Impact of road traffic accidents on the elderly

Understanding key contributing factors on the severity of traffic violations by elderly drivers: a hybrid approach of latent class analysis and XGBoost based SHAP

Traffic violation is one of the leading causes of traffic crashes. In the context of global aging, it is important to study traffic violations by elderly drivers for improving traffic safety in preparation for a worldwide aging population. In this study, a hybrid approach of Latent Class Analysis (LCA) and XGBoost based SHAP is proposed to identify hidden clusters and to understand the key contributing factors on the severity of traffic violations by elderly drivers, based on the police-reported traffic violation dataset of Beijing (China). First, LCA is applied to segment the dataset into several latent homogeneous clusters, then XGBoost based SHAP is established on each cluster to identify feature contributions and the interaction effects of the key contributing factors on the severity of traffic violations by elderly drivers. Two comparison groups were set up to analyze factors, which are responsible for the different severities of traffic violations. The results show that elderly drivers can be classified into four groups by age, urban or not, license, and season; factors such as less annual number of traffic violations, national & provincial highway, night and winter are key contributing factors for higher severity of traffic violations, which are consistent with common cognition; key contributing factors for all clusters are similar but not identical, for example, more annual number of traffic violations contribute to more severe violation for all clusters except for Cluster 2; some factors which are not key contributing factors may affect the severity of traffic violations when they are combined with other factors, for example, the combination of lower annual number of traffic violations and county & township highway contributes to more severe violation for Cluster 1. These findings can help government to formulate targeted countermeasures to decrease the severity of traffic violations by specific elderly groups and improve road service for the driving population.

Are There Any Differences in Road Traffic Injury Outcomes between Older and Younger Adults? Setting the Grounds for Posttraumatic Senior Personal Injury Assessment Guidelines

Injury outcomes seem to be more severe in older than younger persons. This may make personal injury assessment (PIA) particularly difficult, mainly because of seniors’ previous health frailties. To set the grounds for seniors’ PIA guidelines, we compared an older with a younger adult population of trauma victims and, secondarily, identified differences between the groups regarding three-dimensional and medico-legal damage parameters assessment. Using a retrospective study of victims of road traffic accidents, we compared the groups (n = 239 each), assuring similar acute injury severity (ISS standardised difference = 0.01): G1 (older adults); G2 (younger adults). Logistic regression was used to estimate the odds ratio. G1 revealed higher negative consequences when considering the three-dimensional damage assessment, with more frequent and severe outcomes, being a cause of further difficulties in daily living activities, with a loss of independence and autonomy. Nevertheless, regarding the medico-legal damage parameters, permanent functional disability did not show significant differences. This study generates evidence that reveals the need to rethink the traditional methodology of PIA in older persons, giving more relevance to the real-life contexts of each person. It is essential to: obtain complete information about previous physiologic and health states, begin the medico-legal assessment as early as possible, make regular follow-ups, and perform a multidisciplinary evaluation.

Factors associated with EMS on-scene time and its regional difference in road traffic injuries: a population-based observational study

Background

The outcome of road traffic injury (RTI) is determined by duration of prehospital time, patient’s demographics, and the type of injury and its mechanism. During the emergency medical service (EMS) prehospital time interval, on-scene time should be minimized for early treatment. This study aimed to examine the factors influencing on-scene EMS time among RTI patients.

Methods

We evaluated 19,141 cases of traffic trauma recorded between April 2014 and March 2020 in the EMS database of the Nara Wide Area Fire Department and the prehospital database of the emergency Medical Alliance for Total Coordination of Healthcare (e-MATCH). To examine the association of the number of EMS phone calls until hospital acceptance, age ≥65 years, high-risk injury, vital signs, holiday, and nighttime (0:00–8:00) with on-scene time, a generalized linear mixed model with random effects for four study regions was conducted.

Results

EMS phone calls were the biggest factor, accounting for 5.69 minutes per call, and high-risk injury accounted for an additional 2.78 minutes. Holiday, nighttime, and age ≥65 years were also associated with increased on-scene time, but there were no significant vital sign variables for on-scene time, except for the level of consciousness. Regional differences were also noted based on random effects, with a maximum difference of 2 minutes among regions.

Conclusions

The number of EMS phone calls until hospital acceptance was the most significant influencing factor in reducing on-scene time, and high-risk injury accounted for up to an additional 2.78 minutes. Considering these factors, including regional differences, can help improve the regional EMS policies and outcomes of RTI patients.

Major trauma associated with mobility scooters: An analysis of the trauma audit research network

AIMS

To establish the incidence and nature of injuries seen in patients following mobility scooter incidents.

METHODS

The Trauma Audit and Research Network (TARN) database was used to collect data concerning injuries associated with mobility scooters. The data was taken from incidents that occurred between February 2014 and November 2020. The data analysed included: patient demographics, injury mechanism and patterns and associated mortality rates.

RESULTS

1,504 patients were identified of which 61.4% were male. The median age was 76.2 years (IQR 63.5-84.9). The median injury severity score (ISS) was 9 (IQR 9-17), with major trauma (ISS ≥16) being observed in 29.4% of patients. Injuries to the limb were most common, although injuries to the head were most severe. Vehicle collisions accounted for 65.4% of injuries and were most closely associated with the most severe incidents. The median length of stay in hospital was 12 days, excluding the patients who died. Overall, mortality following injury was 10.6%, but the mortality rate was 15.4% in those aged 75 years and over, and 24.2% in those sustaining severe trauma.

CONCLUSION

As the population ages, injury characteristics of those with both major and non-major trauma changes. Mobility scooter use is prevalent amongst older people, and we provided a detailed analysis of injuries sustained with their use across a national database. The length of stay and the inherent resource use, because of admission following mobility scooter trauma, is considerable. These injuries particularly affect the 'most elderly' and carry a considerable mortality burden.

Exploring the determinants of older adults' susceptibility to pedestrians' incidents

Older pedestrians (65 years and above) are among the most vulnerable road users. As the number and proportion of older adults grows in many countries, and awareness of the benefits of active travel becomes increasingly evident, it behooves researchers to further investigate the safety of older pedestrians. This study contributes to the literature by examining the factors that influence older adults' susceptibility to pedestrian incidents (falls incidents and pedestrian-vehicle collisions). To this end, a sample of older adults living in the Greater Golden Horseshoe, South Ontario, Canada was surveyed. The data were analyzed using descriptive statistics, Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM), to identify several latent factors that are significantly associated with older adults' involvement in pedestrian incidents. The results revealed that the factors that affect older adults' susceptibility to pedestrian incidents are level of difficulty while walking, fear of falling, and crossing evaluation capability. In contrast, level of pedestrian confidence and level of risk-taking crossing behavior are not among the significant factors. It was also found that older pedestrians aged 65-75 years, males, and those who are still working had a greater probability to be involved in pedestrian incidents. These findings shed light on some key constraints of older pedestrians, and the extent to which each factor could improve their safety. This information, in turn, can be used by transportation authorities in prioritizing their plans, policies, and programs towards improving the safety and mobility of older pedestrians.

Determinant contributing variables to severity levels of pedestrian crossed the road crashes in three cities in Indonesia

OBJECTIVE

The study has two objectives: (1) to determine the factors on severity levels of pedestrian crossed the road crashes in three cities in Indonesia, (2) to suggest countermeasures at the most crash-prone areas in each city.

METHODS

Study areas are chosen based on the highest pedestrian fatality rate in Central Java Province. The determinant severity levels are based on 19 variables categorized into the pedestrian, road, environment, vehicle, and drivers' characteristics. The crash data was collected from Indonesia Traffic Corps' (Korlantas) database and site visits to all crash locations. The data was processed using the Ordered Probit Model (OPM) Method to find the contributing variables to determine Pedestrian Crossing Road crash severity level.

RESULTS

The significant variables are different in each city; Tegal is Crash location (0.296) and Type of Vehicle (0.176), Salatiga are Pedestrian age (0.484) and type of vehicle (0.472), Magelang are Road hierarchy (-0.582) and Driving license ownership (-0.262).

CONCLUSIONS

Each city has unique variables to determine the severity level. Therefore, treatments and countermeasures must be specific to each city based on study findings.

Assessment pedestrian crossing safety using vehicle-pedestrian interaction data through two different approaches: Fixed videography (FV) vs In-Motion Videography (IMV)

A significant portion of pedestrian accidents occurs in the outskirts areas due to the high vehicle speed and lack of safety facilities for pedestrians. Behavioral study on drivers and pedestrians is the key to better understand the causes of pedestrian accidents in order to develop safety models. Despite numerous studies on pedestrian safety based on various roads, outskirt areas have not been considered. Hence, the present study focuses on evaluating the safety of pedestrian crossing in urban and outskirt areas and to determine the differences of drivers and pedestrians' behaviors between these areas through data based on fixed videography (FV) and in-motion videography (IMV). These approaches may lead to an exact analysis of the behavioral differences of road users behaviors from the perspective of pedestrians (FV data) and drivers (IMV data) in urban and outskirts roads. Accordingly, behavioral studies were conducted at urban and outskirts sites through FV as well as IMV using the behavior of 29 participants in the same roads in Babol city, Iran. The gap acceptance model using linear regression and pedestrian crossing probability model using logistic regression for both approaches showed similarity on results in both urban and outskirts roads. Furthermore, behaviors of pedestrians crossing and drivers' yielding on urban and outskirts roads were very similar. Vehicle speed, the distance of vehicle to pedestrian at the possible collision point, size of pedestrian groups, and waiting time before crossing were the most important behavioral differences of pedestrian for choosing a gap acceptance and probability of crossing on various sites through two different approaches. The inference of the models obtained in this study will lead to a better understanding of the behavior of road users for studies on advanced driving assistance systems (ADAS).

A comparison between Artificial Neural Network and Hybrid Intelligent Genetic Algorithm in predicting the severity of fixed object crashes among elderly drivers

Run-off-road (ROR) crashes have always been a major concern as this type of crash is usually associated with a considerable number of serious injury and fatal crashes. A substantial portion of ROR fatalities occur in collisions with fixed objects at the roadside. Thus, this study seeks to investigate the severity of ROR crashes where elderly drivers, aged 65 years or more, hit a fixed object. The reason why the present study investigates this issue among older drivers is that, comparing to younger drivers, this age group of drivers have different psychological and physical features. Because of these differences, they are more likely to get injured in ROR types of crashes. This paper applies two types of Artificial Intelligence (AI) techniques, including hybrid Intelligent Genetic Algorithm and Artificial Neural Network (ANN) using the crashe information of California in 2012 obtained from Highway Safety Information System (HSIS) database. Although the results showed that the developed ANN outperformed the hybrid Intelligent Genetic Algorithm, the hybrid approach was more capable of predicting high-severity crashes. This is rooted in the way the hybrid model was trained by taking advantage of the Genetic Algorithm (GA). The results also indicated that the light condition has been the most significant parameter in evaluating the level of severity associated with fixed object crashes among elderly drivers, which is followed by the existence of the right and left shoulders. Following these three contributing factors, cause of collision, Average Annual Daily Traffic (AADT), number of involved vehicles, age, road surface condition, and gender have been identified as the most important variables in the developed ANN, respectively. This helps to identify gaps and improve public safety towards improving the overall highway safety situation of older drivers.

Spatial analysis of traffic accidents involving older adults in a city in the northeast of Brazil

Abstract Objective: to describe the epidemiological characteristics of traffic accidents involving older victims, responded to by the Mobile Emergency Service (or SAMU), and to analyze the spatial distribution of these events in the city of Olinda, Pernambuco, Brazil, from 2015 to 2018. Method: a composite cross-sectional study was performed, using SAMU service records as a data source. Descriptive statistics were applied, based on frequency distribution. For the mapping and detection of spatial clusters, the Kernel intensity estimator was used. Results: SAMU responded to 137 traffic accidents with older victims. The most affected age group were older adults aged 60 to 69 years (81; 59.1%), and there was a predominance of male victims (90; 65.7%). The day of the week when most accidents occurred was Wednesday (29; 21.25%), and the highest number of accidents occurred in the morning (46; 33.6%). As for the nature of the accident, accidents involving pedestrians (80; 58.4) predominated over collisions (57; 41.6%). The Kernel intensity estimator identified a significant focus in the Peixinhos neighborhood, with other foci distributed throughout the coastal area. Conclusion: the study identified the characteristics of older victims of traffic accidents and areas of greatest risk for their occurrence in the city studied. This information can be useful when planning environmental engineering measures to be carried out in the regions identified, in order to reduce the frequency of accidents and injuries.

Road traffic accidents involving elderly people: an integrative review

Abstract Objective: To identify the epidemiological and socio-demographic profile of elderly victims of traffic accidents reported in articles published in scientific literature from 2013 to 2018. Method: The Literatura Latino Americana em Ciências da Saúde (Latin American Literature in Health Sciences), Base de Dados de Enfermagem (Database in Nursing), Scientific Electronic Library Online, and Medical Literature Analysis and Retrieval System Online databases were used, with the guiding question being: What is the scientific production on traffic accidents involving elderly people? A total of 355 articles were found. After the application of the selection criteria, 16 were evaluated, and nine remained for final analysis. Results: The age range was 60 to 69 years and the majority of the sample were men, who were married and had low schooling. Being run over was the most frequent accident. The width of the traffic lanes and the time of the accident influenced the frequency and risk of accidents and the severity of the injuries. Conclusion: Younger elderly persons were the most affected, and being run over was the most frequent type of accident.

Epidemiology of Road Traffic Injuries among Elderly People; A Systematic Review and Meta-Analysis

Objective:

To systematically review the epidemiological patterns and interventions for prevention of road traffic injuries (RTIs) among elderly.

Methods:

Searching keywords including: accident, trauma, road injury, road traffic injuries, aging, old, elder, strategy, intervention, road traffic crash prevention and traffic accident in databases including, Google scholar, SID, IranMedex, PubMed and Scopus. English and non-Persian articles, articles presented in congresses, articles that considered elderly people to have age under than 60 years were excluded. The reporting quality of articles was assessed by two experts using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) check list.

Results:

RTIs compromised 23.6% of total injuries among elderly. The most frequent injuries were about car accidents (51.4%). Pedestrian injuries composed 48.1% of the RTIs. Head and neck (32.1%) were most injured body parts. There was a significant difference between elderly and non-elderly people in terms of RTIs associated mortality (Odd=2.57 [1.2-5.4 CI 95%]). Overall 25 main domains of intervention and 73 subordinate domains were extracted in five categories (human, road and environment, tools and cars, medical, legal and political issues).

Conclusion:

According to the notable prevalence and fatality of RTIs, lack of sufficient studies and valid evidence of the present study can provide an appropriate evidence for better interventions for RTIs prevention among elderly.

Epidemiologic Aspects of Overall Injuries in Hamadan Province; A Six-Year Registry-Based Analysis

Objective:

To investigate the epidemiological aspects of all-cause injuries in Hamadan province during a 6-year period.

Methods:

We conducted a cross-sectional study on injured subjects admitted to private or governmental hospitals in Hamadan province during March 2009 to March 2015. The epidemiological characteristics were retrieved from a registry-based system including gender, residency, injury mechanism and date of injury occurrence, outcome of hospitalization (full recovery/disability/death).

Results:

Totally, 135,925 hospitalized injured cases were recorded. The majority of cases were male (72.6%) and were occurred in urban areas (60%), about 40% of patients were in 20-34 years’ age group, and the highest proportion (30.13%) of injuries occurred in summer. Logistic regression showed that the odds of disability vs. recovery was significantly higher in rural areas [Adjusted odds ratio (AOR) =3.42] and the odds of death vs. recovery was higher among male gender (AOR=1.46). In addition, comparing to the 0-4-year age-group, odds of death were significantly higher in middle aged and elderly victims.  

Conclusion:

Our findings showed that middle age groups, male gender and urban area increase the odds of death. Injured males and old age subjects had the highest odds of death and out of residential area injuries were common cause of leading death injuries.

Epidemiology of Pedestrian-Motor Vehicle Fatalities and Injuries, 2006-2015

INTRODUCTION

Pedestrian road safety remains a public health priority. The objective of this study is to describe trends in fatalities and injuries after pedestrian-motor vehicle collisions in the U.S. and identify associated risk factors for pedestrian fatalities.

METHODS

This is a cross-sectional study of U.S. pedestrian-motor vehicle collisions from 2006 to 2015 (performed in 2017). Pedestrian fatality and injury data were obtained from the National Highway Traffic Safety Administration's Fatality Analysis Reporting System and National Automotive Sampling System General Estimates System. Frequencies of fatalities, injuries, and associated characteristics were calculated. Multivariable logistic regression was performed for risk of fatality, controlling for demographic and crash-related factors.

RESULTS

There were 47,789 pedestrian fatalities and 674,414 injuries during the 10-year study period. Fatality rates were highest among the elderly aged 85 years and older (2.95/100,000 population), whereas injury rates were highest for those aged 15-19 years (35.23/100,000 population). Predictors associated with increased risk for death include the following: male sex (AOR=1.36, 95% CI=1.15, 1.62), age ≥65 years (AOR=3.44, 95% CI=2.62, 4.50), alcohol involvement (AOR=2.63, 95% CI=1.88, 3.67), collisions after midnight (AOR=5.21, 95% CI=3.20, 8.49), at non-intersections (AOR=2.76, 95% CI=2.21, 3.45), and involving trucks (AOR=2.15, 95% CI=1.16, 3.97) and buses (AOR=5.82, 95% CI=3.67, 9.21).

CONCLUSIONS

Potentially modifiable factors are associated with increased risk of death after pedestrian-motor vehicle collisions. Interventions including elder-friendly intersections and increasing visibility of pedestrians may aid in decreasing pedestrian injuries and deaths.

Community activities predict disability and mortality in community-dwelling older adults

AIM

With aging, it is important to maintain older community dwellers' regular engagement with familiar community activities (CA) engaged in close to home to protect them from frailty. Thus, the present study aimed to examine whether CA items or CA score were associated with mortality or the need for care under the new long-term care insurance service requirements over 3 years among community-dwelling older Japanese adults.

METHODS

We analyzed cohort data for older adults from a prospective cohort study in Kami town, Japan. The response rate to the self-reported questionnaire was 94.3% (n = 5094), and we followed these participants for 3 years. Our final sample comprised 5076 older adults. Missing data were filled in using multiple imputation. We used seven items to assess CA: (i) volunteer activity; (ii) regional activity related to the neighborhood; (iii) visiting friends; (iv) hobbies or favorite lessons; (v) earning an income; (vi) farm work and growing vegetables; and (vii) shopping daily by oneself. The Kihon Checklist and new long-term care insurance service certifications were used as the frailty screening and disability indices, respectively.

RESULTS

During the follow-up survey, 705 participants obtained new long-term care insurance service certifications and 262 died. Using the receiver operating characteristic curve, the desirable cut-off of the CA score to predict disability and mortality was at least two items for all elderly age groups in rural areas.

CONCLUSIONS

CA items and CA score could predict disability and mortality in community-dwelling older adults in Japanese rural areas. Therefore, it is recommended that older adults from all age groups participate in CA. Geriatr Gerontol Int 2018; 18: 1114-1124.

A decade of road traffic fatalities among the elderly in north-West Iran

Background

Iran has a uniquely catastrophic status for road traffic injury incidence and fatality. The elderly account for a substantial number of the hospitalizations and fatalities due to traffic injuries. The aim of this study was to investigate the crash mechanisms and medical outcomes of traffic fatalities among the elderly in East Azerbaijan province of Iran during the period 2006–2016.

Methods

A total of 9435 fatalities registered in East Azerbaijan forensic medicine database, Iran, during 2006–2016, were investigated. Of these, 1357 were elderly persons (age > 65). Both victim- and crash-related variables were compared for the elderly and other age groups. Bivariate and multivariate analysis methods were applied using Stata statistical software package version 13.

Results

Of the 9435 fatalities, 1357 victims (14.4%) were elderly persons. The mean age of the elderly traffic fatalities was 75.3(SD = 6.2) years. About 78% of the elderly versus 80% of those in other age groups were males. A decreasing trend of fatal traffic accidents was observed over the study period both for the elderly and other age groups. The elderly were nearly seven times more likely to die as a pedestrian compared to other age groups. By exclusively analyzing pedestrians, it was found that motorcycles were responsible for pedestrian deaths in 9.1% of the fatalities while this figure was 5.5% for pedestrians in other age groups killed in a traffic accident (P < 0.05). About 56% (N = 761) of the elderly died in hospital which was higher than the proportion for other age groups (39%). Ambulance was the main vehicle for transferring the injured victims in four-fifths of the cases both for the elderly and other age groups. Although, in the present study, head injuries were the most common type of injury regardless of the age group, the elderly had a lower percentage of head injuries and a higher percentage of injuries to the torso, pelvis and limbs compared to younger victims.

Conclusions

Pedestrian inner-city crashes in East Azerbaijan province of Iran are a major cause of road injury fatalities among the elderly and should be considered as a priority in road safety interventions.

Road Crashes in Older Persons and the Use of Comorbidity Polypharmacy Score in an Asian Population

Introduction: Age-related physiological changes predispose older road users to higher mortality from traffic crashes. We aimed to describe the injury epidemiology of these patients, and explore the association between the comorbidity polypharmacy score (CPS) and outcomes. Materials and Methods: This retrospective study utilised data from the Trauma Registry in the National University Hospital, Singapore, between January 2011 and December 2014. Patients involved in traffic crashes aged 45 years and above with injury severity scores (ISS) of 9 and higher were included. Results: There were 432 patients; median age was 58 (interquartile range, 51 to 65.5) years with predominance of male patients (82.2%) and Chinese ethnicity (66%). Overall mortality was 9.95%, with lower odds associated with higher Glasgow Coma Scale (odds ratio [OR] 0.73; 95% confidence interval [CI], 0.65 to 0.81, P <0.001), higher diastolic blood pressure (OR 0.98; 95% CI, 0.97 to 1.00, P = 0.031), and lower ISS of 9 to 15 (OR 0.10; 95% CI, 0.02 to 0.43, P = 0.002). The need for blood products was associated with higher mortality (OR 7.62; 95% CI, 2.67 to 21.7, P <0.001). CPS did not predict mortality. Independent predictors of discharge venue included length of stay, tier of injury and CPS group. Moderate CPS was statistically significant for nursing home placement (OR 10.7; 95% CI, 2.33 to 49.6, P = 0.002) but not for rehabilitation facility. Conclusion: CPS score is useful in predicting discharge to a nursing home facility for older patients with traffic crashes. Further larger studies involving other trauma types in the Asian population are needed to evaluate its utility. Key words: Elderly, Motor vehicle crashes, Trauma severity indices

Global burden of road traffic accidents in older adults: A systematic review and meta-regression analysis

PURPOSE OF THE STUDY

This study aims to estimate the burden of road traffic accidents and death among older adults.

DESIGN AND METHODS

A systematic literature review was conducted on 10 electronic databases for articles describing Road Traffic Accident(RTA) mortality in older adults until September 2016. A random-effects meta-regression analyses was conducted to estimate the pooled rates of road traffic accidents and death.

RESULTS

A total 5018 studies were identified and 23 studies were included. Most of the reported older adults were aged between 60 and 74 years, with majority being male gender and sustained minor trauma due to Motor-Vehicle Collision (MVC). The overall pooled mortality rate was 14% (95% Confidence Interval, CI: 11%, 16%), with higher mortality rates in studies conducted in North America (15%, 95% CI: 12%, 18%) and older adults admitted to trauma centers (17%, 95% CI: 14%, 21%). Secondary analysis showed that the very elderly adults (aged >75years) and pedestrians had higher odds of mortality death (Odds Ratio, OR: 2.05, 95% CI: 1.25, 3.38; OR: 2.08, 95% CI: 1.63, 2.66, respectively).

IMPLICATION

A new comprehensive trauma management guidelines tailored to older adults should be established in low and middle-income countries where such guidelines are still lacking.

Epidemiological Patterns of Road Traffic Crashes During the Last Two Decades in Iran: A Review of the Literature from 1996 to 2014

Context

Despite considerable attention given to health statistics of road traffic crashes (RTCs), the epidemiological aspects of injuries resulting from RTCs are not fully understood in Iran and other developing countries. The aim of this review was to study the epidemiological pattern and issues arising due to RTCs in Iran.

Evidence Acquisition

The scope of this study involves data from a broad range of published literature on RTCs in Iran. Data collection for this study was conducted by searching for keywords such as traffic accidents, traffic crashes, motorcycle accidents, motorcycle crashes, motorcycle injury, motor vehicle injury, motor vehicle crashes and motor vehicle accidents, Iran and Iranian in various databases such as Embase, PubMed, Google Scholar, Scopus, Magiran, Iranian scientific information database (SID) and IranMedex.

Results

This study comprised of 95 articles. It is evident from this review that a large number of severe RTCs occur due to collision of two or more vehicles and most of the victims are males aged between 30 and 39 years. Male pedestrian, drivers and passengers are more likely to be severely injured in comparison to females. One of the most prevalent causes of death among adults involved in the RTCs are head injuries and the majority of deaths occur prior to hospitalization. Mortality rates for RTCs are higher in summer, especially during midnight among all age groups. The most common individual and environmental risk factors associated with RTCs include lack of attention, getting trapped in the car, listening to music, fatigue and sleepiness, duration and distance and negligence of seatbelt usage while driving.

Conclusions

The findings of the current study will be beneficial in prevention of RTCs and its associated complications and hence will be vital for policy makers, health service managers and stakeholders.