title: Prognostic significance of specific injury patterns in casualties of traffic-related accidents.
abstract: OBJECTIVE
  Fatal triad and ipsilateral dyad are patterns of pedestrian injuries related to significant mortality in traffic-related accidents. The aim of this research was to investigate the correlation between specific injury patterns and fatal outcome in other participants of traffic-related accidents.
  
  
  METHODS
  This was a retrospective study of traffic-related accidents in the broader area of the city of Osijek in a five-year period from 1995 to 1999. Autopsy results from the Institute of Pathology and Forensic Medicine of the Clinical Hospital Centre Osijek were analysed of individuals who died after their accident. The total severity of injuries was measured using the ISS. Logistic regression analysis was used for assessing the correlation between specific injury patterns and an early outcome from the severe injury.
  
  
  RESULTS
  There were 213 individuals included in the study: 72 pedestrians and 141 other participants (drivers, assistant drivers, passengers, cyclists and motorcyclists). A total of129 individuals died on the spot and 84 died in the hospital during the first 48h. Femoral and pelvic fracture, fatal triad and both variants of ipsilateral dyad were related to higher ISS values. Ipsilateral fracture of upper and lower extremities (ipsilateral dyad 1) was associated with a 4.59 times higher risk of an immediate fatal outcome in the total sample. In pedestrians, the risk was 5.99 higher, and in other participants, the risk was 4.11 times higher.
  
  
  CONCLUSIONS
  Specific skeletal injuries and injury patterns are a significant indicator for total injury severity and related poor prognosis for all participants of traffic-related injuries, not only for pedestrians. In this study, the ipsilateral fracture of upper and lower extremity was related to the largest total severity of injuries and the poorest prognosis.
authors.affiliation: Emergency Medical Centre of the Osječko-Baranjska County, Josipa Hutllera 2, 31000 Osijek, Croatia. Electronic address: scalosev@gmail.com.
authors.forename: Srdjan
authors.initials: S
authors.lastname: Calosevic
authors.affiliation: Chief of the Department for Traumatology and Orthopaedics, University Hospital Dubrava, Zagreb, Av. Gojka Suska 6, HR-10040 Zagreb, Croatia. Electronic address: zlovric@kbd.hr.
authors.forename: Zvonimir
authors.initials: Z
authors.lastname: Lovric
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality*; D017677:Age Distribution; D001344:Autopsy; D002423:Cause of Death; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D017678:Sex Distribution; D013997:Time Factors; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000401:mortality* / Q000473:pathology
keywords: Fatal; Injuries; Injury pattern; Pedestrian; Traffic-related