title: Fatal injuries among motorcyclists in Klang Valley, Malaysia.
abstract: BACKGROUND
  Motorcycle fatalities constitute the majority of road traffic deaths in Malaysia. The aims of this study were to describe the pattern of fatal injuries among Klang Valley fatal motorcyclists and to describe the factors associated with fatal (vs non-fatal) injuries.
  
  
  METHODS
  A cross-sectional analysis was performed on data from a case series of injured (fatal and non-fatal) motorcyclists recruited from Klang Valley between 14th March 2010 and 13th March 2011. Fatal cases in the cases series were identified from the Police files. Non-fatal cases were recruited from five major hospitals in the study region. Information used in the analyses were obtained from Police crash reports, hospital medical records, and Coroner's records of the participant sample.
  
  
  RESULTS
  Of the 177 fatal cases, 142 (80.2%) were categorised as instantaneous death while 35 (19.8%) cases were categorised as experiencing delayed death. Thirty two percent of the cases had a Maximum Abbreviated Injury Score (MAIS) of 5 with head injury being the most common cause of death. Significant predictors of fatal (vs non-fatal) injury included ethnic groups, monthly income, alcohol and drug use and road type. Alcohol and drug use was shown to be the strongest predictor with adjusted odds ratio (AOR) of 14.77 (95% CI 3.32-65.65).
  
  
  CONCLUSIONS
  Factors related to the motorcyclists, road user behaviour and the road environment as well as pre-hospitalisation emergency care must be addressed efficiently in low and middle income countries to reduce the number and severity of motorcycle-related injuries.
authors: Dept of Oral and Maxillofacial Surgery, Universiti Kebangsaan Malaysia Medical Centre, 56000 Jln Yaacob Latif, Kuala Lumpur, Malaysia; Monash University Accident Research Centre (MUARC), Monash University Sunway Campus, Jalan Lagoon Selatan, 46150 Bandar Sunway, Selangor Darul Ehsan, Malaysia. Electronic address: roszalina@ppukm.ukm.edu.my.
authors: Roszalina
authors: R
authors: Ramli
authors: Monash Injury Research Institute (MIRI), Building 70, Monash University, Victoria 3800, Australia. Electronic address: jennie.oxley@monash.edu.
authors: Jennifer
authors: J
authors: Oxley
authors: Dept of Pathology, Universiti Kebangsaan Malaysia Medical Centre, 56000 Jln Yaacob Latif, Kuala Lumpur, Malaysia.
authors: Faridah Mohd
authors: FM
authors: Noor
authors: National Institute of Forensic Medicine, Kuala Lumpur Hospital, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
authors: Nurul Kharmila
authors: NK
authors: Abdullah
authors: National Institute of Forensic Medicine, Kuala Lumpur Hospital, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
authors: Mohd Shah
authors: MS
authors: Mahmood
authors: Forensic Unit, Serdang Hospital, Jalan Puchong, 43000 Kajang, Selangor Darul Ehsan, Malaysia.
authors: Abdul Karim
authors: AK
authors: Tajuddin
authors: Monash Injury Research Institute (MIRI), Building 70, Monash University, Victoria 3800, Australia. Electronic address: rod.mcclure@monash.edu.
authors: Roderick
authors: R
authors: McClure
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality* / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006260:Head Protective Devices / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D015601:Injury Severity Score; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D009104:Multiple Trauma / Q000401:mortality; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000097:blood / Q000401:mortality / Q000652:urine; D014947:Wounds and Injuries / Q000401:mortality*; D055815:Young Adult
keywords: Fatal motorcycle crash; Injury; Klang Valley; Malaysia; Predictors of death