Estudio sobre la gravedad de las incapacidades en personas sobrevivientes lesionadas por accidentes de tránsito, valoradas en la clínica médico forense del departamento de medicina legal, entre 2019 y 2021
Fecha
2023
Tipo
tesis de maestría
Autores
Flores Sandí, Grettchen
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Editor
Resumen
Contexto: Las consecuencias clínicas a largo plazo en las personas lesionadas en accidentes de tránsito han sido poco estudiadas, además existen diferentes modelos, factores y normas en cada país para definir y evaluar la discapacidad resultante. En Costa Rica y en el campo médico legal, no existen estudios sobre la relación existente entre las lesiones clínicas iniciales y la gravedad final que se encuentra determinada por las incapacidades resultantes.
Propósito: Determinar la gravedad de las lesiones no fatales en la población víctima de accidentes de tránsito, tomando en cuenta las regiones corporales lesionadas, los niveles de gravedad de las lesiones iniciales y los criterios de incapacidad temporal y permanente.
Metodología: Se realizó un estudio de tipo descriptivo de corte transversal, para conocer variables cuantitativas y cualitativas del registro de los dictámenes medicolegales de personas atendidas en la Clínica Médico Forense del Departamento de Medicina Legal de Costa Rica durante el trienio 2019-2021. Se seleccionó una muestra que cumpliera con criterios de inclusión y exclusión preestablecidos, considerando un porcentaje de error de 5% y un nivel de confianza de 90%, la cual se estableció en 240 casos.
Resultados: Los casos se clasificaron según variables socioeconómicas, relacionadas con el accidente, con traumatismos e incapacidades resultantes. De acuerdo con la Escala Abreviada de Lesiones (AIS) las lesiones iniciales más frecuentes fueron de gravedad menor y la mayoría de las lesiones que tuvieron consecuencias a largo plazo fueron clasificadas como lesiones menores por AIS. Las pruebas de independencia estadística evidenciaron que las variables que se encontraron asociadas fueron: ocupación y sexo, tipo de accidente y sexo, tipo de accidente y tipo de lesión, mecanismo de trauma y tipo de lesión, tipo de accidente y rango de edad de las personas, tipo de vehículo y tipo de accidente, provincia de ocurrencia y tipo de vehículo, gravedad final y tipo de vehículo. Las pruebas de análisis de varianza mostraron que, en cuanto al porcentaje de incapacidad permanente, las variables: mecanismo de trauma y tipo de secuelas sí son significativas y en relación con los días de incapacidad temporal, las variables: tipo de vehículo, mecanismo de trauma, concausa y tipo de secuelas sí son significativas. Según el análisis realizado que origina el diagrama de correlación se evidencia que la edad y los días de incapacidad temporal tienen una correlación positiva y baja al igual que la edad y el porcentaje de incapacidad permanente, al observar la correlación entre los días de incapacidad temporal y el porcentaje de incapacidad permanente la misma es positiva y alta.
Conclusión: La gravedad final de la lesión tomando en cuenta los criterios de incapacidad temporal y permanente y la clasificación legal existente en Costa Rica que la categoriza, fue en la mayoría de los casos gravísima, seguida de leve y grave. Las lesiones gravísimas fueron más frecuentes en hombres y las lesiones leves en mujeres. Además, las lesiones gravísimas fueron más frecuentes cuando el vehículo involucrado era una motocicleta.
Context: The long-term clinical consequences in people injured in traffic accidents have not been widely investigated, and there are different models, factors and regulations in each country to define and evaluate the resulting disability. In Costa Rica and in the medical-legal field, there are no studies on the relationship between the initial clinical injuries and the final severity that is determined by the resulting impairments. Purpose: To determine the severity of non-fatal injuries in traffic accident victims, considering the injured body regions, the severity levels of initial injuries and the criteria of temporary and permanent impairment. Methodology: A cross-sectional descriptive study was conducted to determine quantitative and qualitative variables of the registration of medicolegal reports of people attended at the Forensic Medical Clinic of the Department of Legal Medicine of Costa Rica during the 2019-2021 triennium. A sample was selected with pre-established inclusion and exclusion criteria, considering an error rate of 5% and a confidence level of 90%, which was established in 240 cases. Results: The cases were classified according to socioeconomic variables, related to the accident, injuries and resulting impairments. According to the Abbreviated Injury Scale (AIS) the most frequent initial injuries were of minor severity and most injuries that had long-term consequences were classified as minor AIS injuries. The statistical independence tests showed that the variables that were associated were: occupation and sex, type of accident and sex, type of accident and type of injury, mechanism of trauma and type of injury, type of accident and age range of people, type of vehicle and type of accident, province of occurrence and type of vehicle, final severity and type of vehicle. The analysis of variance tests showed that, in terms of the percentage of permanent impairment, the variables: mechanism of trauma and type of sequelae are significant and in relation to the days of temporary impairment, the variables: type of vehicle, mechanism of trauma, cause and type of sequelae are significant. According to the correlation diagram it is evident that age and days of temporary impairment have a positive and low correlation as well as age and the percentage of permanent impairment, when observing the correlation between days of temporary impairment and the percentage of permanent impairment it is positive and high. Conclusion: The final severity of the injury according to the criteria of temporary and permanent impairment and the existing legal classification in Costa Rica that categorizes it, was in most cases very serious, followed by mild and severe. Very serious injuries were more frequent in men and mild injuries in women. In addition, very serious injuries were more frequent when the vehicle involved was a motorcycle.
Context: The long-term clinical consequences in people injured in traffic accidents have not been widely investigated, and there are different models, factors and regulations in each country to define and evaluate the resulting disability. In Costa Rica and in the medical-legal field, there are no studies on the relationship between the initial clinical injuries and the final severity that is determined by the resulting impairments. Purpose: To determine the severity of non-fatal injuries in traffic accident victims, considering the injured body regions, the severity levels of initial injuries and the criteria of temporary and permanent impairment. Methodology: A cross-sectional descriptive study was conducted to determine quantitative and qualitative variables of the registration of medicolegal reports of people attended at the Forensic Medical Clinic of the Department of Legal Medicine of Costa Rica during the 2019-2021 triennium. A sample was selected with pre-established inclusion and exclusion criteria, considering an error rate of 5% and a confidence level of 90%, which was established in 240 cases. Results: The cases were classified according to socioeconomic variables, related to the accident, injuries and resulting impairments. According to the Abbreviated Injury Scale (AIS) the most frequent initial injuries were of minor severity and most injuries that had long-term consequences were classified as minor AIS injuries. The statistical independence tests showed that the variables that were associated were: occupation and sex, type of accident and sex, type of accident and type of injury, mechanism of trauma and type of injury, type of accident and age range of people, type of vehicle and type of accident, province of occurrence and type of vehicle, final severity and type of vehicle. The analysis of variance tests showed that, in terms of the percentage of permanent impairment, the variables: mechanism of trauma and type of sequelae are significant and in relation to the days of temporary impairment, the variables: type of vehicle, mechanism of trauma, cause and type of sequelae are significant. According to the correlation diagram it is evident that age and days of temporary impairment have a positive and low correlation as well as age and the percentage of permanent impairment, when observing the correlation between days of temporary impairment and the percentage of permanent impairment it is positive and high. Conclusion: The final severity of the injury according to the criteria of temporary and permanent impairment and the existing legal classification in Costa Rica that categorizes it, was in most cases very serious, followed by mild and severe. Very serious injuries were more frequent in men and mild injuries in women. In addition, very serious injuries were more frequent when the vehicle involved was a motorcycle.
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ACCIDENTE DE TRÁFICO, LESIÓN, INCAPACIDAD