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BACKGROUND: Falls are the leading cause of geriatric injury. OBJECTIVES: We aimed to study the anatomical distribution, severity, and outcome of geriatric fall-related injuries in order to give recommendations regarding their prevention. METHODS: All injured patients with an age ≥ 60 years who were admitted to Al-Ain Hospital or died in the Emergency Department due to falls were prospectively studied over a four year period. RESULTS: We studied 92 patients. Fifty six of them (60.9%) were females. The mean (standard deviation) of age was 72.2 (9.6) years. Seventy three (89%) of all incidents occurred at home. Eighty three patients (90.2%) fell on the same level. The median (range) ISS was 4 (1-16) and the median GCS (range) was 15 (12-15). The lower limb was the most common injured body region (63%). There were no statistical significant differences between males and females regarding age, ISS, and hospital stay (p = 0.85, p = 0.57, and p = 0.35 respectively). CONCLUSION: The majority of geriatric fall-related injuries were due to fall from the same level at home. Assessment of risk factors for falls including home hazards is essential for prevention of geriatric fall-related injuries.

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OBJECTIVE: We aimed to prospectively study the demography, severity of injury and outcome of alcohol-related road traffic collision (RTC) injuries in the United Arab Emirates. METHODS: Data of RTC Registry of Al-Ain City were prospectively collected from Al-Ain and Tawam hospitals during the period of April 2006 to October 2007. It included all RTC trauma patients who were admitted or those who died after arrival to these hospitals. Car occupants with complete data on alcohol use were included in the study. Patients were divided into two groups, those who reported using alcohol and those who did not. RESULTS: Out of the 771 car occupants, sixteen (16) used alcohol (2.1%), 15 (94%) of them were males. The median (range) age of the alcohol group was significantly higher than those without alcohol (35 (15-53) years compared with 26 (1-78) years, p = 0.02). The UAE nationals were significantly more (P = 0.01) and the revised trauma score was significantly less in the alcohol group (P = 0.03). Head/face was the most commonly injured region in the alcohol group (94%). CONCLUSION: Self reported alcohol-related car collisions in Al-Ain City had a low incidence. It affected older Emirati male nationals and was associated with lower revised trauma score, mainly due to head injury. There is a need for a national registry with data on alcohol abuse so as to assess its effects and strategies for its prevention.

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OBJECTIVES: To evaluate the quantity and quality of published vascular surgery research articles from the Gulf Cooperation Council (GCC) countries so as to identify areas for improvement. DESIGN: Descriptive study. MATERIALS: Published MEDLINE articles on vascular surgery from the GCC countries (1960-2010). METHODS: Critical analysis of the articles. RESULTS: A total of 146 articles were studied, majority of which were case series/case reports (55.5%); 33% of the articles were prospective. The first author was from a university in 67.1% of the articles. Only one randomized controlled trial was found. The median (range) impact factor of the journals was 1.16 (0.16-12.64). Kuwait had the highest number of publications/country, standardized/100,000 inhabitants. There were 11 experimental studies, which were all from Kuwait. More statistically significant, experimental vascular surgery papers were published prior to 1993 (11/30 compared with 0/111 afterward, p < 0.0001; Fisher exact test). The GCC countries had the lowest vascular surgery research output compared with Turkey, Hong Kong, Singapore, and Japan when standardized by the population. The h index of the GCC countries' vascular research publications was the lowest (19) compared with the other four countries (29-97). Furthermore, the average citation of the GCC countries (5.81) was similar to Turkey (5.66), but less than Hong Kong (17.38), Singapore (12.79), and Japan (11.75). CONCLUSION: The quality and quantity of vascular surgery research in the GCC countries should be improved to answer important local questions related to vascular diseases. This needs better strategic planning and more collaboration between various institutions.

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We aimed to study the anatomical distribution, severity and outcome of hospitalised interpersonal violence-related injured patients in Al-Ain, United Arab Emirates so as to give recommendations regarding the magnitude of this problem, its causes and priorities of prevention. Data were retrieved from Al-Ain Hospital Trauma Registry, which was prospectively collected over three years. There were 75 patients (males = 85.3%) having a mean age of 30 years. Eighty-one percent had blunt trauma. The estimated annual injury hospitalisation of interpersonal violence in Al-Ain city was 6.7 per 100,000 population. Females were significantly more injured by a family member (p = 0.02), at home (p = 0.005), and had more severe injuries (p = 0.003). There was a trend for children less than 18 years old to have more penetrating trauma (p = 0.06) and to be injured by a family member (p = 0.09). There was only one case of woman sexual assault and two cases of child abuse. The mean (SD) hospital stay was 7.87 (14.1) days. Less than 3% (n = 2) were admitted to the intensive care unit with no deaths. In conclusion, the majority of patients in our study had minor injuries. Nevertheless, the psychological impact may be major. This highlights the need to develop suitable mental health services in support of victims of interpersonal violence.

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AIM: To study the biomechanism, pattern of injury, management, and outcome of major vascular injuries treated at Mubarak Al-Kabeer Teaching Hospital, Kuwait during the Second Gulf War. METHODS: This is a descriptive retrospective study. War-related injured patients who had major vascular injuries and were treated at Mubarak Al-Kabeer Teaching Hospital from August 1990 to September 1991 were studied. Studied variables included age, gender, anatomical site of vascular injury, mechanism of injury, associated injuries, type of vascular repair, and clinical outcome. RESULTS: 36 patients having a mean (SD) age of 29.8 (10.2) years were studied. 32 (89%) were males and 21 (58%) were civilians. Majority of injuries were caused by bullets (47.2%) and blast injuries (47.2%). Eight patients (22%) presented with shock.There were 31 arterial injuries, common and superficial femoral artery injuries were most common (10/31). Arterial repair included interposition saphenous vein graft in seven patients, thrombectomy with end-to-end / lateral repair in twelve patients, vein patch in two patients, and arterial ligation in four patients. Six patients had arterial ligation as part of primary amputation. 3/21 (14.3%) patients had secondary amputation after attempted arterial vascular repair of an extremity. There were a total of 17 venous injuries, 13 managed by lateral suture repair and 4 by ligation. The median (range) hospital stay was 8 (1-76) days. 5 patients died (14%). CONCLUSIONS: Major vascular injuries occurred in 10% of hospitalized war-related injured patients. Our secondary amputation rate of extremities was 14%. The presence of a vascular surgeon within a military surgical team is highly recommended. Basic principles and techniques of vascular repair remain an essential part of training general surgeons because it may be needed in unexpected wars.

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BACKGROUND: The high risk of injury and death of motorcycle riders is a major global health problem. This study aimed to evaluate the effect of helmet wearing on motorcycle riders' death rates on a global level. METHODS: Data for motorcycle riders were collected from 70 countries. These data included motorcycle-related death rates per 100,000 population, helmet non-usage percentage, Gross National Income per capita (GNI), number of registered motorized 2-3 wheelers, the effectiveness of law enforcement in each country, and whether there was standards for helmets use or not. Correlations between studied variables were done using Pearson correlation. Multiple linear regression models were used to define factors affecting motorcycle-related death rates. RESULTS: The correlation between motorcycle-related death rate and helmet non-usage, was almost significant (p=0.056, r=0.28). Helmet non-usage percentage was significantly correlated with GNI (p<0.0001, r=-0.61) and effectiveness of the law (p<0.0001, r=-0.73). A multiple linear regression model which was highly significant (adjusted R-squared=0.3, F=6.69, p<0.001) has shown that helmet non-usage percentage (p=0.003), motorcycle per person ratio (p=0.01) and the presence of helmet standards (p=0.05) were positively associated with motorcycle-related death rates. A simple linear regression model between helmet usage and road traffic death rate has shown that for each 10% increase in helmet usage, one life per 1,000,000 inhabitants can be saved per year. CONCLUSION: Helmet non-usage percentage was the most significant factor affecting motorcyclists' death rate. Wearing a motorcycle helmet reduces the risk of death from a motorcycle crash. Enforcement of motorcycle helmet laws should be effectively supported by motorcycle safety programs.

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BACKGROUND: We aimed to study the distribution and causes of trauma in women of child-bearing age. METHODS: Data were collected from Al-Ain Hospital (United Arab Emirates-UAE) Trauma Registry. Females aged 16 to 45 years (child-bearing age) who were admitted with trauma between March 2003 and March 2006 were included in the study. RESULTS: Females represented 9% (n=171) of all trauma patients (n=1809) of the same age group, of which 29% were UAE nationals. The mean age for females was 30.5 years. Road traffic collision (RTC) was the main mechanism of injury (n=78, 46%). Burns were significantly higher in females than males (p=0.001). Cervical fractures were significantly higher in females (p=0.04), while lumbar fractures were significantly higher in males (p=0.03). In females, pelvic fractures were diagnosed in 6.4%, spinal fractures in 7%, and both injuries in 1.2%. Three females died (1.7%), and all were due to RTC. CONCLUSION: The majority of females involved in trauma were aged 20- 34 years. RTC is the main mechanism of injury and fatality. Female trauma is associated with a high incidence of pelvic fractures. A higher rate of cervical injuries was observed in females in contrast to lumbar injuries in males.

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BACKGROUND/OBJECTIVE: To review published pediatric trauma research from the Gulf Cooperation Council (GCC) countries so as to identify research fields that need to be enhanced. METHODS: A MEDLINE search for articles on pediatric trauma from GCC countries during the period 1960 to 2010 was performed. The content of articles was analyzed, classified and summarized. RESULTS: Fifty-three articles were found and retrieved of which 18 (34%) were published in the last 5 years, 42 (79.2%) were original articles. The first author was affiliated to a university in 29 reports (54.7%), to a community hospital in 13 (24.5%) and to a military hospital in 10 (18.9%). All articles were observational studies that included 18 (34%) case-control studies, 18 (34%) case reports/case series studies, 8 (15.1%) prospective studies, and 7 (13.2%) cross sectional studies. The median (range) impact factor of the journals was 1.3 (0.5-3.72). No meta-analysis studies were found. CONCLUSION: A strategic plan is required to support pediatric trauma research in GCC countries so as to address unmet needs. Areas of deficiency include pre-hospital care, post-traumatic psychological effects and post-traumatic rehabilitation, interventional studies focused on a safe child environment and attitude changes, and the socioeconomic impact of pediatric trauma.

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BACKGROUND: Injury and death from road traffic collisions (RTCs) is a major health problem worldwide. The seat belt is the most important RTC safety innovation to reduce injury severity and death from RTCs. We aimed to study the effects of seat belt usage on injury patterns and outcomes of restrained vehicle occupants compared with unrestrained occupants after RTCs. METHODS: RTC trauma patients who were vehicle occupants and admitted to Al-Ain and Tawam Hospitals, or who died after arrival at the emergency departments were prospectively studied during the period of April 2006 to October 2007. Demography of patients, position in the vehicle, usage of seat belts, injury severity markers, Glasgow Coma Scale (GCS), hospital stay, need for surgery, injured body regions, and mortality were analyzed. RESULTS: Of 783 vehicle occupants, 766 (98%) patients with known seat belt status were studied. Among them, the 631 (82.4%) who were unrestrained were significantly younger than the restrained patients (P < 0.0001). The Abbreviated Injury Scale (AIS) scores for the thorax, back, and lower extremity were significantly higher in unrestrained than in restrained patients (P = 0.001, P = 0.036, and P = 0.045 respectively). The GCS was significantly lower in unrestrained than in restrained patients (P = 0.006). More surgical operations were performed in the unrestrained patients (P = 0.027). CONCLUSIONS: Seat belt usage reduces the severity of injury, hospital stay, and number of operations in injured patients. Seat belt compliance is low in our community. More legal enforcement of seat belt usage is mandatory to reduce the severity of injury caused by RTCs.

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BACKGROUND AND OBJECTIVES: Mortality from road traffic collisions (RTC) is a major problem in the Gulf Cooperation Council (GCC) countries. Low compliance with seatbelt usage can be a contributing factor for increased mortality. The present study aimed to ascertain the presence of a relationship between seatbelt non-compliance of vehicle occupants and mortality rates in the GCC countries versus other high-income countries. DESIGN AND SETTING: Observational and descriptive study using information published by the World Health Organization. METHODS: Data for all GCC countries (n=6) and other high-income countries (n=37) were retrieved and compared with regard to population, gross national income, number of vehicles, seatbelt non-compliance and road traffic death rates. Univariate and multivariate analysis were used to define factors affecting the mortality rates. RESULTS: The median road traffic death rates, occupant death rates, and the percentage of seatbelt non-compliance were significantly higher in the GCC countries (P<.0001, P=.02, P<.001, respectively). There was a strong correlation between occupant death rates and seatbelt non-compliance (R=.52, P=.008). Seatbelt non-compliance percentage was the only significant factor predicting mortality in the multiple linear regression model (P=.015). CONCLUSIONS: Seatbelt non-compliance percentages in the GCC countries are significantly higher than in other high-income countries. This is a contributing factor in the increased road traffic collision mortality rate in these countries. Enforcement of seatbelt usage by law should be mandatory so as to reduce the toll of death of RTC in the GCC countries.

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Modification of seatbelts and their legislation played an important role in reducing morbidity and mortality of occupants in road traffic collisions. We aimed to review seatbelt development, its mechanism of action and its effects. Seatbelts reduce injury by preventing the occupant from hitting the interior parts of the vehicle or being ejected from the car. We have made a linear regression correlation between the overall seatbelt compliance and road traffic death rates in 46 high income countries to study the relationship between seatbelt use and mortality. There was a very highly significant negative correlation between the seatbelt compliance and road traffic death rates (R = - 0.77, F = 65.5, p < 0.00001). Seatbelt-related injuries include spinal, abdominal or pelvic injuries. The presence of a seatbelt sign must raise the suspicion of an intra-abdominal injury. These injuries can be reduced if seatbelts were applied correctly. Although seatbelts were recognized as an important safety measure, it still remains underused in many countries. Enforcement of seatbelt usage by law is mandatory so as to reduce the toll of death of road traffic collisions.