Disability scores rate changes and predictors among road traffic injury victims admitted at Gondar specialized comprehensive hospital northwest Ethiopia: A prospective follow-up study

Abstract BackgroundRoad traffic injury-related mortality continues to increase from time to time globally, but its burden is more than three times higher in low-income countries. This discrepancy is mainly due to poor trauma care system both at the pre-hospital and in-hospital. The analysis of injury patterns and time to mortality is crucial for the development and improvement of trauma care systems. This study aimed to identify patterns of RTI , and predictors of mortality following a RTI. MethodsA prospective hospital-based follow up study was conducted among road traffic injury victims admitted to Gondar University Hospital between May 2019 and February 2020. The total follow-up time was 30 days. Injury severity was determined using revised trauma score (RTS). A Cox regression model was used to identify the time to death and predictors of mortality. Hazard ratios (HR), attributable risks (AR) and population attributable percent (PAR) were computed to estimate the effect size and public health impacts of road traffic injuries.ResultsA total of 454 victims were followed for 275,534 person-hours. There were 80 deaths with an overall incidence of 2.90 deaths per 10,000 person-hours of observation (95% CI: 2.77, 3.03). The significant predictors of time to death were being a driver (AHR=2.26; 95% CI: 1.09, 4.65, AR=14.8), accident at inter urban roads (AHR=1.98; 95% CI: 1.02, 3.82, AR=21%), hospital arrival time (AHR=0.41; 95% CI: .16, 0.63; AR= 3%), SBP on admission (AHR= 3.66; 95% CI: 2.14, 6.26; AR=57%), GCS of <8 (AHR= 7.39; 95% CI, 3.0819 17.74464;AR=75.7%), head injury with polytrauma (AHR= 2.32 (1.12774 4.79; AR=37%) and interaction of distance from hospital with pre-hospital care.ConclusionThis study demonstrated that trauma deaths follow the classical tri-modal pattern in low resource settings. Interventions on pre hospital care, and advancing the hospital trauma care system is required to reduce preventable deaths caused by road traffic injuries. We recommend further study that assess capability of primary hospitals in the area in providing primary trauma care.

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Disability and mortality following road traffic injury: a follow-up study from a tertiary care centre of India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20175356 ◽

2017 ◽

Vol 4 (12) ◽

pp. 4712 ◽

Cited By ~ 1

Author(s):

Ashish Chauhan ◽

Naim Ahmed ◽

Jai Veer Singh ◽

Vijay Kumar Singh ◽

Ajai Singh ◽

...

Keyword(s):

Road Traffic ◽

Tertiary Care ◽

Road Traffic Injury ◽

Care Centre ◽

Tertiary Care Centre ◽

Lower Limb Injury ◽

Road Traffic Injuries ◽

Follow Up Study ◽

Traffic Injury

Background: Road traffic injury (RTI) is emerging as a huge public health problem throughout the world. The problem is magnified manifold as it mainly affects people in productive age-group causing significant mortality and disability. Very few studies have been done in India to assess disability following RTI though it has attained astronomic proportions. This study was undertaken to know the proportion of disability as an outcome amongst patients admitted for road traffic injuries in a tertiary care centre of Lucknow, India and to know the determinants of mortality and disability following Road Traffic Injuries amongst these patients.Methods: A follow-up study was conducted on 267 patients of RTI admitted at Trauma Centre of King George’s Medical University UP (tertiary care centre), Lucknow, India from November 2012 to June 2013. Systemic random sampling was used to select the patients. Disability was assessed using ten points modified Barthel index. Data analysis was done using SPSS 17.0 software.Results: Mortality and disability were seen in 13.1 percent and 16.36 percent of the patients. Residence locale, road user type, time at first aid and admission, and head injury were significantly associated with mortality while extremes of age, residence locale and lower limb injury were significantly associated with disability. The level of significance was set at p value of 0.05.Conclusions: RTI poses a huge burden on healthcare delivery system and society in the form of mortality and disability. Attempts pertaining various sectors should be made to reduce the incidence of RTI and ensuing disability.

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