SCALE FOR THE EVALUATION OF CIRCUMSTANCES SURROUNDING AN ACCIDENT AND THE RISK OF RECURRENCE (ECARR). A PROSPECTIVE VALIDATION STUDY OF ACCIDENT REPETITION

Accidents are, by far, the main cause of morbidity and mortality in young people between 15 and 24 years of age. Among them, traffic accidents are the principal cause of mortality in France. Indeed, France is the European country which presents one of the highest such rates. Among these young accident victims, a large percentage, between 30 and 50 percent, will have another accident in the year following the first one. Thus, in emergency wards, many adolescents admitted as a result of an accident are clearly in a logic of repetition. The objective of the present study is to propose an evaluation scale making it possible to spot those adolescents in the group of accident victims who are most likely to have a second accident. This study is based on a population of 350 adolescents consulting in emergency wards following an accident of any kind whether it be serious or not. The scale for the evaluation of circumstances surrounding an accident and the risk of repetition (ECARR), a 12-item scale which was specifically conceived with this intention, was proposed to all the adolescents during their first admission for accident treatment (accident index). Out of this population of 350 young people, almost half, (46 %), will suffer from a second accident in the following two years, often within months of the first one. The ECARR score for inclusion for all the adolescents was 4.3. However, this score was only 3.9 among those adolescents showing no repetition and was all the higher when the repetition concerned traffic accidents and occurred soon after the first one (the ECARR score for adolescents having recurring traffic accidents was 6.2). Thus, the ECARR scale makes it possible to spot adolescents at risk of suffering from a second accident shortly thereafter, an accident for which there clearly exists a connection between the initial event and its recurrence. A score superior or equal to 5 seems to be predictive of a rapid accident repetition, particularly as concerns traffic accidents. Based on these observations, it would be very useful whenever possible, to envisage regular clinical care for all adolescents presenting a score equal or superior to 5 on the ECARR scale so as to reduce the number of repetitions.