Road traffic accidents involving elderly people: an integrative review

Betise Mery Alencar Sousa Macau Furtado Ana Carolina Bezerra de Lima Ranna Carinny Gonçalves Ferreira About the authors

Abstract

Objective:

To identify the epidemiological and socio-demographic profile of elderly victims of traffic accidents reported in articles published in scientific literature from 2013 to 2018.

Method:

The Literatura Latino Americana em Ciências da Saúde (Latin American Literature in Health Sciences), Base de Dados de Enfermagem (Database in Nursing), Scientific Electronic Library Online, and Medical Literature Analysis and Retrieval System Online databases were used, with the guiding question being: What is the scientific production on traffic accidents involving elderly people? A total of 355 articles were found. After the application of the selection criteria, 16 were evaluated, and nine remained for final analysis.

Results:

The age range was 60 to 69 years and the majority of the sample were men, who were married and had low schooling. Being run over was the most frequent accident. The width of the traffic lanes and the time of the accident influenced the frequency and risk of accidents and the severity of the injuries.

Conclusion:

Younger elderly persons were the most affected, and being run over was the most frequent type of accident.

Keywords:
Accidents Traffic; Health of the Elderly; Wounds and Injuries; Elderly Population

Resumo

Objetivo:

Conhecer o perfil epidemiológico e sociodemográfico de idosos vítimas de acidentes de transporte terrestre relatados em artigos publicados na literatura científica no período de 2013 a 2018.

Método:

Foram utilizadas as bases de dados eletrônicas Medical Literature Analysis and Retrieval System Online (PubMed), Literatura Latino Americana em Ciências da Saúde (LILACS), a biblioteca virtual Scientific Electronic Library Online (SciELO) e a plataforma ScienceDirect, com a pergunta norteadora: Qual a produção científica sobre acidentes de transporte terrestre envolvendo pessoas idosas? Encontrados 355 artigos. Após aplicação dos critérios de seleção, 16 artigos foram avaliados, restando nove para análise final.

Resultados:

A faixa de idade mais prevalente foi de 60 a 69 anos, homens, casados, com baixa escolaridade. Os atropelamentos foram os mais frequentes. A largura das vias, e o horário dos acidentes influenciam na frequência, no risco de acontecer os acidentes e na gravidade das lesões.

Conclusão:

Os idosos mais jovens foram os mais afetados, e o atropelamento foi o tipo de acidente mais frequente.

Palavras-chave:
Acidentes de Transporte; Saúde do Idoso; Ferimentos e Lesões; População Idosa

INTRODUCTION

Traffic accidents are one of the main causes of death in the young and adult population. This cause is also significant among the elderly, especially with the increasing size of the older population11 Instituto Brasileiro de Geografia e Estatística, Diretoria de Pesquisas, Coordenação de População e Indicadores Sociais. Síntese de Indicadores Sociais: uma análise das condições de vida da população brasileira [Internet]. Rio de Janeiro: IBGE; 2013 [acesso em 10 ago. 2018]. Disponível em: https://biblioteca.ibge.gov.br/visualizacao/livros/liv98965.pdf
https://biblioteca.ibge.gov.br/visualiza...

2 Simões CCS. Relações entre as alterações históricas na dinâmica demográfica brasileira e os impactos decorrentes do processo de envelhecimento da população [Internet]. Rio de Janeiro: IBGE; 2016 [acesso em 10 ago. 2018]. Disponível em: https://biblioteca.ibge.gov.br/pt/biblioteca-catalogo?view=detalhes&id=298579
https://biblioteca.ibge.gov.br/pt/biblio...

3 United Nations Population Fundation. 2011 Annual Report: Delivering results in a world of 7 billion [Internet]. New York: UNFPA; 2012 [acesso em 10 ago. 2018]. Disponível em: https://www.unfpa.org/publications/unfpa-annual-report-2011
https://www.unfpa.org/publications/unfpa...
-44 World Health Organization. Informe mundial sobre el envejecimiento y la salud [Internet]. Geneva: WHO; 2015 [acesso em 10 ago. 2018]. Disponível em: https://www.who.int/ageing/publications/world-report-2015/es/
https://www.who.int/ageing/publications/...
.

A study on external causes carried out by the SEADE Foundation in the state of São Paulo, Brazil, found that car accidents and falls are among the main causes of death among the elderly. When the other causes of death among this population are compared, external causes have a lower impact, but are greater within the group itself55 Camargo ABM. Idosos e mortalidade: preocupante relação com as causas externas [Internet]. Prim Anál Seade [Internet] 2016 [acesso em 15 nov. 2018];35:4-20. Disponível em: http://www.seade.gov.br/wp-content/uploads/2016/03/Primeira_Analise_35_fev16.pdf
http://www.seade.gov.br/wp-content/uploa...
.

Although external causes affect the younger population more frequently, the risks of dying from accidents or violence increase dramatically among those over 60. This is caused both by the condition of exposure to risk due to locomotion and other tasks that are part of activities of daily living, as well as by the inherent difficulties of age.

Among the accidents that can affect the elderly population are Road Traffic Accidents (RTA). The number of existing vehicles is a preponderant factor for the occurrence of these accidents, involving both automobiles and motorcycles, as they cause complications in the traffic in general, and increase the risks of this type of accident55 Camargo ABM. Idosos e mortalidade: preocupante relação com as causas externas [Internet]. Prim Anál Seade [Internet] 2016 [acesso em 15 nov. 2018];35:4-20. Disponível em: http://www.seade.gov.br/wp-content/uploads/2016/03/Primeira_Analise_35_fev16.pdf
http://www.seade.gov.br/wp-content/uploa...
,66 Veras RP. International experiences and trends in health care models for the elderly. Ciênc Saúde Colet [Internet]. 2012 [acesso em 15 jan. 2019];17(1):231-8. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232012000100025&lng=pt&tlng=pt
http://www.scielo.br/scielo.php?script=s...
. With the changing age of the population44 World Health Organization. Informe mundial sobre el envejecimiento y la salud [Internet]. Geneva: WHO; 2015 [acesso em 10 ago. 2018]. Disponível em: https://www.who.int/ageing/publications/world-report-2015/es/
https://www.who.int/ageing/publications/...
,66 Veras RP. International experiences and trends in health care models for the elderly. Ciênc Saúde Colet [Internet]. 2012 [acesso em 15 jan. 2019];17(1):231-8. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232012000100025&lng=pt&tlng=pt
http://www.scielo.br/scielo.php?script=s...
, RTA suffered by the elderly have become a major public health problem, and one with an increasing trend77 Parreira JG, Farrath S, Soldá SC, Perlingeiro JAG, Assef JC. Comparative analysis of trauma characteristics between elderly and superelderly. Rev Col Bras Cir [Internet]. 2013 [acesso em 12 nov. 2018];40(4):269-74. Disponível em: http://www.scielo.br/pdf/rcbc/v40n4/en_v40n4a03.pdf
http://www.scielo.br/pdf/rcbc/v40n4/en_v...
.

People in the 60 years or older age group have a higher mortality from external causes in Brazil, as well as hospitalizations from these causes within the Unified Health System (or SUS), with rates of 109 and 650 per 100,000 inhabitants, respectively, in 2008. Between 2008 and 2010, there were 413,139 hospitalizations for external causes among the elderly in the SUS, costing approximately R$570 million. These hospitalizations were mainly due to falls (62.4%), traffic accidents (8.1%) and unclassified external causes (7%)88 Vicente FR, Santos SMA. MultidimensionaL evaluation of determinants of active aging in older adults in a municipality in Santa Catarina. Texto & Context Enferm [Internet]. 2013 [acesso em 12 jan. 2019];22(2):370-8. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-07072013000200013&lng=pt&nrm=iso&tlng=en
http://www.scielo.br/scielo.php?script=s...
.

Between 2000 and 2010, the mortality rate from RTA increased from 18 to 22.5 deaths per 100,000 inhabitants in Brazil. Such accidents were also the second most frequent cause of hospitalizations in the SUS between 2002 and 2011, resulting in costs estimated at R$50 billion99 Morais Neto OL, Montenegro MMS, Monteiro RAP, Siqueira Júnior JB, Marta Silva MMA, Lima CM, et al. Mortality due to Road Traffic Accidents in Brazil in the last decade: trends and risk clusters. Ciênc Saúde Colet [Internet]. 2012 [acesso em 13 jan. 2019];17(9):2223-36. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232012000900002&lng=pt&tlng=pt
http://www.scielo.br/scielo.php?script=s...

10 Mascarenas MDM, Barros MBA. Evolution of public health system hospital admissions due to external causes - Brazil, 2002-2011. Epidemiol Serv Saúde [Internet]. 2015 [acesso em 25 fev. 2019] 24(1):19-29. Disponível em: http://www.scielo.br/pdf/ress/v24n1/2237-9622-ress-24-01-00019.pdf
http://www.scielo.br/pdf/ress/v24n1/2237...
-1111 Andrade SSCA, Jorge MHPM. Hospitalization due to road traffic injuries in Brazil, 2013: hospital stay and costs. Epidemiol Serv Saúde [Internet]. 2017 [acesso em 18 fev. 2019];26(1):31-8. Disponível em: http://www.scielo.br/pdf/ress/v26n1/2237-9622-ress-26-01-00031.pdf
http://www.scielo.br/pdf/ress/v26n1/2237...
.

Although older people are living longer and more healthily, they face new challenges, among which are traumas resulting from RTA, which significantly affect this group1010 Mascarenas MDM, Barros MBA. Evolution of public health system hospital admissions due to external causes - Brazil, 2002-2011. Epidemiol Serv Saúde [Internet]. 2015 [acesso em 25 fev. 2019] 24(1):19-29. Disponível em: http://www.scielo.br/pdf/ress/v24n1/2237-9622-ress-24-01-00019.pdf
http://www.scielo.br/pdf/ress/v24n1/2237...
.

It was therefore felt that there was a need to better understand how RTA affect this population through the identification of published works on the subject in scientific literature, and from this knowledge provide a foundation to contribute to the preparation of preventive public policies to benefit this age group.

Therefore, the present study aimed to identify the epidemiological and sociodemographic profile of elderly victims of RTA through articles published in scientific literature from 2013 to 2018.

METHOD

An integrative review of literature was carried out, which consists of the creation of an evidence-based scientific framework. This form of knowledge production requires a methodological rigor and is effective for the analysis and critique of literature, constituting one of the main research modalities in the context of health1212 Soares CB, Hoga LAK, Peduzzi M, Sangaleti C, Yonekura T, Silva DRAD. Integrative Review: concepts and methods used in nursing. Rev Esc Enferm USP [Internet]. 2014 [acesso em 29 jan. 2019];48(2):335-45. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342014000200335
http://www.scielo.br/scielo.php?script=s...
.

As a research strategy, the electronic databases Medical Literature Analysis and Retrieval System Online (PubMed), Latin American & Caribbean Health Sciences Literature (LILACS), the Scientific Electronic Library Online (SciELO) virtual library and the ScienceDirect platform were used.

The inclusion criteria were: (a) articles indexed by descriptors registered in the Medical Subject Headings (MeSH) database: “Traffic Accidents”, “Elderly”, “Old Age”, “Old Adults” and in the Health Sciences Descriptors (DeCS): “Traffic Accidents” and “Elderly”; (b) articles published from 2013 to 2018 involving people over 60 years of age and (c) articles that answered the research question. The exclusion criterion was published literature other than primary articles, excluding, in this manner, case studies, monographs, master’s dissertations, doctoral theses, chapters of books and systematic reviews.

The survey was conducted between February and April 2018, with data collection performed at two different moments. The first was the selection of articles for a complete reading, the description of which is detailed in figure 1. Initially, 936 articles were established from the chosen descriptors. A total of 848 were discarded as they did not meet the inclusion criteria (n=840) or were duplicates (n=8), leaving 90 articles potentially eligible for the study.

Figure 1
Selection process of articles included in the present review. Recife, Pernambuco, Brazil, 2018.

From a careful reading of the titles and abstracts, 65 articles were excluded because they were outside the defined age group (n=49) or did not relate to the studied subject (n=16) and, thus, 25 articles were chosen as they responded closely to the guiding research question proposed.

For the second part of the data collection, an instrument was created by the research team that contained the following items: article title, year of publication, country of affiliation of the main author, type of study and main results. Data analysis was performed in a descriptive manner, based on the Thematic-Categorical Content Analysis1313 Oliveira DC. Theme/Category-based Content Analysis: a proposal for systematization. Rev Enferm UERJ [Internet]. 2008 [acesso em 14 fev. 2019];16(4):569-76. Disponível em: http://www.facenf.uerj.br/v16n4/v16n4a19.pdf
http://www.facenf.uerj.br/v16n4/v16n4a19...
. This process was divided into three stages, namely: pre-analysis, exploration of material or coding and treatment of results - inference and interpretation.

RESULTS

Chart 1 lists the studies included in the review.

Chart 1
Studies included in review, Recife, Pernambuco, 2018.

DISCUSSION

Globally, trauma cases are the fifth highest cause of mortality among the elderly, with cases of Road Traffic Accidents (RTA) contributing to this increase3535 Bell TM, Qiao N, Zarzaur BL. Mature driver laws and state predictors of motor vehicle crash fatality rates among the elderly: a cross-sectional ecological study. Traffic Inj Prev [Internet]. 2015 [acesso em 17 jan. 2019];16(7):669-76. Disponível em: https://www.tandfonline.com/doi/full/10.1080/15389588.2014.999858
https://www.tandfonline.com/doi/full/10....
. In Brazil, the RTA-related death rate among elderly individuals has been increasing since 1996, especially in the northeast region of the country2020 Scolari GAS, Derhun FM, Rossoni DF, Mathias TAF, Fernando CAM, Carreira L. Trend in mortality of elderly by land transport accidents In Brazil. Cogitare Enferm [Internet]. 2017 [acesso em 17 jan. 2019];22(3):1-9. Disponível em: https://revistas.ufpr.br/cogitare/article/view/50170/pdf_en
https://revistas.ufpr.br/cogitare/articl...
.

The demographic profile identified in several studies reveals that younger elderly persons, especially in the 60-69 age group, are the main victims of traffic accidents1616 Lombardi DA, Horrey WJ, Courtney TK. Age-related differences in fatal intersection crashes in the United States. Accid Anal Prev [Internet]. 2017 [acesso em 28 jan. 2019];99(Pt A):20-9. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/27855312
https://www.ncbi.nlm.nih.gov/pubmed/2785...
,2121 Santos AMR, Rodrigues RAP, Diniz MA. Trauma by traffic accident in elderly people risk factors and consequences. Texto & Contexto Enferm [Internet]. 2017 [acesso em 17 jan. 2019];26(2):2-10. Disponível em: http://www.scielo.br/pdf/tce/v26n2/pt_0104-0707-tce-26-02-e4220015.pdf
http://www.scielo.br/pdf/tce/v26n2/pt_01...
,2727 Etehad H, Yousefzadeh-Chabok SH, Davoudi-Kiakalaye A, Dehnadi AM, Hemati H, Mohtasham-Amiri Z. Impact of road traffic accidents on the elderly. Arch Gerontol Geriatr [Internet]. 2015 [acesso em 17 jan. 2019];61(3):489-93. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26321733
https://www.ncbi.nlm.nih.gov/pubmed/2632...
,2929 Freitas MG, Bonolo PF, Moraes EN, Machado CJ. Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents. Ciênc Saúde Colet [Internet]. 2015 [acesso em 17 jan. 2019];20(3):701-12. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232015000300701
http://www.scielo.br/scielo.php?script=s...
,3838 Broska Júnior CA, Folchini AB, Ruediger RR. Comparative study of trauma in the elderly and non-elderly patients in a University Hospital in Curitiba. Rev Col Bras Cir [Internet]. 2013 [acesso em 17 jan. 2019];40(4):281-6. Disponível em: http://www.scielo.br/pdf/rcbc/v40n4/en_v40n4a05.pdf
http://www.scielo.br/pdf/rcbc/v40n4/en_v...
. However, health care costs are higher for the population of drivers aged over 65 years, as they are more likely to suffer more severe traumatic injuries and have a lower recovery capacity for these injuries than younger elderly persons, thus leading to longer hospitalization and higher costs1818 Chevalier A, Coxon K, Chevalier AJ, Clarke E, Rogers K, Brown J, et al. Predictors of older drivers’ involvement in rapid deceleration events. Accid Anal Prev [Internet]. 2017 [acesso em 17 jan. 2019];98:312-9. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/27810673
https://www.ncbi.nlm.nih.gov/pubmed/2781...
,1919 Noh Y, Yoon Y. Elderly road collision injury outcomes associated with seat positions and seatbelt use in a rapidly aging society: a case study in South Korea. PLoS ONE [Internet]. 2017 [acesso em 17 jan. 2019];12(8):1-13. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0183043
https://journals.plos.org/plosone/articl...
,3030 Shen S, Neyens DM. The effects of age, gender, and crash types on drivers’ injury-related health care costs. Accid Anal Prev [Internet]. 2015 [acesso em 17 jan. 2019];77:82-90. Disponível em: https://www.sciencedirect.com/science/article/pii/S0001457515000251?via%3Dihub
https://www.sciencedirect.com/science/ar...
,3737 Haleem K, Gan A. Effect of driver’s age and side of impact on crash severity along urban freeways: a mixed logit approach. J Safety Res [Internet]. 2013 [acesso em 17 jan. 2019];46:67-76. Disponível em: https://www.sciencedirect.com/science/article/pii/S0022437513000285?via%3Dihub
https://www.sciencedirect.com/science/ar...
.

When the results were analyzed by gender, men were the most affected, which may be related to their greater movement around the urban perimeter of cities, due to their greater involvement in leisure activities and as participants in the labor market3030 Shen S, Neyens DM. The effects of age, gender, and crash types on drivers’ injury-related health care costs. Accid Anal Prev [Internet]. 2015 [acesso em 17 jan. 2019];77:82-90. Disponível em: https://www.sciencedirect.com/science/article/pii/S0001457515000251?via%3Dihub
https://www.sciencedirect.com/science/ar...
,3636 Classen S, Wang Y, Crizzle AM, Winter SM, Lanford DN. Gender differences among older drivers in a comprehensive driving evaluation. Accid Anal Prev [Internet]. 2013 [acesso em 17 jan. 2019];61:146-52. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S0001457512003661
https://linkinghub.elsevier.com/retrieve...
. In addition, there is a greater proportion of RTA among married elderly persons, as well as those with lower schooling, as this is one of the determinants for a greater occurrence of traumatic lesions2121 Santos AMR, Rodrigues RAP, Diniz MA. Trauma by traffic accident in elderly people risk factors and consequences. Texto & Contexto Enferm [Internet]. 2017 [acesso em 17 jan. 2019];26(2):2-10. Disponível em: http://www.scielo.br/pdf/tce/v26n2/pt_0104-0707-tce-26-02-e4220015.pdf
http://www.scielo.br/pdf/tce/v26n2/pt_01...
,2929 Freitas MG, Bonolo PF, Moraes EN, Machado CJ. Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents. Ciênc Saúde Colet [Internet]. 2015 [acesso em 17 jan. 2019];20(3):701-12. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232015000300701
http://www.scielo.br/scielo.php?script=s...
.

Risk factors that increase the vulnerability of the elderly population to traffic accidents may be related to the aging process itself, the prevalence of comorbidities, alcohol use, polypharmacy, traffic dynamics and the structural difficulties of places the elderly attend2121 Santos AMR, Rodrigues RAP, Diniz MA. Trauma by traffic accident in elderly people risk factors and consequences. Texto & Contexto Enferm [Internet]. 2017 [acesso em 17 jan. 2019];26(2):2-10. Disponível em: http://www.scielo.br/pdf/tce/v26n2/pt_0104-0707-tce-26-02-e4220015.pdf
http://www.scielo.br/pdf/tce/v26n2/pt_01...
,2222 Niebuhr T, Junge M, Rosén E. Pedestrian injury risk and the effect of age. Accid Anal Prev [Internet]. 2016 [acesso em 17 jan. 2019];86:121-8. Disponível em: https://www.sciencedirect.com/science/article/pii/S0001457515301081?via%3Dihub
https://www.sciencedirect.com/science/ar...
,2727 Etehad H, Yousefzadeh-Chabok SH, Davoudi-Kiakalaye A, Dehnadi AM, Hemati H, Mohtasham-Amiri Z. Impact of road traffic accidents on the elderly. Arch Gerontol Geriatr [Internet]. 2015 [acesso em 17 jan. 2019];61(3):489-93. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26321733
https://www.ncbi.nlm.nih.gov/pubmed/2632...
,3737 Haleem K, Gan A. Effect of driver’s age and side of impact on crash severity along urban freeways: a mixed logit approach. J Safety Res [Internet]. 2013 [acesso em 17 jan. 2019];46:67-76. Disponível em: https://www.sciencedirect.com/science/article/pii/S0022437513000285?via%3Dihub
https://www.sciencedirect.com/science/ar...
.

When comparing risk factors between genders, employability is found to be the greatest factor for males, with arthritis the most frequent comorbidity among females, and depressive symptoms evident factors for both genders2828 Hong K, Lee KM, Jang S. Incidence and related factors of traffic accidents among the older population in a rapidly aging society. Arch Gerontol Geriatr [Internet]. 2015 [acesso em 17 jan. 2019];60(3):471-7. Disponível em: https://www.sciencedirect.com/science/article/pii/S0167494315000230
https://www.sciencedirect.com/science/ar...
. Being overweight and elderly people over 65 with university degrees were other risk factors cited3535 Bell TM, Qiao N, Zarzaur BL. Mature driver laws and state predictors of motor vehicle crash fatality rates among the elderly: a cross-sectional ecological study. Traffic Inj Prev [Internet]. 2015 [acesso em 17 jan. 2019];16(7):669-76. Disponível em: https://www.tandfonline.com/doi/full/10.1080/15389588.2014.999858
https://www.tandfonline.com/doi/full/10....
.

Another important risk factor was the use of alcohol and other drugs. One study that characterized such use in elderly drivers involved in fatal automobile collisions in the USA found that among drivers considered drug-positive, there was a 43% greater tendency to be without a seat belt at the time of the collision. The most commonly reported drugs were antidepressants and narcotics, as well as benzodiazepines, many of which can alter driving ability if not prescribed and administered properly2323 Rudisill TM, Zhu M, Abate M, Davidov D, Delagarza V, Long DL, et al. The characterization of drug and alcohol use among senior drivers fatally injured in U.S. motor vehicle collisions, 2008-2012. Traffic Inj Prev [Internet]. 2016 [acesso em 17 jan. 2019];17(8):788-95. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039044/
https://www.ncbi.nlm.nih.gov/pmc/article...
.

Literature shows that elderly pedestrians are the most vulnerable to traffic accidents. This may be explained, in addition to the functional conditions of the elderly, by current traffic conditions and improper driving behaviors, such as carelessness on the part of car drivers and motorcycle riders, as well as situations where the elderly cross the road away from crossings or when the red light is showing for pedestrians1515 Heinrich D, Holzmann C, Wagner A, Fischer A, Pfeifer H, Graw M, et al. What are the differences in injury patterns of young and elderly traffic accident fatalities considering death on scene and death in hospital? Int J Legal Med [Internet]. 2017 [acesso em 28 ago. 2019];131(4):1023-37. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/28180986
https://www.ncbi.nlm.nih.gov/pubmed/2818...
,2121 Santos AMR, Rodrigues RAP, Diniz MA. Trauma by traffic accident in elderly people risk factors and consequences. Texto & Contexto Enferm [Internet]. 2017 [acesso em 17 jan. 2019];26(2):2-10. Disponível em: http://www.scielo.br/pdf/tce/v26n2/pt_0104-0707-tce-26-02-e4220015.pdf
http://www.scielo.br/pdf/tce/v26n2/pt_01...
,3838 Broska Júnior CA, Folchini AB, Ruediger RR. Comparative study of trauma in the elderly and non-elderly patients in a University Hospital in Curitiba. Rev Col Bras Cir [Internet]. 2013 [acesso em 17 jan. 2019];40(4):281-6. Disponível em: http://www.scielo.br/pdf/rcbc/v40n4/en_v40n4a05.pdf
http://www.scielo.br/pdf/rcbc/v40n4/en_v...
. Such situations potentiate trauma events in traffic and reaffirm their status as a public health problem2525 Silva HC, Pessoa RL, Menezes RMP. Trauma in elderly people: access to the health system through pre-hospital care. Rev Latinoam Enferm [Internet]. 2016 [acesso em 17 jan. 2019];24:1-8. Disponível em: http://www.scielo.br/pdf/rlae/v24/0104-1169-rlae-24-02690.pdf
http://www.scielo.br/pdf/rlae/v24/0104-1...
.

The predominance of being knocked down among traffic accidents involving the elderly is partly related to the difficulty these pedestrians have when crossing the road, as cognitive decline is accentuated by increases in age. A study also showed the unsafe behavior of elderly people when crossing two-way streets, where they have difficulties in increasing step speed and length in comparison with young people3232 Dommes A, Cavallo V, Dubuisson JB, Tournier I, Vienne F. Crossing a two-way street: comparison of young and old pedestrians. J Safety Res [Internet]. 2014 [acesso em 17 jan. 2019];50:27-34. Disponível em: https://www.sciencedirect.com/science/article/pii/S0022437514000395
https://www.sciencedirect.com/science/ar...
. A greater risk was also perceived among elderly drivers when decelerating vehicles due to reduced sensitivity and confidence1818 Chevalier A, Coxon K, Chevalier AJ, Clarke E, Rogers K, Brown J, et al. Predictors of older drivers’ involvement in rapid deceleration events. Accid Anal Prev [Internet]. 2017 [acesso em 17 jan. 2019];98:312-9. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/27810673
https://www.ncbi.nlm.nih.gov/pubmed/2781...
.

A study in Switzerland compared the behavior of young and old people at the intersection of a lane, and found that the latter looked more towards the ground than to both sides of the street before crossing than the former3131 Zito GA, Cazzoli D, Scheffler L, Jäger M, Müri RM, Mosimann UP, et al. Street crossing behavior in younger and older pedestrians: an eye- and head-tracking study. BMC Geriatrics [Internet]. 2015 [acesso em 17 jan. 2019];15:1-10. Disponível em: https://bmcgeriatr.biomedcentral.com/track/pdf/10.1186/s12877-015-0175-0
https://bmcgeriatr.biomedcentral.com/tra...
. This was justified by the fact that the elderly do not generally take a second look for potential hazards at intersections2424 Yamani Y, Horrey WJ, Liang Y, Fisher DL. Age-related differences in vehicle control and eye movement patterns at intersections: older and middle-aged drivers. PLoS ONE [Internet]. 2016 [acesso em 17 jan. 2019];11(10):1-17. Disponível em: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0164124&type=printable
https://journals.plos.org/plosone/articl...
.

Regarding the day of the week, time of occurrence and speed of collision, when compared to traffic accidents involving younger people, accidents involving elderly people were more frequent during the day, from Tuesday to Friday, and involved a lower collision speed1616 Lombardi DA, Horrey WJ, Courtney TK. Age-related differences in fatal intersection crashes in the United States. Accid Anal Prev [Internet]. 2017 [acesso em 28 jan. 2019];99(Pt A):20-9. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/27855312
https://www.ncbi.nlm.nih.gov/pubmed/2785...
.

The most commonly reported injury patterns were traumatic brain injuries (TBI), due to the impact of parts of the vehicle or throwing the victim onto the road, and limb fractures due to the reduction in the bone mineral content characteristic of aging2222 Niebuhr T, Junge M, Rosén E. Pedestrian injury risk and the effect of age. Accid Anal Prev [Internet]. 2016 [acesso em 17 jan. 2019];86:121-8. Disponível em: https://www.sciencedirect.com/science/article/pii/S0001457515301081?via%3Dihub
https://www.sciencedirect.com/science/ar...
,2727 Etehad H, Yousefzadeh-Chabok SH, Davoudi-Kiakalaye A, Dehnadi AM, Hemati H, Mohtasham-Amiri Z. Impact of road traffic accidents on the elderly. Arch Gerontol Geriatr [Internet]. 2015 [acesso em 17 jan. 2019];61(3):489-93. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26321733
https://www.ncbi.nlm.nih.gov/pubmed/2632...
,3838 Broska Júnior CA, Folchini AB, Ruediger RR. Comparative study of trauma in the elderly and non-elderly patients in a University Hospital in Curitiba. Rev Col Bras Cir [Internet]. 2013 [acesso em 17 jan. 2019];40(4):281-6. Disponível em: http://www.scielo.br/pdf/rcbc/v40n4/en_v40n4a05.pdf
http://www.scielo.br/pdf/rcbc/v40n4/en_v...
. In addition, it was also identified that in the elderly, most of the deaths at the scene of the accident were due to thoracic and pelvic injuries, while in hospitals the majority of deaths were due to abdominal injuries1515 Heinrich D, Holzmann C, Wagner A, Fischer A, Pfeifer H, Graw M, et al. What are the differences in injury patterns of young and elderly traffic accident fatalities considering death on scene and death in hospital? Int J Legal Med [Internet]. 2017 [acesso em 28 ago. 2019];131(4):1023-37. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/28180986
https://www.ncbi.nlm.nih.gov/pubmed/2818...
. Although these lesions may be conveniently treated, some elderly cyclists died because rescue teams did not identify early retroperitoneal bleeding after pelvic fractures, which require the careful clinical evaluation by the team that provides first response care to the injured elderly person1717 Matsui Y, Oikawa S, Hitosugi M. Features of fatal injuries in older cyclists in vehicle: bicycle accidents in Japan. Traffic Inj Prev [Internet]. 2017 [acesso em 17 jan. 2019];19(1):60-5. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/28581829
https://www.ncbi.nlm.nih.gov/pubmed/2858...
.

In contrast, comorbidities help to reduce the risk of the elderly being victims of a RTA event, as they employ self-regulating behaviors. These behaviors are characterized by the self-reported decision to adopt protective strategies in traffic when perceiving their weakened physical condition, such as reducing their exposure to traffic, driving a vehicle at lower speeds and avoiding driving at night, which becomes preventive behavior1414 Makizako H, Shimada H, Hotta R, Doi T, Tsutsumimoto K, Nakakubo S, et al. Associations of near-miss traffic incidents with attention and executive function among older japanese drivers. Gerontology [Internet]. 2018 [acesso em 17 fev. 2019];64(5):495-502. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/29428957
https://www.ncbi.nlm.nih.gov/pubmed/2942...
,2020 Scolari GAS, Derhun FM, Rossoni DF, Mathias TAF, Fernando CAM, Carreira L. Trend in mortality of elderly by land transport accidents In Brazil. Cogitare Enferm [Internet]. 2017 [acesso em 17 jan. 2019];22(3):1-9. Disponível em: https://revistas.ufpr.br/cogitare/article/view/50170/pdf_en
https://revistas.ufpr.br/cogitare/articl...
,3333 Papa M, Boccardi V, Prestano R, Angellotti E, Desiderio M, Marano L, et al. Comorbidities and crash involvement among younger and older drivers. PloS ONE [Internet]. 2014 [acesso em 18 jan. 2019];9(4):1-6. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0094564
https://journals.plos.org/plosone/articl...
,3434 Sandlin D, McGwin Jr G, Owsley C. Association between vision impairment and driving exposure in older adults aged 70 years and over: a population-based examination. Acta Ophthalmol [Internet]. 2014 [acesso em 17 jan. 2019];92(3):207-12. Disponível em: https://onlinelibrary.wiley.com/doi/full/10.1111/aos.12050
https://onlinelibrary.wiley.com/doi/full...
,3636 Classen S, Wang Y, Crizzle AM, Winter SM, Lanford DN. Gender differences among older drivers in a comprehensive driving evaluation. Accid Anal Prev [Internet]. 2013 [acesso em 17 jan. 2019];61:146-52. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S0001457512003661
https://linkinghub.elsevier.com/retrieve...
.

With regard to the impacts of traffic accidents on the elderly population, it is known that this type of event can negatively affect the functional capacity of such individuals, depending on the severity of the trauma. Immobilizations were the most frequent results, and the greater the intensity of the trauma, the more serious the consequences and the behavior adopted2626 Almeida MHM, Caromano FA, Ribeiro SS, Batista MPP. An orientation program for elderly drivers with an emphasis on self-care practices. Rev Bras Geriatr Gerontol [Internet]. 2016 [acesso em 17 jan. 2019];19(2):303-11. Disponível em: http://www.scielo.br/pdf/rbgg/v19n2/en_1809-9823-rbgg-19-02-00303.pdf
http://www.scielo.br/pdf/rbgg/v19n2/en_1...
. It was evidenced that the elderly are more predisposed to suffering fractures or trauma to the cranial and vertebral column3838 Broska Júnior CA, Folchini AB, Ruediger RR. Comparative study of trauma in the elderly and non-elderly patients in a University Hospital in Curitiba. Rev Col Bras Cir [Internet]. 2013 [acesso em 17 jan. 2019];40(4):281-6. Disponível em: http://www.scielo.br/pdf/rcbc/v40n4/en_v40n4a05.pdf
http://www.scielo.br/pdf/rcbc/v40n4/en_v...
.

One initiative worthy of note involved the development of a mentoring program for elderly drivers on driving difficulties associated with aging, encouraging self-care2626 Almeida MHM, Caromano FA, Ribeiro SS, Batista MPP. An orientation program for elderly drivers with an emphasis on self-care practices. Rev Bras Geriatr Gerontol [Internet]. 2016 [acesso em 17 jan. 2019];19(2):303-11. Disponível em: http://www.scielo.br/pdf/rbgg/v19n2/en_1809-9823-rbgg-19-02-00303.pdf
http://www.scielo.br/pdf/rbgg/v19n2/en_1...
. From this perspective, health services that care for the elderly, irrespective of the level of complexity, must be prepared to meet the specifics of trauma among this public, investing in professional training, infrastructure, health education, self-care practice and family participation2424 Yamani Y, Horrey WJ, Liang Y, Fisher DL. Age-related differences in vehicle control and eye movement patterns at intersections: older and middle-aged drivers. PLoS ONE [Internet]. 2016 [acesso em 17 jan. 2019];11(10):1-17. Disponível em: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0164124&type=printable
https://journals.plos.org/plosone/articl...
. These and other initiatives can serve as incentives to prevent the growth of the morbidity and mortality of elderly people due to traffic accidents and should be stimulated in the various contexts of care of this population.

The limitations of the present study concern the heterogeneity of the studies included in the review in terms of the discussion of the results, which may have hampered a more consistent analysis. The descriptors selected may not have found all the published studies. In addition, many of the articles surveyed are restricted access, which can be considered as a limiting factor. It is important that more studies are carried out in the area of gerontology and geriatrics involving traffic accidents.

CONCLUSION

According to this review, the profile of the elderly persons suffering traffic accidents was: elderly persons in the age group of 60 to 69 years, males, married, with low schooling and who worked. Pedestrians were the most vulnerable, with a predominance of being knocked down. The accidents occurred most often during the day, and cranio-encephalic trauma was the most frequent injury.

In view of the results, it can be inferred that there is a need to invest in the area of urgent and emergency care, in the planning of actions that contribute to the preparation of health teams for the integral care for the elderly, noting their particular characteristics, related to the frailty of age, such as the pathophysiological alterations that can compromise the quality of life of these individuals.

A fresh approach should be taken among professionals who work directly with traffic in cities with an elderly population, with the aim of training such individuals and raising their awareness about the treatment of the elderly, avoiding greater harm.

It is hoped that other researchers are encouraged to carry out further studies in the areas of geriatrics and gerontology involving Road Traffic Accidents (RTA) in order to create strategies where this population can have more freedom in their mobility without the risk of accidents, and with a better quality of life.

REFERENCES

  • 1
    Instituto Brasileiro de Geografia e Estatística, Diretoria de Pesquisas, Coordenação de População e Indicadores Sociais. Síntese de Indicadores Sociais: uma análise das condições de vida da população brasileira [Internet]. Rio de Janeiro: IBGE; 2013 [acesso em 10 ago. 2018]. Disponível em: https://biblioteca.ibge.gov.br/visualizacao/livros/liv98965.pdf
    » https://biblioteca.ibge.gov.br/visualizacao/livros/liv98965.pdf
  • 2
    Simões CCS. Relações entre as alterações históricas na dinâmica demográfica brasileira e os impactos decorrentes do processo de envelhecimento da população [Internet]. Rio de Janeiro: IBGE; 2016 [acesso em 10 ago. 2018]. Disponível em: https://biblioteca.ibge.gov.br/pt/biblioteca-catalogo?view=detalhes&id=298579
    » https://biblioteca.ibge.gov.br/pt/biblioteca-catalogo?view=detalhes&id=298579
  • 3
    United Nations Population Fundation. 2011 Annual Report: Delivering results in a world of 7 billion [Internet]. New York: UNFPA; 2012 [acesso em 10 ago. 2018]. Disponível em: https://www.unfpa.org/publications/unfpa-annual-report-2011
    » https://www.unfpa.org/publications/unfpa-annual-report-2011
  • 4
    World Health Organization. Informe mundial sobre el envejecimiento y la salud [Internet]. Geneva: WHO; 2015 [acesso em 10 ago. 2018]. Disponível em: https://www.who.int/ageing/publications/world-report-2015/es/
    » https://www.who.int/ageing/publications/world-report-2015/es/
  • 5
    Camargo ABM. Idosos e mortalidade: preocupante relação com as causas externas [Internet]. Prim Anál Seade [Internet] 2016 [acesso em 15 nov. 2018];35:4-20. Disponível em: http://www.seade.gov.br/wp-content/uploads/2016/03/Primeira_Analise_35_fev16.pdf
    » http://www.seade.gov.br/wp-content/uploads/2016/03/Primeira_Analise_35_fev16.pdf
  • 6
    Veras RP. International experiences and trends in health care models for the elderly. Ciênc Saúde Colet [Internet]. 2012 [acesso em 15 jan. 2019];17(1):231-8. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232012000100025&lng=pt&tlng=pt
    » http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232012000100025&lng=pt&tlng=pt
  • 7
    Parreira JG, Farrath S, Soldá SC, Perlingeiro JAG, Assef JC. Comparative analysis of trauma characteristics between elderly and superelderly. Rev Col Bras Cir [Internet]. 2013 [acesso em 12 nov. 2018];40(4):269-74. Disponível em: http://www.scielo.br/pdf/rcbc/v40n4/en_v40n4a03.pdf
    » http://www.scielo.br/pdf/rcbc/v40n4/en_v40n4a03.pdf
  • 8
    Vicente FR, Santos SMA. MultidimensionaL evaluation of determinants of active aging in older adults in a municipality in Santa Catarina. Texto & Context Enferm [Internet]. 2013 [acesso em 12 jan. 2019];22(2):370-8. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-07072013000200013&lng=pt&nrm=iso&tlng=en
    » http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-07072013000200013&lng=pt&nrm=iso&tlng=en
  • 9
    Morais Neto OL, Montenegro MMS, Monteiro RAP, Siqueira Júnior JB, Marta Silva MMA, Lima CM, et al. Mortality due to Road Traffic Accidents in Brazil in the last decade: trends and risk clusters. Ciênc Saúde Colet [Internet]. 2012 [acesso em 13 jan. 2019];17(9):2223-36. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232012000900002&lng=pt&tlng=pt
    » http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232012000900002&lng=pt&tlng=pt
  • 10
    Mascarenas MDM, Barros MBA. Evolution of public health system hospital admissions due to external causes - Brazil, 2002-2011. Epidemiol Serv Saúde [Internet]. 2015 [acesso em 25 fev. 2019] 24(1):19-29. Disponível em: http://www.scielo.br/pdf/ress/v24n1/2237-9622-ress-24-01-00019.pdf
    » http://www.scielo.br/pdf/ress/v24n1/2237-9622-ress-24-01-00019.pdf
  • 11
    Andrade SSCA, Jorge MHPM. Hospitalization due to road traffic injuries in Brazil, 2013: hospital stay and costs. Epidemiol Serv Saúde [Internet]. 2017 [acesso em 18 fev. 2019];26(1):31-8. Disponível em: http://www.scielo.br/pdf/ress/v26n1/2237-9622-ress-26-01-00031.pdf
    » http://www.scielo.br/pdf/ress/v26n1/2237-9622-ress-26-01-00031.pdf
  • 12
    Soares CB, Hoga LAK, Peduzzi M, Sangaleti C, Yonekura T, Silva DRAD. Integrative Review: concepts and methods used in nursing. Rev Esc Enferm USP [Internet]. 2014 [acesso em 29 jan. 2019];48(2):335-45. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342014000200335
    » http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0080-62342014000200335
  • 13
    Oliveira DC. Theme/Category-based Content Analysis: a proposal for systematization. Rev Enferm UERJ [Internet]. 2008 [acesso em 14 fev. 2019];16(4):569-76. Disponível em: http://www.facenf.uerj.br/v16n4/v16n4a19.pdf
    » http://www.facenf.uerj.br/v16n4/v16n4a19.pdf
  • 14
    Makizako H, Shimada H, Hotta R, Doi T, Tsutsumimoto K, Nakakubo S, et al. Associations of near-miss traffic incidents with attention and executive function among older japanese drivers. Gerontology [Internet]. 2018 [acesso em 17 fev. 2019];64(5):495-502. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/29428957
    » https://www.ncbi.nlm.nih.gov/pubmed/29428957
  • 15
    Heinrich D, Holzmann C, Wagner A, Fischer A, Pfeifer H, Graw M, et al. What are the differences in injury patterns of young and elderly traffic accident fatalities considering death on scene and death in hospital? Int J Legal Med [Internet]. 2017 [acesso em 28 ago. 2019];131(4):1023-37. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/28180986
    » https://www.ncbi.nlm.nih.gov/pubmed/28180986
  • 16
    Lombardi DA, Horrey WJ, Courtney TK. Age-related differences in fatal intersection crashes in the United States. Accid Anal Prev [Internet]. 2017 [acesso em 28 jan. 2019];99(Pt A):20-9. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/27855312
    » https://www.ncbi.nlm.nih.gov/pubmed/27855312
  • 17
    Matsui Y, Oikawa S, Hitosugi M. Features of fatal injuries in older cyclists in vehicle: bicycle accidents in Japan. Traffic Inj Prev [Internet]. 2017 [acesso em 17 jan. 2019];19(1):60-5. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/28581829
    » https://www.ncbi.nlm.nih.gov/pubmed/28581829
  • 18
    Chevalier A, Coxon K, Chevalier AJ, Clarke E, Rogers K, Brown J, et al. Predictors of older drivers’ involvement in rapid deceleration events. Accid Anal Prev [Internet]. 2017 [acesso em 17 jan. 2019];98:312-9. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/27810673
    » https://www.ncbi.nlm.nih.gov/pubmed/27810673
  • 19
    Noh Y, Yoon Y. Elderly road collision injury outcomes associated with seat positions and seatbelt use in a rapidly aging society: a case study in South Korea. PLoS ONE [Internet]. 2017 [acesso em 17 jan. 2019];12(8):1-13. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0183043
    » https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0183043
  • 20
    Scolari GAS, Derhun FM, Rossoni DF, Mathias TAF, Fernando CAM, Carreira L. Trend in mortality of elderly by land transport accidents In Brazil. Cogitare Enferm [Internet]. 2017 [acesso em 17 jan. 2019];22(3):1-9. Disponível em: https://revistas.ufpr.br/cogitare/article/view/50170/pdf_en
    » https://revistas.ufpr.br/cogitare/article/view/50170/pdf_en
  • 21
    Santos AMR, Rodrigues RAP, Diniz MA. Trauma by traffic accident in elderly people risk factors and consequences. Texto & Contexto Enferm [Internet]. 2017 [acesso em 17 jan. 2019];26(2):2-10. Disponível em: http://www.scielo.br/pdf/tce/v26n2/pt_0104-0707-tce-26-02-e4220015.pdf
    » http://www.scielo.br/pdf/tce/v26n2/pt_0104-0707-tce-26-02-e4220015.pdf
  • 22
    Niebuhr T, Junge M, Rosén E. Pedestrian injury risk and the effect of age. Accid Anal Prev [Internet]. 2016 [acesso em 17 jan. 2019];86:121-8. Disponível em: https://www.sciencedirect.com/science/article/pii/S0001457515301081?via%3Dihub
    » https://www.sciencedirect.com/science/article/pii/S0001457515301081?via%3Dihub
  • 23
    Rudisill TM, Zhu M, Abate M, Davidov D, Delagarza V, Long DL, et al. The characterization of drug and alcohol use among senior drivers fatally injured in U.S. motor vehicle collisions, 2008-2012. Traffic Inj Prev [Internet]. 2016 [acesso em 17 jan. 2019];17(8):788-95. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039044/
    » https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5039044/
  • 24
    Yamani Y, Horrey WJ, Liang Y, Fisher DL. Age-related differences in vehicle control and eye movement patterns at intersections: older and middle-aged drivers. PLoS ONE [Internet]. 2016 [acesso em 17 jan. 2019];11(10):1-17. Disponível em: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0164124&type=printable
    » https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0164124&type=printable
  • 25
    Silva HC, Pessoa RL, Menezes RMP. Trauma in elderly people: access to the health system through pre-hospital care. Rev Latinoam Enferm [Internet]. 2016 [acesso em 17 jan. 2019];24:1-8. Disponível em: http://www.scielo.br/pdf/rlae/v24/0104-1169-rlae-24-02690.pdf
    » http://www.scielo.br/pdf/rlae/v24/0104-1169-rlae-24-02690.pdf
  • 26
    Almeida MHM, Caromano FA, Ribeiro SS, Batista MPP. An orientation program for elderly drivers with an emphasis on self-care practices. Rev Bras Geriatr Gerontol [Internet]. 2016 [acesso em 17 jan. 2019];19(2):303-11. Disponível em: http://www.scielo.br/pdf/rbgg/v19n2/en_1809-9823-rbgg-19-02-00303.pdf
    » http://www.scielo.br/pdf/rbgg/v19n2/en_1809-9823-rbgg-19-02-00303.pdf
  • 27
    Etehad H, Yousefzadeh-Chabok SH, Davoudi-Kiakalaye A, Dehnadi AM, Hemati H, Mohtasham-Amiri Z. Impact of road traffic accidents on the elderly. Arch Gerontol Geriatr [Internet]. 2015 [acesso em 17 jan. 2019];61(3):489-93. Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/26321733
    » https://www.ncbi.nlm.nih.gov/pubmed/26321733
  • 28
    Hong K, Lee KM, Jang S. Incidence and related factors of traffic accidents among the older population in a rapidly aging society. Arch Gerontol Geriatr [Internet]. 2015 [acesso em 17 jan. 2019];60(3):471-7. Disponível em: https://www.sciencedirect.com/science/article/pii/S0167494315000230
    » https://www.sciencedirect.com/science/article/pii/S0167494315000230
  • 29
    Freitas MG, Bonolo PF, Moraes EN, Machado CJ. Elderly patients attended in emergency health services in Brazil: a study for victims of falls and traffic accidents. Ciênc Saúde Colet [Internet]. 2015 [acesso em 17 jan. 2019];20(3):701-12. Disponível em: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232015000300701
    » http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-81232015000300701
  • 30
    Shen S, Neyens DM. The effects of age, gender, and crash types on drivers’ injury-related health care costs. Accid Anal Prev [Internet]. 2015 [acesso em 17 jan. 2019];77:82-90. Disponível em: https://www.sciencedirect.com/science/article/pii/S0001457515000251?via%3Dihub
    » https://www.sciencedirect.com/science/article/pii/S0001457515000251?via%3Dihub
  • 31
    Zito GA, Cazzoli D, Scheffler L, Jäger M, Müri RM, Mosimann UP, et al. Street crossing behavior in younger and older pedestrians: an eye- and head-tracking study. BMC Geriatrics [Internet]. 2015 [acesso em 17 jan. 2019];15:1-10. Disponível em: https://bmcgeriatr.biomedcentral.com/track/pdf/10.1186/s12877-015-0175-0
    » https://bmcgeriatr.biomedcentral.com/track/pdf/10.1186/s12877-015-0175-0
  • 32
    Dommes A, Cavallo V, Dubuisson JB, Tournier I, Vienne F. Crossing a two-way street: comparison of young and old pedestrians. J Safety Res [Internet]. 2014 [acesso em 17 jan. 2019];50:27-34. Disponível em: https://www.sciencedirect.com/science/article/pii/S0022437514000395
    » https://www.sciencedirect.com/science/article/pii/S0022437514000395
  • 33
    Papa M, Boccardi V, Prestano R, Angellotti E, Desiderio M, Marano L, et al. Comorbidities and crash involvement among younger and older drivers. PloS ONE [Internet]. 2014 [acesso em 18 jan. 2019];9(4):1-6. Disponível em: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0094564
    » https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0094564
  • 34
    Sandlin D, McGwin Jr G, Owsley C. Association between vision impairment and driving exposure in older adults aged 70 years and over: a population-based examination. Acta Ophthalmol [Internet]. 2014 [acesso em 17 jan. 2019];92(3):207-12. Disponível em: https://onlinelibrary.wiley.com/doi/full/10.1111/aos.12050
    » https://onlinelibrary.wiley.com/doi/full/10.1111/aos.12050
  • 35
    Bell TM, Qiao N, Zarzaur BL. Mature driver laws and state predictors of motor vehicle crash fatality rates among the elderly: a cross-sectional ecological study. Traffic Inj Prev [Internet]. 2015 [acesso em 17 jan. 2019];16(7):669-76. Disponível em: https://www.tandfonline.com/doi/full/10.1080/15389588.2014.999858
    » https://www.tandfonline.com/doi/full/10.1080/15389588.2014.999858
  • 36
    Classen S, Wang Y, Crizzle AM, Winter SM, Lanford DN. Gender differences among older drivers in a comprehensive driving evaluation. Accid Anal Prev [Internet]. 2013 [acesso em 17 jan. 2019];61:146-52. Disponível em: https://linkinghub.elsevier.com/retrieve/pii/S0001457512003661
    » https://linkinghub.elsevier.com/retrieve/pii/S0001457512003661
  • 37
    Haleem K, Gan A. Effect of driver’s age and side of impact on crash severity along urban freeways: a mixed logit approach. J Safety Res [Internet]. 2013 [acesso em 17 jan. 2019];46:67-76. Disponível em: https://www.sciencedirect.com/science/article/pii/S0022437513000285?via%3Dihub
    » https://www.sciencedirect.com/science/article/pii/S0022437513000285?via%3Dihub
  • 38
    Broska Júnior CA, Folchini AB, Ruediger RR. Comparative study of trauma in the elderly and non-elderly patients in a University Hospital in Curitiba. Rev Col Bras Cir [Internet]. 2013 [acesso em 17 jan. 2019];40(4):281-6. Disponível em: http://www.scielo.br/pdf/rcbc/v40n4/en_v40n4a05.pdf
    » http://www.scielo.br/pdf/rcbc/v40n4/en_v40n4a05.pdf

Publication Dates

  • Publication in this collection
    26 Sept 2019
  • Date of issue
    2019

History

  • Received
    01 Nov 2018
  • Accepted
    21 May 2019
Universidade do Estado do Rio Janeiro Rua São Francisco Xavier, 524 - Bloco F, 20559-900 Rio de Janeiro - RJ Brasil, Tel.: (55 21) 2334-0168 - Rio de Janeiro - RJ - Brazil
E-mail: revistabgg@gmail.com
Accessibility / Report Error