Do deaths from road traffic injuries follow a classical trimodal pattern in North West Ethiopia? A hospital-based prospective cohort study.

Autor:	Denu ZA; Department of Anaesthesia, University of Gondar, Gondar, Ethiopia zewditudenuabdissa@gmail.com., Yassin MO; Department of Surgery, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia., Azale T; Department of Health Promotion and Behavioral Sciences, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia., Biks GA; Department of Health Policy and Management, Institute of Public health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia., Gelaye KA; Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2021 Dec 20; Vol. 11 (12), pp. e051017. Date of Electronic Publication: 2021 Dec 20.
DOI:	10.1136/bmjopen-2021-051017
Abstrakt:	Objective: The objective of this study was to identify timing distribution and predictors of deaths following road traffic injuries among all age groups at Gondar Comprehensive specialised hospital. Design: A single-centre prospective cohort study. Setting: The study hospital is a tertiary hospital in North West Ethiopia. Participants: We enrolled 454 participants who sustained road traffic injuries in to the current study. All age groups and injury severity were included except those who arrived dead, had no attendant and when the injury time was unknown. Primary and Secondary Outcome Measures: The primary outcome was time to death measured in hours from injury time up to the 30th day of the injuries. Secondary outcomes were prehospital first aid, length of hospital stay and hospital arrival time. The article has been registered, with a unique identification number of research registry 6556. Results: A total of 454 victims were followed for 275 534 person hours. There were 80 deaths with an overall incidence of 2.90 deaths per 10 000 person hours of observation (95% CI 2.77 to 3.03). The significant predictors of time to death were being a driver (AHR=2.26; 95% CI 1.09 to 4.65, AR=14.8), accident at interurban roads ((AHR (Adjusted HAzard Ratio=1.98; 95% CI 1.02 to 3.82, AR (Attributable Risk)=21%)), time from injury to hospital arrival (AHR=0.41; 95% CI 0.16 to 0.63; AR=3%), systolic blood pressure on admission of <90 mm Hg (AHR=3.66; 95% CI 2.14 to 6.26; AR=57%), Glasgow Coma Scale of <8 (AHR=7.39; 95% CI 3.0819 to 17.74464; AR=75.7%), head injury with polytrauma (AHR=2.32 (1.12774 4.79; AR=37%) and interaction of distance from hospital with prehospital care. Conclusion: Though the maturation of trauma centres in many developed countries has changed the temporal pattern of deaths following any trauma, our study demonstrated that trauma deaths follow the traditional trimodal pattern. That implies that potentially preventable causes of death continued in low-resource countries. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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