Clinical profile and outcome of road traffic accidents among adult patients treated at urban government hospitals in Ethiopia

Abstract

Background Around 1.19 million people per year die as a result of traffic collisions worldwide. Road traffic injuries (RTI) are on the decline in industrialized nations but rising in many low and middle income countries, including Ethiopia. However, there is a lack of evidence regarding the clinical profile and outcome of RTI in Ethiopia. This study assessed the clinical profile, emergency department (ED) visit outcome, and factors associated with ED mortality of RTI victims treated at five selected government hospitals in Addis Ababa. Methods An institutional-based prospective cross-sectional study was conducted by interviewing RTI victims and attendants as well as reviewing their charts in July 2023. Systematic random sampling was employed to select 247 samples. The primary outcome measure was ED mortality. Secondary outcome measures included other ED treatment outcomes (treated and discharged, hospital admission, ICU admission, and referral). Result A total of 224 RTI victims were included in this study. The male-to-female ratio was 2.07:1, with the 24–33 age group predominantly affected by trauma. Ambulance was the predominant mode of arrival to the hospital (89.7%). Mostly pedestrians were affected, 161 (71.9%). Although the largest group of injured patients (94, 42.0%) were treated and immediately discharged from the ED, a significant number (45, 20.1%) required intensive care unit admission. ED RTI mortality rate was 1.8%. Delayed arrival ( p = 0.02), lack of pre-hospital care ( p = 0.01), and poly-trauma ( p = 0.02) were associated with increased ED death. Conclusion This study revealed that RTIs primarily affect young, economically engaged men and pedestrians. The overall mortality in the ED was low. Delayed arrival (1–24 h), lack of pre-hospital care, and poly-trauma were associated with increased ED death. Various interventions are suggested from improving prehospital emergency care, to improving tertiary hospital trauma care, as well as prevention strategies including promoting public awareness of RTI dangers.