Analysis of road traffic injuries and length of stay at the emergency department among patients in a trauma hospital in Ethiopia

Abstract

Background: Road traffic injuries (RTIs) are a leading cause of mortality in low and middle-income countries. The study aimed to assess the magnitude of RTIs, determine the length of stay (LoS) for RTI patients and identify factors associated with prolonged LoS. Methods: A retrospective study was conducted at the Addis Ababa Burn, Emergency and Trauma Hospital in Addis Ababa, Ethiopia. Data were extracted from medical records for the period between 1 April 2021 and 30 March 2022, using a structured data collection form. Descriptive statistics were used to summarize patient and injury characteristics, and Poisson regression model with robust variance was applied to identify factors associated with prolonged LoS in the emergency department (ED). Results: Over the 1 year, 2693 RTI patient records were reviewed, accounting for 38.5% (95% CI 37.4% to 39.7%) of all injury cases. Of these, 2661 patients' data were included in the analysis. The majority of patients were male (n=1932, 72.6%) and 1031 (38.7%) were aged 18-29 years. The most frequently affected body region was the head (n=966, 36.3%), and fracture was the most common injury (n=991, 37.2%). Overall, 59 (2.2%) patients died, and 780 (29.0%; 95% CI 27.6 to 31.0) experienced a LoS exceeding 24 hours. The identified factors associated with prolonged LoS included: residence outside Addis Ababa (adjusted prevalence ratio (APR)=1.41; 95% CI (1.24 to 1.60)), being in the age group of 18-29 years (APR=0.78; 95% CI (0.63 to 0.95), neck injuries (APR: 1.75; 95% CI 1.17 to 2.65), trunk injuries (APR: 1.43; 95% CI 1.09 to 1.89) and outcome of fractures (APR: 4.34; 95% CI 2.66 to 7.00); and contusions and crushing injuries (APR: 3.81; 95% CI 2.33 to 6.21). Conclusions: The magnitude of RTI was substantially high compared with previous studies in Ethiopia. One-third of RTI patients' LoS in the ED exceeded the country's health system standard. The study highlights the need for enhanced road safety and healthcare resource allocation to manage RTIs effectively. Level of evidence: III.