title: An annual analysis of clinical diagnosis versus autopsy findings in fatal motor vehicle accident in legal medicine organization of Kerman province, Iran.
abstract: BACKGROUND
  One of the most common causes of death in Iran and other developing countries, are traffic accidents. Accordingly, this study was done based on the investigation and prevention of traffic injuries.
  
  
  METHODS
  This cross sectional study includes all fatal traffic accidents in the province of Kerman during a year; moreover, spss19 software is used for analyzing data. The main references of this survey were both the clinical reports of the victims of the road accidents as well as their Autopsy findings in forensic medicine center of the Iranian province of Kerman. In this study, 1185 victims of road accidents have been under supervision. Furthermore, statistical information such as age, sex, education, career, position of the occupant (Car drivers, motorcycle drivers and pedestrians), injuries related to the accident, type of vehicle, City-location of the accident and Place of death are observed. The main causes of death victims of road accidents were categorized into six groups. Occupational groups according EE0-1Job category were classified into 9 groups. Results are reported as descriptive as a frequency index (%), mean ± standard deviation, in addition, chi squared test was used to compare the clinical findings and autopsy And p < 0.05 was considered to indicate significance.
  
  
  RESULTS
  In total 1185 people, there are 939 men (79.2%) and 246 women (20.8%). Most deaths occurred in young adult, 26.7% (19-24 years, n = 316). Injuries recorded during the autopsy examination include abrasion (n = 267, 22.5%) and laceration (n = 201, 17%) That was different significantly (p = 0.0001). In comparing of the skin lesions and Fractures between the hospital clinical records and autopsy finding, the difference was significant (p = 0.0001). The most common brain injury in hospital was epidural hematoma (n = 152, 12.8%). There was significant difference when compared with autopsy (n = 165, 13.9%) then brain contusion was most autopsy findings (n = 144, 12.2%). Whereas 141 cases was diagnosed in the hospital (11.9%) (p = 0.0001), And the diagnosis of diffuse axonal injury in both groups was similar (n = 75).
  
  
  CONCLUSIONS
  The morbidity and mortality caused by head injury not only caused by traumatic brain injury, but it is sometimes due to cause delay in diagnosis and surgical procedures. We recommend abrasion & laceration injuries that could be suggestive of more serious injuries to more accurately assess the patient's bedside.
  
  
  CONCLUSIONS
  In spite the high rate of deaths in road accidents in the Iranian province of Kerman, Epidemiological data on road accidents in this area is still low. Although all improvement in clinical approach and medical facilities in Iran, a clinical diagnosis cannot be replaced autopsy in the diagnosis of death's causes. All in all, data registration and strong attention to findings of clinical tests such as laceration & abrasion is firmly encouraged to estimate of financial loss in the case of patients' survival.
authors.affiliation: Legal Medicine Research Center, Tehran, Iran.
authors.forename: Masood
authors.initials: M
authors.lastname: Ghadipasha
authors.affiliation: Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: soheilavaghefi@sbmu.ac.ir.
authors.forename: Soheila Sadat
authors.initials: SS
authors.lastname: Vaghefi
authors.affiliation: Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Shahrooz
authors.initials: S
authors.lastname: Kazemi Esfeh
authors.affiliation: Legal Medicine Organization of Golestan province, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Teimoori
authors.affiliation: Legal Medicine organization, Kerman, Iran.
authors.forename: Amin Reza
authors.initials: AR
authors.lastname: Ouhadi
authors.affiliation: Expert Department of Roads and Transportation, Kerman, Iran.
authors.forename: Seyed Mohammad
authors.initials: SM
authors.lastname: Mirhosseini
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D000328:Adult; D017677:Age Distribution; D001930:Brain Injuries / Q000175:diagnosis; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D003951:Diagnostic Errors; D020833:Diffuse Axonal Injury / Q000175:diagnosis; D005260:Female; D049429:Forensic Pathology; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis; D006760:Hospitalization; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D017678:Sex Distribution; D014947:Wounds and Injuries / Q000175:diagnosis*; D055815:Young Adult
keywords: Autopsy; Clinical finding; Traffic accident