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International Journal of Medicine and 
Pharmaceutical Science (IJMPS) 

ISSN(P): 2250-0049; ISSN(E): 2321-0095 
Vol. 6, Issue 1, Feb 2016, 125-130 
© TJPRC Pvt. Ltd. 

EPIDEMIOLOGY OF ACCIDENT CASES ATTENDING A TERTIARY 
CARE HOSPITAL IN KANPUR 

SHIBAJEE DEBBARMA 1 , SEEMA NIGAM 2 , D.S MARTOLIA 3 , PUNIT VARMA 3 , 

S.K barman 4 & tanu midha 4 

1 Junior Resident, Department of Community Medicine, G.S.V.M Medical College, Kanpur, Uttar Pradesh, India 
2 Professor & Head, Department of Community Medicine, G.S.V.M Medical College, Kanpur, Uttar Pradesh, India 
3 Professor , Department of Community Medicine, G.S.V.M Medical College, Kanpur, Uttar Pradesh, India 
4 Associate Professor, Department of Community Medicine, G.S.V.M Medical College, Kanpur, Uttar Pradesh, India 

ABSTRACT 

Background 

Injuries following accidents are responsible for approximately 9 percent of all causes of deaths in the world 
and about 16 percent of the disabilities are reported due to injuries. Injuries worldwide, are dominated by those 
incurred in road traffic accidents. 

Objectives 

To study the biosocial correlates, type of accident and type of injury sustained by accident cases. 

Material& Methods 

The study was conducted among accident cases attending LLR Hospital, Kanpur. Data was entered in a pre- 
designed and pre-tested questionnaire and analyzed using percentages. 

Results 

Most of the accident cases were males (73.26%) and from rural areas (58.84%). Majority of the cases were 
literate (94.63%) and employed (90.00%). RTA (64.11%) was the commonest type of accident. Maximum number 
(30.63%) of accidents were in 20-30 year age group. Fracture (61.93%) was the commonest type of injury sustained. 

Conclusions 

Most of the accident victims were males and were in the economically most productive age group. RTA was 
the commonest type of accident. Fracture was the commonest type of injury sustained. 

KEYWORDS: Accident; RTA; Fall; Poisoning; Fracture 



TRANS 

STELLAR 

•Journal Publications • Research Consultancy 


Received: Feb 01, 2016; Accepted: Feb 06, 2016; Published: Feb 12, 2016; Paper Id.: IJMPSFEB201615 

INTRODUCTION 

Anything that is unexpected and unplanned is an accident.* 1 ’According to the World Health Organization 
(WHO), an accident is an unpremeditated event resulting in recognizable damage. (2) Injuries following accidents 
are responsible for approximately 9 percent of all causes of deaths in the world and about 16 percent of the 
disabilities are reported due to injuries. 

Of all the systems that people have to deal with on a daily basis, road transport is the most complex and 


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Original Article 




126 Shibajee Debbarma, Seema Nigam, D. S Martolia, 

Punit Varma, S. K Barman & Tanu Midha 

the most dangerous. Injuries worldwide, are dominated by those incurred in road traffic accidents. Road traffic accident 
(RTA) is an accident that occurs on a way or street, involves at least one moving vehicle and results in injury or death of 
one or more persons/ 3 ' 

Globally, more than a million people die each year following RTA leading to considerable financial loss, 
particularly in developing economies. According to an estimate, road traffic injuries cost low and middle income countries 
between 1-2% of their gross national product. Injuries following RTA are the 8 th leading cause of death globally and the 
leading cause of death for young people aged 15-29 years. 

Globalization has brought India into the forefront of progress. Expansion of road networks, surge in motorization, 
increasing mechanization in agriculture and industry and rapid rise in population have resulted in an increase in the 
incidence of accidents. Studies conducted in different parts of the country have reported that accidents are one of the 
commonest emergencies presenting to the emergency department. <4 ' (5),<6 ' 

Kanpur is the main centre of commercial, trading, educational and industrial activities in Uttar Pradesh. A study 
conducted in 1992 showed that RTA comprises the highest mode of injury and also the highest mode of mortality in 
Kanpur. <7) Recent studies regarding accidents in Kanpur are rare. Reliable and accurate data are needed to raise awareness 
about the magnitude of this public health problem and to convince policy-makers of the need for action. Hence, the present 
study was conducted in a tertiary care hospital in Kanpur to study the biosocial correlates, type of accident and type of 
injury sustained by accident cases. 

MATERIALS & METHODS 

The hospital based cross sectional study was conducted at the Emergency Ward of Lala Lajpat Rai Hospital which 
is an associated hospital of G.S.V.M Medical College, Kanpur. Ethical clearance was obtained from the Institutional 
Ethical Committee prior to the conduction of the study. All accident cases attending the Emergency Ward during the period 
of March-September, 2015 were included in the present study. Unconscious cases with no accompanying person, cases 
where complete information could not be obtained and cases who did not give consent for the study were excluded. 

The final sample size consisted of 950 accident cases. Epidemiological information and other related data of study 
subjects was recorded in a pre -designed and pre-tested questionnaire. A general health examination of cases was done 
using standard methods and body part sustaining injury was recorded as per WHO’s injury reporting form/ 8 ' 

Statistical Analysis 

The Master table was prepared from the data collected using MS Excel software. SPSS software version 16.0 was 
used for analysis of collected data using percentages. 

RESULTS 

Most (73.26%) of the accident cases were males. Maximum cases (58.84%) were from rural areas. Majority of the 
cases were literate (94.63%) and were employed (90.00%) [Table 1], 

Most (68.32%) of the accidents took place on road followed by home (22.63%) [Table 2]. 

RTA (64.11%) was the commonest type of accident followed by fall (19.89%). The commonest type of accident 
among both males (61.21%) and females (72.05%) was RTA. The second commonest type of accident among males was 


Impact Factor (JCC): 5.4638 


NAAS Rating: 3.54 



Epidemiology of Accident Cases Attending a Tertiary Care Hospital in Kanpur 


127 


fall (26.01%) while among females it was bum as well as poisoning, 12.20% each [Table 3], 

Maximum number (30.63%) of accident cases were in 20-30 year age group. The least (1.05%) were in >80 years 
age group. Among all the victims of RTA, maximum number (29.89%) of cases belonged to 20-30 years age group. The 
least (0.66%) were in >80 years age group [Table 4]. 

Fracture was the commonest type of injury sustained in all types of accidents (61.93%) and also in RTA 
(68.50%)[Table 5]. 

DISCUSSIONS 

In the present study most (73.26%) of the accident victims were males. Similar trend was observed in Bangalore 
by Suryanarayana SP et al (16A% males), Menon Geetha R et al (76.9% males) and Pruthi N et al (70.4% males). (9) ’ <10),<11) 

In the present study, maximum number (58.84%) of cases were from rural areas. This finding is similar to the 
study conducted byKaul V et aim Hubli, Karnataka where 70% of victims were from rural areas. n:i Ruikar Min her analysis 
of national trends of road traffic accidents also reported that in 2011, 53.5% of accidents occurred in rural areas. (13) 

In the present study, majority (94.63%) of the cases were literate. Similar trend was observed in the studies 
conducted by Suryanarayana SP et a /where 88.4% of the victims were literate and Kaul V et a/where 79.28% of the 
victims were literate. <9Ml2 ’ 

In our study, majority (90.00%) of the cases were employed. Similar trend was observed in the study conducted 
byMahajan N et aim Shimla where the highest number of victims were employees (34.7%). (14) 

In our study, most (68.32%) of the accidents occurred on road. This is similar to the finding in the study 
conductedby Suryanarayana SP et al where 65.8% were injured on the road.’ 9 ’ 

In the present study, RTA was the commonest type of accident (64.11%) followed by fall (19.89%), poisoning 
(7.37%), burn (5. 58%). Gupta AK et a/had also reported that RTA was the commonest (50.15%) type of accident in Kanpur 
followed by fall from height (18.8%). (7) Similarly, RTA was the most common mode of injury in the studies conducted by 
Suryanarayana SP et al (65.8%), Menon Geetha R et al (44%) and Agarwal A et al (46.8%). <9) ’ (10) ’ (15, Ruikar M in her 
analysis of national trends of RTA reported that during 2012, road traffic accidents shared 35.2% of the accidental deaths 
in India. (I3) 

In our study, maximum number of accidents were in 20-30 year age group (30.63%). Maximum number of RTA 
victims were in 20-30 years age group (29. 89%). Similarly the most common age group involved in RTA was 21-30 years 
in the studies conducted bySingh H et al (27.3%), Patil SS et al( 31%) and Aggarwal KK et a/(31%). (16> ' (17> ' <18) 

In the present study, fracture was the commonest type of injury sustained in all types of accidents (61.93%) and 
also in RTA (68.50%). Similarly fracture was the commonest type of injury among RTA victims in the studies conducted 
by Kaul V et al (70.82%) and Bayan P et al (71.69%). (12) ’ (19) 

CONCLUSIONS 

Most of the accident victims were male and from rural areas. Majority of the cases were literate and employed. 
Most of the accidents took place on road. RTA was the commonest type of accident irrespective of gender. Maximum 
victims of accident as well as RTA were in the economically productive age group. Fracture was the commonest type of 


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128 


Shibajee Debbarma, Seema Nigam, D. S Martolia, 
Punit Varma, S. K Barman & Tanu Midha 


injury sustained by the victims. 

RECOMMENDATIONS 

The drivers and travelling public should be educated regarding traffic rules. There should be strict enforcement of 
traffic rules by the concerned authorities. Setting up of Injury Surveillance system at the national level will help in proper 
planning, implementation and evaluation of road safety activities. 

REFERENCES 

1. Hogarth J (1978): Glossary of health care terminology, WHO, Copenhagen 

2. World Health Organization (1957): Technical Report Series, No. 118 

3. Gopalakrishnan S: A Public Health Perspective of Road Traffic Accidents. J Family Med Prim Care 2012;1:144-50 

4. Saddichha S, Saxena MK, Pandey V, Methuku M. Emergency medical epidemiology in Assam, India. J Emerg Trauma Shock 
2009;2:170-4 

5. Balsari S. EMcounter-charting the epidemiology of medical emergencies in India: A status report. Int J Emerg Med 
2008;1:55-8. 

6. Ramanujam P, Aschkenasy M. Identifying the need for pre-hospital and emergency care in the developing world: A case study 
in Chennai, India. J Assoc Physicians India 2007;55:491-5 

7. Gupta AK, Nath R. Rastogi S, Shukla RK, Kumar Vinod: Epidemiological study of injured patients admitted in medical college 
hospital Kanpur. Indian J Orthop 1994;28(3 ) 

8. World Health Organization (2010): Injury surveillance: a tool for decision-making: annual injury surveillance report, Egypt, 
2009 

9. Suryanarayana SP, Gautham MS, Manjunath M, Narendranath V: Surveillance of injuries in a tertiary care hospital. Indian J 
Community Med 2010;35:191-2 

10. Menon GR, Gururaj G, Tambe MP, Shah B: A multi-sectoral approach to capture information on road traffic injuries. Indian 
J Community Med 2010;35:305-10 

11. Pruthi N, Ashok M, Kumar VS, Jhavar K, Sampath S, Devi B I: Magnitude of pedestrian head injuries & fatalities in 
Bangalore, south India: A retrospective study from an apex neurotrauma center. Indian J Med Res 2012;136:1039-43 

12. Kaul V, Bant DD, Bendigeri N D. Bhatija G: A brief medico-socio-demographic profile ofnon-fatal road traffic accident cases 
admitted to Karnataka Institute of Medical Sciences. Scho Res J 2011;1:32-6 

13. Ruikar M: National statistics of road traffic accidents in India. J Orthop Traumatol Rehabil 2013;6:1-6 

14. Mahajan N, Aggarwal M, Raina S, Verma LR, Mazta SR, Gupta B P: Pattern ofnon-fatal injuries in road traffic crashes in a 
hilly area: A study from Shimla, North India. Int J Crit Illn Inj Sci 2013;3:190-4 

15. Agrawal A, Galwankar S, Kapil V, Coronado V, Basavaraju SV, McGuire LC, Joshi R, Quazi SZ, Dwivedi S: Epidemiology 
and clinical characteristics of traumatic brain injuries in a rural setting in Maharashtra, India. 2007-2009. Int J Crit Illn Inj 
Sci 2012;2:167-71 

16. Singh Harnam, Dhattarwal SK: Pattern and distribution ofinuries in fatal road traffic accidents in Rohtak(Haryana). J Indian 
Acad Forensic Med Toxicol 2004:24(1 ):20-3 


Impact Factor ( JCC j: 5.4638 


NAAS Rating: 3.54 



Epidemiology of Accident Cases Attending a Tertiary Care Hospital in Kanpur 


129 


17. Patil SS, Kakade RV, Durgawale PM, Kakade SV: Pattern of road traffic injuries: A study from western Maharashtra. Indian 
J Community Med 2008;33:56-7 

18. Aggarwal KK, Oberoi SS: Distribution of fatal road traffic accident cases. J Punjab Acad Forensic Med Toxicol 2009;9( 1 ):9- 
11 . 

19. Bay an P. Bhawalkar J S, Jadhav S L, Banerjee A: Profile of non-fatal injuries due to road traffic accidents from a industrial 
town in India. Int J Crit llln Inj Sci 2013;3:8-1 1 

20. World Health Organization: Global status report on road safety 2013: Supporting a decade of action, 2013. Available from : 
http://www.who. int/violence injury prevention/road safety status/201 3/en/ 

APPENDICES 


Table 1: Bio-Social Correlates of Accident Cases (N=950) 


Biosocial Correlates 

Cases 

% 

Gender 

Male 

696 

73.26 

Female 

254 

26.74 

Residence 

Rural 

559 

58.84 

Urban 

391 

41.16 

Educational status 

Literate 

899 

94.63 

Illiterate 

51 

5.37 

Occupational status 

Employed 

855 

90.00 

Unemployed 

95 

10.00 


Table 2:Place of Accident (N=950) 


Place of Accident* 

Cases 

% 

Road 

649 

68.32 

Home 

215 

22.63 

Workplace 

33 

3.47 

Educational institute 

2 

0.21 

Field 

29 

3.05 

Industry 

18 

1.89 

Railway 

4 

0.42 


*As per WHO’s Injury Reporting Form 


Table 3: Type of Accident and Gender (N=950) 


Type of Accident 

Male (%) 

Female (%) 

Total (%) 

RTA 

426 (61.21) 

183 (72.05) 

609 (64.11) 

Fall 

181 (26.01) 

8 (3.15) 

189 (19.89) 

Industrial accident 

18 (2.59) 

- 

18 (1.89) 

Burn 

22 (3.16) 

31 (12.20) 

53 (5.58) 

Snake bite 

6 (0.86) 

1 (0.39) 

7 (0.73) 

Poisoning 

39 (5.60) 

31 (12.20) 

70 (7.37) 

Railway accident 

4 (0.57) 

- 

4 (0.42) 

Total 

696 (100) 

254(100) 

950 (100) 


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Shibajee Debbarma, Seema Nigam, D. S Martolia, 
Punit Varma, S. K Barman & Tanu Midha 


Table 4: Type of Accident According to Age (N=950) 


Age 

Group 

(in 

years) 

Mode of Accident 

Total (%) 

RTA (%) 

Fall (%) 

Industrial 

accident 

(%) 

Burn (%) 

Snake 
Bite (%) 

Poisoning 

(%) 

Railway 

Accident 

(%) 

<10 

9(1.48) 

3 (1.59) 

- 

1 (1.89) 

- 

- 

- 

13 (1.37) 

10-20 

78 (12.81) 

27 (14.29) 

- 

13 (24.53) 

3 (42.86) 

13 (18.57) 

- 

134(14.11) 

20-30 

182 (29.89) 

42 (22.22) 

9 (50.00) 

23 (43.40) 

1 (14.29) 

32 (45.71) 

2 (50.00) 

291 (30.63) 

30-40 

148 (24.30) 

31 (16.40) 

1 (5.56) 

12 (22.64) 

- 

15 (21.43) 

1 (25.00) 

208 (21.89) 

40-50 

94 (15.44) 

27 (14.29) 

4 (22.22) 

4 (7.55) 

1 (14.29) 

5 (7.14) 

- 

135 (14.21) 

50-60 

46 (7.55) 

20 (10.58) 

4 (22.22) 

- 

- 

4(5.71) 

1 (25.00) 

75 (7.89) 

60-70 

40 (6.57) 

19 (10.05) 

- 

- 

2 (28.57) 

1 (1.43) 

- 

62 (6.53) 

70-80 

8(1.31) 

14 (7.41) 

- 

- 

- 

- 

- 

22 (2.32) 

>80 

4(0.66) 

6(3.17) 

- 

- 

- 

- 

- 

10(1.05) 

Total 

609 (100) 

189 (100) 

18 (100) 

53 (100) 

7 (100) 

70 (100) 

4 (100) 

950 (100) 


Table 5: Distribution of Cases According to Type of Injury Sustained (N=950) 


Type of 
Injury* 

RTA 

(%) 

Fall (%) 

Industrial 

Accident 

(%) 

Burn 

(%) 

Snake 
Bite (%) 

Poisoning 

(%) 

Railway 

Accident 

(%) 

Total (%) 

Superficial 

Injury 

5 

(0.69) 

2(1.03) 

- 

53 

(98.15) 

1 (35.00) 

- 

2 (28.57) 

69 (6.28) 

Open 

wound 

95 

(13.07) 

15 (7.73) 

6 (23.08) 

- 

- 

- 

- 

116(10.56) 

Fracture 

498 

(68.50) 

167 (86.08) 

13 (50.00) 

- 

- 

- 

2 (28.57) 

680 (61.93) 

Joint 

Dislocation 

73 

(10.04) 

2(1.03) 

2 (7.69) 

- 

- 

- 

- 

77 (7.01) 

Nerve 

Injury 

- 

1 (0.52) 

- 

- 

- 

- 

- 

1 (0.09) 

Muscle 

Injury 

25 

(3.44) 

4 (2.06) 

4(15.38) 

- 

- 

- 

- 

33 (3.01) 

Organ 

Injury 

1 

(0.14) 

1 (0.52) 

- 

- 

- 

- 

- 

2(0.18) 

Amputation 

- 

- 

1 (3.85) 

1 

(1.85) 

- 

- 

3 (42.86) 

5 (0.46) 

Others** 

30 

(4.13) 

2(1.03) 

- 

- 

13 (65.00) 

70(100) 

- 

115 (10.47) 

Total*** 

727 

( 100 ) 

194 ( 100 ) 

26 ( 100 ) 

54 

( 100 ) 

20 ( 100 ) 

70 ( 100 ) 

7 ( 100 ) 

1098 ( 100 ) 


*as per WHO’s Injury Reporting Form 

**Others include cases presenting with eye injury, respiratory distress, gastro-intestinal symptoms, urinary 
problems etc. 

***Multiple type of injuries were recorded 


Impact Factor (JCC): 5.4638 


NAAS Rating: 3.54