The Buffering analysis to identify common geographical factors within the vicinity of severe injury related to motor vehicle crash in Malaysia

doi:10.5847/wjem.j.1920-8642.2016.04.007

Abstract

Abstract:

BACKGROUND: The main objective was to identify common geographical buildup within the 100-meter buffer of severely injured based on injury severity score (ISS) among the motor vehicle crash (MVC) victims in Malaysia.
METHODS: This was a prospective cohort study from July 2011 until June 2013 and involved all MVC patients attending emergency departments (ED) of two tertiary centers in a district in Malaysia. A set of digital maps was obtained from the Town Planning Unit of the district Municipal Office (local district map). Vector spaces were spanned over these maps using GIS software (ARCGIS 10.1 licensed to the study center), and data from the identified severe injured cases based on ISS of 16 or more were added. Buffer analysis was performed and included all events occurring within a 100 -meter perimeter around a reference point.
RESULTS: A total of 439 cases were recruited over the ten-month data collection period. Fifty two (11%) of the cases were categorized as severe cased based on ISS scoring of 16 and more. Further buffer analysis looking at the buildup areas within the vicinity of the severely injured locations showed that most of the severe injuries occurred at locations on municipal roads (15, 29%), straight roads (16, 30%) and within villages buildup (suburban) areas (18, 35%).
CONCLUSION: This study has successfully achieved its objective in identifying common geographical factors and buildup areas within the vicinity of severely injured road traffic cases.

Key words: Motor vehicle crash, Emergency department, Injury severity score

Nik Hisamuddin Rahman, Ruslan Rainis, Syed Hatim Noor, Sharifah Mastura Syed Mohamad. The Buffering analysis to identify common geographical factors within the vicinity of severe injury related to motor vehicle crash in Malaysia[J]. World Journal of Emergency Medicine, 2016, 7(4): 278-284.

Figures/Tables 6

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References 27

1	Hyder AA, Vecino-Ortiz AI. BRICS: opportunities to improve road safety. Bull World Health Organ 2014; 92:423-428.
2	Elias W, Shiftan Y. Analyzing and modeling risk exposure of pedestrian children to involvement in car crashes. Accid Anal Prev 2014; 62:397-405.
3	Hobday M, Knight S. Motor vehicle collisions involving child pedestrians in eThekwini in 2007. J Child Health Care 2010; 14:67-81. pmid: 20056732
4	Abdul Razak J. Application of Geographical Information System (GIS) for mapping road traffic injuries using existing source of data in Karachi, Pakistan — A pilot study. J Pak Med Assoc 2011; 61:640-643. pmid: 22204236
5	Health Facts 2012 by The Ministry of Health Malaysia. Available at Facts 2012 by The Ministry of Health Malaysia. Available at http://www.moh.gov.my/images/gallery/stats/heal_fact/health_fact_2012_page_by_page.pdf in January 2015.[Accessed online on 4th March 2015]
6	Ahmad R, Rahmat R, Hisamudin N, Rahman NA, Noh AY, Mohammad N, et al. Demographic and clinical characteristics of red tag patients and their one-week mortality rate from the emergency department of the Hospital Universiti Sains Malaysia. Southeast Asian J Trop Med Public Health 2009; 40:1322-1330.
7	Umar RS. Motorcycle safety programs in Malaysia: how effective are they? Int J Inj Contr Saf Promot 2006; 13:71-79.
8	Chekijian S, Paul M, Kohl VP, Walker DM, Tomassoni AJ, Cone DC, et al. The global burden of road injury: its relevance to the emergency physician. Emerg Med Int 2014; 139219. Epub 2014 Jan 21.
9	Chalya PL, Mabula JB, Dass RM, Mbelenge N, Ngayomela IH, Chandika AB, et al. Injury characteristics and outcome of road traffic crash victims at Bugando Medical Centre in Northwestern Tanzania. J Trauma Manag Outcomes 2012; 6:1. pmid: 22321248
10	MIROS: Report on Mode of Choice for Vulnerable Motorcyclists in Malaysia. Available at http://www.miros.gov.my/1/publications.php/id_page=23&id_event=358. Accessed on 20th April 2016.
11	Summala H, Rajalin S, Radun I. Risky driving and recorded driving offences: a 24-year follow-up study. Accid Anal Prev 2014; 73:27-33.
12	Constantinou E, Panayiotou G, Konstantinou N, Loutsiou-Ladd A, Kapardis A. Risky and aggressive driving in young adults: Personality matters. Accid Anal Prev 2011; 43:1323-1331.
13	Blackman RA, Haworth NL. Comparison of moped, scooter and motorcycle crash risk and crash severity. Accid Anal Prev 2013; 57:1-9.
14	Albalate D, Fernández-Villadangos L. Motorcycle injury severity in Barcelona: the role of vehicle type and congestion. Traffic Inj Prev 2010; 11:623-631. pmid: 21128193
15	Munivenkatappa A, Devi BI, Gregor TI, Bhat DI, Kumarsamy AD, Shukla DP. Bicycle accident-related head injuries in India. J Neurosci Rural Pract 2013; 4:262-266.
16	Ramli R, Oxley J, Hillard P, Mohd Sadullah AF, McClure R. The effect of motorcycle helmet type, components and fixation status on facial injury in Klang Valley, Malaysia: a case control study. BMC Emerg Med 2014; 3:14-17.
17	Tohira H, Jacobs I, Mountain D, Gibson N, Yeo A. Systematic review of predictive performance of injury severity scoring tools. Scand J Trauma Resusc Emerg Med 2012; 20:63.
18	Boufous S, Finch C, Hayen A, Williamson A. The impact of environmental, vehicle and driver characteristics on injury severity in older drivers hospitalized as a result of a traffic crash. J Safety Res 2008; 39:65-72.
19	Zambon F, Hasselberg M. Factors affecting the severity of injuries among young motorcyclists--a Swedish nationwide cohort study. Traffic Inj Prev 2006; 7:143-149.
20	Moini M, Rezaishiraz H, Zafarghandi MR. Characteristics and outcome of injured patients treated in urban trauma centers in Iran. J Trauma 2000; 48:503-507. pmid: 10744293
21	Gururaj G, Uthkarsh PS, Rao GN, Jayaram AN, Panduranganath V. Burden, pattern and outcomes of road traffic injuries in a rural district of India. Int J Inj Contr Saf Promot 2014; 11:1-8.
22	Aarts L, van Schagen I. Driving speed and the risk of road crashes: a review. Accid Anal Prev 2006; 38:215-224. pmid: 16256932
23	Weiner EJ, Tepas JJ. Application of electronic surveillance and global information system mapping to track the epidemiology of pediatric pedestrian injury. J Trauma 2009; 66(3 Suppl):S10-16. doi: 10.1097/TA.0b013e3181937bc8 pmid: 19276720
24	Rakauskas ME, Ward NJ, Gerberich SG. Identification of differences between rural and urban safety cultures. Accid Anal Prev 2009; 41:931-937.
25	Abdul Manan MM, Várhely A. Motorcycle fatalities in Malaysia. IATSS Research 2012; 36:30-39.
26	Oxley J, Ravi MD, Yuen J, Hoareau E, Hashim HH. Identifying contributing factors to fatal and serious injury motorcycle collisions involving children in Malaysia. Ann Adv Automot Med 2013; 57:329-336.
27	Mehrtash S, Taher BM, Mohamed RK, Ramli S. The safety performance of guardrail systems: review and analysis of crash tests data. International Journal of Crashworthiness 2013; 18:530-543.

Reasons	Number excluded out of total cases, n (%)
Various degree of data lacking	27 (6.1)
All data missing (general demography, prehospital, clinical & geographical data)	17 (3.8)
Parts of data missing	10 (2.3)
Coordinate missing or location outwith border of maintenance by the Kota Bharu District Council (MPKB)	66 (15)

Injury severiry	Range (min, max)	Mean (SD)	Variance	Skewness (SE)
Systolic BP on arrival	150 (80, 230)	130.06 (18.31)	335.50	1.15	0.12
Respiratory rate on arrival	30 (6, 36)	17.84 (3.83)	14.67	1.151	0.12
Glasgow Coma Scale on arrival	15 (3, 18)	14.55 (1.75)	3.06	-4.73	0.12
Revised Trauma Score	4.91 (2.93, 7.84)	7.70 (0.57)	0.33	-5.46	0.12
Injury Severity Score	74 (1, 75)	8.79 (10.49)	110.13	3.54	0.13
Number of body systems injured	4 (0, 4)	1.19 (0.62)	0.38	1.21	0.11
Number of body parts injured	11 (0, 11)	1.65 (1.07)	1.15	2.33	0.11

Geographical variables	n	Percent
Road lay out
Straight	289	68.6
Curve	12	2.9
4-way junction	26	6.2
T-junction	84	20.0
On the bridge	8	1.9
Others	2	0.5
Presence of shoplots
No shoplots	220	52.1
Shoplots	202	47.9
Presence of school building
No schools in the vicinity	381	90.5
Schools in the vicinity	40	9.5
MVC occurred at traffic light junction
Yes	34	8.0
No	389	92.0
Distant from the nearest junction
More than 100 meters	242	57.6
Less than 100 meters	178	42.4

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