title: Traumatic train injuries.
abstract: Train accidents involving motor vehicles and pedestrians can be devastating. Approximately 1,234 fatalities were recorded in the United States in 1989. The literature from the United States is sparse, prompting a 7-year review of 23 consecutive train accident victims. Twenty (87%) were male, with an average age of 30.6 years. Sixteen (70%) were intoxicated at the time of the accident, and the average Injury Severity Score was 21.4. There was a total of eight traumatic amputations occurring in the 11 (48%) patients involved as pedestrians. Two of these were railroad workers, and nine were trespassers. Fourteen (61%) accidents occurred between the hours of 2300 and 0700. Three (14%) patients died. Although alcohol use occurred in 16 (70%), there was no significance between alcohol use and amputation. Thus, non-railroad employed pedestrians, because of a lack of protection, are more prone to traumatic amputations, primarily of the lower extremities, than those involved in motor vehicle accidents.
authors.affiliation: Department of Surgery, St Louis University Medical Center, MO 63110-0250.
authors.forename: M J
authors.initials: MJ
authors.lastname: Shapiro
authors.forename: W B
authors.initials: WB
authors.lastname: Luchtefeld
authors.forename: R M
authors.initials: RM
authors.lastname: Durham
authors.forename: J E
authors.initials: JE
authors.lastname: Mazuski
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000062:Accidents, Occupational / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000673:Amputation, Traumatic / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D011890:Railroads