Predictors of Survival in Motor Vehicle Accidents Among Motorcyclists, Bicyclists and Pedestrians

Background: Motor vehicle accidents are the leading cause of death in adolescents and young adults worldwide. Road traffic fatality is high in Iran; about 28,000 individuals die from road traffic accidents annually. Previous studies on trauma care in Iran have mainly focused on pre-hospital trauma care. This paper deals with the rate and the related factors of traffic injury deaths in hospitals. Objectives: The objectives of the present study were to investigate the predictors of survival rates of 2-wheel vehicle and pedestrian traffic injuries in hospitals of Tabriz, Iran. Patients and Methods: This longitudinal study reviewed 15,331 injuries in 21 hospitals in the city of Tabriz from March 2012 to March 2013. The required data on motorcycle, bicycle and pedestrian (MBP) traffic injuries were collected from hospital information systems (HISs). Operation codes were extracted according to the 2010 California Billing Code and the data were analyzed using the STATA 13 statistical software package. Results: The total number of deaths due to traffic injuries was 266. Of these deaths, 184 were among inpatient traffic injuries 166 were MBP inpatients and 82 were outpatients. Young MBP patients (20 to 40 years of age) experienced a higher injury rate than older ones (48.4%, P < 0.05). Of all traffic injuries, 26% were pedestrian, 32% were motorcyclist, 4.6% were bicyclist, and 37.1% were nonMBPs. Most of the 266 deaths (251 deaths; 94.3) happened in public teaching hospitals. Fourteen deaths (5.3%) happened in other public hospitals and 1 death (0.4%) occurred in a private hospital. The difference, using the Fisher’s exact test, was significant (P < 0.01). The hazard ratio for the death of victims referred to public teaching hospitals was 5.8 times more than other hospitals (RR = 5.7, 95% CI: 3.4 - 9.6). The likelihood of admission for victims transported by emergency medical services (EMS) was 1.13 times more than for victims not transported by EMS (RR = 1.13 - 1.22, 95% CI: 1.05 - 1.2). Of the 266 deaths, 265 (99.62%) occurred in grade 1 hospitals and 1 (0.38%) occurred in a grade 2 hospital. Conclusions: Close attention to these predictors may aid officials in planning effective training programs and prevention measures. These predictors can also be used in the legislation of traffic laws and regulations and managerial plans of hospitals.