Trends in Road Traffic Deaths in Yazd, Iran, 2004 - 2010

Survival status and its predictors among adult victims of road traffic accident admitted to public hospitals of Bahir Bar City, Amhara regional state, Northwest, Ethiopia, 2023: multi center retrospective follow-up study

INTRODUCTION

Road traffic accident is the most common cause of death in adults worldwide. Road traffic accident-related deaths increased from time to time in low- and middle-income countries including Ethiopia; however, there is limited evidence about Survival status and its predictors among adult victims of road traffic accidents admitted to Hospitals in Ethiopia specifically in the study area. Thus, this study aimed to assess Survival status and its predictors among adult victims of road traffic accident admitted to Hospitals.

METHODS

An institutional-based retrospective follow-up study was conducted from July 01/2019 to June 30/2022. A total of 402 samples were chosen using simple random sampling. Data was collected by a prepared checklist from the victims' chart and entered into Epi-Data version 4.6 software and then exported to STATA version 14.1 for analysis. Kaplan-Meier failure function and log-rank test were computed. The assumption was checked by Schoenfeld residual test. All variables in bivariable analysis, p-value < 0.25 were entered into multivariable cox-regression model. Adjusted Hazard Ratio with 95% Confidence Interval was reported to declare the strength of association and statistical significance p-value of < 0.05. Model fitness was checked by using Cox-Snell residual. Data was presented by text, table, and graph.

RESULT

The median survival time was 504 h. From all, 63(15.6%) deaths, 57% of deaths occurred between 24 and 168 h of follow-up with an overall incidence of 15.34deaths per10, 000 victims-hours observation. According to the Kaplan-Meier failure curve together with the log-rank test, the incidence density rate of death among victims who had a complication during admission was71.86per10,000victims-hour observation (95%, CI:53.66-96.25), which is different from those who did not have complication 5.17per10,000person-hour observation (95%, CI:3.26-8.21). The incidence density rate of death among victims who had low level of arterial oxygen saturation (SPO2 < 95%) during admission was 82.87per10, 000 victims-hour observation (95%, CI: 63.15-108.75), which is different from those who had arterial oxygen saturation ≥ 95% 3.16per10, 000victims -hour observation (95%, CI: 1.75-5.71) Develop complication (AHR = 3.1,95% CI:1.44-6.70), systolic blood pressure measurement value ≤ 89 mmHg (AHR = 2.4,95% CI:1.10-5.19), not admitted intensive care unit (AHR = 0.46,95% CI:0.022-0.97), Glasgow Coma Scale score ≤ 8 (AHR = 2.9,95% CI:1.07-7.75), Glasgow Coma Scale score 9-12(AHR = 3.8,95% CI:1.61-8.97) and, level of arterial oxygen saturation ≤ 95% (AHR = 6.5,95% CI:2.38-17.64) were predictors of outcome variable.

CONCLUSION AND RECOMMENDATIONS

The median survival time was short. Complication, low systolic blood pressure measurement value, low Glasgow Coma Scale score, not admit to intensive care unit and low level of arterial oxygen saturation were significant predictors of the outcome variable. So that healthcare providers better give special attention and care to those victims admitted to Hospitals. A further prospective study is recommended.

Comparison the Ability of Quantitative Trauma Severity Assessment Methods Based On GAP, RTS, and ISS Criteria in Determining the Prognosis of Accidental Patients

Objective

To compare the ability of quantitative trauma severity assessment methods based on Glasgow coma scale, age, and arterial pressure (GAP), revised trauma score (RTS), and injury severity score (ISS) criteria in determining the prognosis of accidental patients.

Methods

This cross-sectional study was performed on random patients referred to Imam Khomeini Hospital in Urmia from March 20, 2020 to September 21, 2020. The data were obtained by using a checklist includes items such as age, sex, respiration rate, oxygen saturation level, pulse rate, primary blood pressure, initial Glascow coma scale (GCS), patient outcome and injury to different parts of body. After collecting the data, it was entered into SPSS 18 and analyzed with the descriptive and analytical statistics include an independent t-test and receiver operating characteristic curve (ROC) curves.

Results

Out of 1930 studied patients, 365 (18.9%) were women and 1565 (81.1%) were men. The mean age of patients was 37.05±17.11 years and women were significantly older than men. The mortality rate was 4.8% and was significantly more in men compared to women. The mean blood pressure, GCS and oxygen saturation level were lower in deceased patients. The mean GAP, ISS and RTS values were 23.13±2.69, 4.07±3.82, 7.72±0.52, respectively. The mean values of GAP and RTS were significantly low in deceased patients whereas the mean ISS value was significantly high in the deceased patients. The Area under the curve (AUS) for ISS was greater than the other two scoring systems.

Conclusion

The findings of the current study showed that all three systems were adequately efficient to prognoses the final outcome in multi-trauma patients but the ISS measure was better than the other two criteria.

Magnitude of death and associated factors among road traffic injury victims admitted to emergency outpatient departments of public and private hospitals at Adama Town, East Shewa Zone, Ethiopia

Objectives:

Road traffic injuries, disabilities, and deaths have been a major public health problem worldwide and in Ethiopia. Globally, around 1.35 million people die every year on the roads and 20–50 million sustain nonfatal injuries as a result of road traffic crashes. This study aimed to assess the magnitude of deaths and associated factors among road traffic injury victims admitted to emergency outpatient departments of public and private hospitals at Adama town, East Shewa Zone, Ethiopia.

Methods:

Institution-based cross-sectional study was conducted among 381 road traffic injury victims admitted to hospitals in Adama town, East Shewa, Ethiopia, from 14 December 2019 to 29 February 2020. Data were collected using interviewer-administered structured questionnaires. Data were entered into EpiData version 4.6.0.2 and analyzed using SPSS version 21. Bivariable and multivariable logistic regressions were fitted to identify variables significantly associated with road traffic injury–related deaths and the results were presented with adjusted odds ratios and 95% confidence interval. Statistical significance was declared at p-value < 0.05.

Results:

The magnitude of deaths among road traffic injury victims were 12.9%. Age (25–44 years) (adjusted odds ratio = 4.24, 95% confidence interval = 1.70–10.61), rural resident (adjusted odds ratio = 2.26, 95% confidence interval = 1.11–4.55), pedestrian (adjusted odds ratio = 3.72, 95% confidence interval = 1.67–7.99), night-time injury (adjusted odds ratio = 5.29, 95% confidence interval = 2.52–11.10), injuries on weekends (adjusted odds ratio = 2.32, 95% confidence interval = 1.12–4.80), not getting first aid at injury site (adjusted odds ratio = 2.64, 95% confidence interval = 1.02–6.84), and known comorbidity conditions (adjusted odds ratio = 3.01, 95% confidence interval = 1.23–7.38) were significantly associated with road traffic injuries–related deaths.

Conclusion:

A significant proportion of road traffic injuries resulted in death. Age, place of residence, pedestrians, night-time injury, and not getting first aid were associated with road traffic injuries–related deaths. Preventive strategies that focus on young adults, rural residents, pedestrians, and people with comorbidities would minimize road traffic injuries–related deaths. Moreover, strict supervision on weekend and night-time drives, and providing accessible lifesaving first aid services would have significant importance.

Years of life lost due to asthma in a population-based 10-year study in Yazd, Iran

INTRODUCTION

Asthma is a prevalent disease in both children and adults. Significant progress in the management of asthma and prevention of asthmatic attacks resulted in a reduction of asthma deaths, but there is a variation among different regions based on health-care access and environmental factors. We aimed to investigate the trend of asthma mortality during a 10-year period in Yazd Province, a region in the center of Iran.

METHODS

We obtained our data from the death registry of Yazd health center. This registry collects data from hospitals, clinics, forensic medicine department, and cemeteries. All deaths due to asthma from 2002 to 2011 were included in our study. We used the remaining life expectancy of each person at death and sex group to calculate the years of life lost (YLL) due to asthma.

RESULTS

Nearly 10,371 years of life was lost due to asthma in our study (M/F ratio of 1.29). Asthma mortality rate increased with age, rising sharply after age 50. Average YLL per death was 18.6 years. Asthma mortality rate decreased from 6.66/100,000 in 2002 to 3.97 in 2011. YLL from asthma among men decreased from 796 in 2002 to 338 in 2011, but among women, it showed an increase from 335 to 534 at the same time.

CONCLUSION

The trend of reduction in asthma mortality is not similar between different age and gender groups. Further studies are needed to determine the cause of increasing trend among more vulnerable groups.

Assessment and prediction of road accident injuries trend using time-series models in Kurdistan

Background

Road traffic accidents are commonly encountered incidents that can cause high-intensity injuries to the victims and have direct impacts on the members of the society. Iran has one of the highest incident rates of road traffic accidents. The objective of this study was to model the patterns of road traffic accidents leading to injury in Kurdistan province, Iran.

Methods

A time-series analysis was conducted to characterize and predict the frequency of road traffic accidents that lead to injury in Kurdistan province. The injuries were categorized into three separate groups which were related to the car occupants, motorcyclists and pedestrian road traffic accident injuries. The Box-Jenkins time-series analysis was used to model the injury observations applying autoregressive integrated moving average (ARIMA) and seasonal autoregressive integrated moving average (SARIMA) from March 2009 to February 2015 and to predict the accidents up to 24 months later (February 2017). The analysis was carried out using R-3.4.2 statistical software package.

Results

A total of 5199 pedestrians, 9015 motorcyclists, and 28,906 car occupants' accidents were observed. The mean (SD) number of car occupant, motorcyclist and pedestrian accident injuries observed were 401.01 (SD 32.78), 123.70 (SD 30.18) and 71.19 (SD 17.92) per year, respectively. The best models for the pattern of car occupant, motorcyclist, and pedestrian injuries were the ARIMA (1, 0, 0), SARIMA (1, 0, 2) (1, 0, 0)₁₂, and SARIMA (1, 1, 1) (0, 0, 1)₁₂, respectively. The motorcyclist and pedestrian injuries showed a seasonal pattern and the peak was during summer (August). The minimum frequency for the motorcyclist and pedestrian injuries were observed during the late autumn and early winter (December and January).

Conclusion

Our findings revealed that the observed motorcyclist and pedestrian injuries had a seasonal pattern that was explained by air temperature changes overtime. These findings call the need for close monitoring of the accidents during the high-risk periods in order to control and decrease the rate of the injuries.

Road traffic deaths in Kashan region, Iran: An eight-year study (2006-2013)

PURPOSE

The aim of this study was to analyze the trend of road traffic fatalities in Kashan Region, Iran, in a period of eight years.

METHODS

Through a cross-sectional study, all road traffic deaths classified under the V01V99 codes according to ICD-10 in Kashan region, central Iran, from March 2006 to March 2013 and population data were collected from the registration system of Kashan University of Medical Sciences. Years of lost life (YLL) and mortality rates were calculated regarding age, gender and year of the accident. Generalized linear model (GLM) with Poisson log-linear link was used to evaluate the effects of the mentioned variables on mortality rate.

RESULTS

During the period of the study (8 years), 928 people (767 men) died due to road traffic injuries (RTIs). The total YLL was 20,818. The mortality rate due to RTIs has been declined constantly from 43.1 in March 2006 to 21.1 per 100,000 in March 2013. The highest mortality rate was found in the age group of over 60 years old and the lowest in the age group of 0-14 years old. Both mortality rate and YLL was greater in men than in women. Poisson regression showed that age, gender and year of the accidents had a significant effect on mortality rate (p < 0.001).

CONCLUSION

Although there has been a constant decline of mortality rate in Kashan area within the study period, the value remains higher than the mean level of Eastern Mediterranean region and the global average, which is a notable fact for policymakers and authorities.