Factors affecting anatomical region of injury, severity, and mortality for road trauma in a high-income developing country: lessons for prevention.
OBJECTIVE
To study the factors affecting anatomical region of injury, severity, and mortality among road users in United Arab Emirates so as to improve preventive measures.


METHODS
Data of the Trauma Registry of Al Ain city were collected prospectively over 3 years (2003-2006) at the main trauma hospital. For traffic injuries, the following were assessed: gender, nationality, road user type, anatomical region(s) of injury, systolic blood pressure on admission, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), and mortality. Analysis included frequencies, cross-tabulations, and logistic regression.


RESULTS
There were 1070 patients, 89% male, 25% UAE nationals, and with a mean age of 31 years. Expatriates, mainly from non-Arabic speaking, low-income countries, accounted for 88% of injured pedestrians, whilst nationals were overrepresented among vehicle occupants (29%), and motorcyclists 37%. Injuries of the extremities and head were frequent among pedestrians, motorcyclists, and bicyclists, whilst head and spine injuries were most common among front and rear vehicle occupants and drivers. The median ISS was five for pedestrians and four for all other road user types, including rear vehicle occupants. The mean hospitalisation was 9.7 days; 13% of patients were admitted to ICU with mean stay of 6.5 days. Overall mortality was 4%; pedestrians accounted for 61% of deaths. Predictors of mortality were GCS (p<0.001), ISS (p<0.01) and systolic blood pressure on admission (p<0.03).


CONCLUSIONS
Head injury was a major factor affecting mortality, followed by injury severity and hypotension. To reduce injury incidence and severity, legislation and education are needed to ensure use of seat belts by all vehicle occupants including rear passengers, high-visibility devices by other road users, helmets by motorcyclists and bicyclists, protective clothing and boots for motorcyclists, and traffic engineering for pedestrians.
Eid
Hani O
HO
Department of Surgery, Faculty of Medicine & Health Sciences, UAE University, Al Ain, United Arab Emirates.
Barss
Peter
P
Adam
Shehabeldin H
SH
Torab
Fawaz Chikh
FC
Lunsjo
Karl
K
Grivna
Michal
M
Abu-Zidan
Fikri M
FM
D000063:Accidents, Traffic / Q000401:mortality* / Q000517:prevention & control / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001642:Bicycling / Q000293:injuries; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000453:epidemiology*; D003906:Developing Countries; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007022:Hypotension / Q000453:epidemiology; D015994:Incidence; D007182:Income; D007223:Infant; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018986:Motor Vehicles; D011446:Prospective Studies; D011482:Protective Devices / Q000706:statistics & numerical data; D012042:Registries; D014479:United Arab Emirates / Q000453:epidemiology; D016138:Walking / Q000293:injuries; D014947:Wounds and Injuries / Q000145:classification / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult