially in two-wheeler drivers and passengers. There is loss of productive and young lives of Country. It is very common to consume alcohol, not using protective measures, reckless driving, crossing the red signal especially in younger generation due to increasing work load of education and employment. © 2020 Published by Innovative Publication. This is an open access article under the CC BY-NC license (https://creativecommons.org/licenses/by-nc/4.0/)


Introduction
According to a study conducted by the National Transportation Planning and Research Centre (NTPRC) every four minutes a person is killed or injured in road accidents in India 1 . The spectrum of injuries depends on site, direction & force of impact, design of vehicle, ejection of victim and supervening factors like overturning or fire. 1 Road Traffic accidents (RTAs) have emerged as a major global public health problem of this century and are With increasing population, increasing vehicular density and meager infrastructure amenities, the 21 st century is plagued by yet another important issue, Road Traffic Accidents (RTA) which has in fact become a slow modern pandemic and prescribing to a pattern of a secular trend of disease epidemiology. 6 A majority of victims of road traffic injuries are men in the age group of 15-44 years and belong to the poorer sections of society. 7 Also, a vast majority of those killed and injured are pedestrians, motorcyclists and pillions riders, and bicyclists. 7 The magnitude of Road traffic accidents and fatalities in India is alarming. In 2009, 4.22 lakh road traffic accidents and 1.27 lakh road traffic fatalities were reported. These numbers translate into one road accident every minute and one road accident death every four minutes. However, this is an underestimate, as not all injuries are reported to the police. 8 The main aim of the study is to study the pattern of injuries among two-wheeler drivers involved in road traffic accidents, in relation to different parameters in a Tertiary Care Hospital of Bhopal City.

Materials and Methods
It is a prospective observational study carried out at a tertiary care hospital in Bhopal, during the one year period from 1 st January 2017 to 31 st December 2017.
Study population were two-wheeler drivers who came to emergency department of the hospital for treatment after sustaining injuries due to RTA.

Inclusion criteria
All victims of different age groups from 11 to 60 years of road traffic accidents who were driving two-wheeler brought to the study place directly after accident.

Exclusion criteria
Victims of less than 11 years and more than 60 years, pillion riders of two-wheeler, pedestrians or drivers/passengers of Four/Three wheelers, patients shifted from other hospitals.

Results
The total numbers of victim were 832 during the study period, among them 709 (85.21%) were male and 123 (14.78%) were female. Most of the victims were of younger age group (21-30 years). The time of accident was evening (6 pm to 12 midnight) in the majority (43.62%) of cases. Most of the accidents (33.65%) have been taken place in rainy season (July to Sept.). In most of the cases (34.25%) the cause of accident was "Rash Driving". The injury sustained in majority of cases was multiple injuries (37.86%) followed by head injury (29.32%). In majority of cases the victims who sustained different injuries were not wearing the helmet (79.68%). The duration of stay in hospital was 1 to 2 weeks in majority (44.95%) of cases. Partial recovery has been observed in 28.12% of cases while 67.06% of victims were completely recovered of their injuries. Deaths were observed in 4.80% of victims.

Discussion
RTA is a major preventable cause of mortality and morbidity in India. The 2-wheeler drivers are 2 nd most common group affected, preceded only by pedestrians. They are more prone owing to inherent instability of the vehicle, poor roads, rash & negligent driving, non-usage of helmets & with recent frequent fuel hikes people prefer to use a 2-wheeler as much as possible.
In the present study the maximum victims were found to be male (85.21% of total 832 cases) as in case of studies by The age group most commonly affected in present study was 21 to 30 years (43.75%), possibly due to greater exposure of males of younger age group to outdoor activities and also due to ignorance of traffic rules and safety measures, similar results were found in studies by Nilambar Jha et al 5 (31.3%), Dr. E. Ravi Kiran et al 6 (25.5%) and Dileep Kumar R. et al. 9 The commonest age group affected was 13-16 years (30.5%) in the study by Harnam Singh and A.D. Aggarwal. 11 The time of accident was in evening hours (from 6 pm to 12 midnight) in maximum number (43.62%) of cases, due to high traffic load on roads in evening hours similar to studies by Dr. E. Ravi Kiran et al 6 (33.5%) and Abhishek Singh et al. 8 Maximum number of accidents (33.65%) were found in rainy season (July to September) probably due to slippery roads, as also found in study by E. Ravi Kiran et al 6 but according to study by Saumil P. Merchanr 1 and Harnam Singh & A.D. Aggarwal 11 maximum cases of RTA were found in summer (40.3%) and winter (54.2%) respectively.
Among various factors responsible for road traffic accidents, in present study most common cause (34.25%) of RTA was rash driving as in case of study by Rakesh Kakkar et al, 10 alcohol was the cause of accident in only 11.05% of cases in present study; almost similar results (13%) was found in the study by E. Ravi Kiran et al. 6 Alcohol impairs judgment, increases reaction time and diminishes visual acuity, hence increasing chances of an accident.
Multiple injuries were sustained in maximum (37.86%) number of cases. The duration of stay in hospital was 1 to 2 weeks in maximum number (44.95%) of cases. Although survival rate has been improved in the recent times due to availability of emergency treatment but still the mortality is       very high. Along with it, there is a high rate of morbidity, leading to very poor quality of life in the survivors due to the devastating consequences. Complete recovery was observed in maximum number (67.06%) of cases. 4.80% of cases proved to be fatal. Partial recovery has been observed in 28.12% of cases. Even in these cases there is loss of productive capacity of a family along with decrease in quality of life.

Conclusion
The incidence of RTA is rising, especially involving twowheelers leading to loss of productive and young lives of Country. It is very common to consume alcohol, lack of protective measures, reckless driving etc. especially in younger generation. Keeping all these factors in mind some steps should be taken to formulate policies with a view of reducing mortality & morbidity due to RTA.

Source of Funding
None.

Conflict of Interest
None.