title: 10-year evaluation of train accidents.
abstract: BACKGROUND
  Although less frequent than automobile accidents, train accidents have a major impact on victims' lives.
  
  
  METHODS
  Records of patients older than 16 years of age admitted to the Adult Emergency Department of Hacettepe University Medical Center due to train accidents were retrospectively evaluated.
  
  
  RESULTS
  44 patients (30 males, 14 females) with a mean age of 31.8±11.4 years were included in the study. The majority of the accidents occurred during commuting hours. 37 patients were discharged, 22 of them from the emergency department. The mortality rate was 7/44 (16%). Overall mean Revised Trauma Score (RTS) was 10.5 (3 in deaths and 11.9 in survivors). In 5 patients, the cause of death was pelvic trauma leading to major vascular injury and lower limb amputation. In 1 patient, thorax and abdomen trauma and in 1 patient head injury were the causes of mortality. Primary risk factors for mortality were alcohol intoxication (100%), cardiopulmonary resuscitation on admittance (100%), recurrent suicide attempt (75%), presence of psychiatric illness (60%), and low RTS.
  
  
  CONCLUSIONS
  In this study, most train accidents causing minor injuries were due to falling from the train prior to acceleration. Nevertheless, train accidents led to a mortality rate of 16% and morbidity rate of 37%. These findings draw attention to the importance of developing preventive strategies.
authors.affiliation: Department of Emergency Medicine, Hacettepe University, Faculty of Medicine, Ankara, Turkey. meltemakkas@hotmail.com
authors.forename: Meltem
authors.initials: M
authors.lastname: Akkaş
authors.forename: Didem
authors.initials: D
authors.lastname: Ay
authors.forename: Nalan
authors.initials: N
authors.lastname: Metin Aksu
authors.forename: Müge
authors.initials: M
authors.lastname: Günalp
mesh_terms: D000059:Accidents / Q000401:mortality / Q000706:statistics & numerical data*; D000328:Adult; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009104:Multiple Trauma / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000473:pathology; D011890:Railroads; D012189:Retrospective Studies; D014421:Turkey / Q000453:epidemiology