Major traumatic pedestrian injury in Australia: Characteristics and in-hospital outcomes from the Australia New Zealand Trauma Registry.

BACKGROUND: The leading global cause of death for people aged 5-29 years is road traffic injury, a quarter of which is borne by pedestrians. The epidemiology of major hospitalised pedestrian injury across Australia is not reported. This study aims to address this gap using data from the Australia New Zealand Trauma Registry. METHODS: The registry hosts information on patients admitted to 25 major trauma centres across Australia who sustain a major injury (ISS > 12) or die following injury. Patients were included if they were injured due to pedestrian injury from 1st July 2015-30 th June 2019. Analysis included patient and injury characteristics, injury patterns and in-hospital outcomes. Primary endpoints included risk-adjusted mortality and length of stay. RESULTS: There were 2159 injured pedestrians; of these, 327 died. Young adults (20-25 years) were the largest group, especially on weekends. Older adults (70 + years) were the largest cohort in pedestrian deaths. The most common injuries were head (42.2 %). One-third of patients were intubated prior to or on ED arrival (n = 731, 34.3 %). CONCLUSION: Emergency clinicians should have a high index for severe pedestrian injury. Further reduction in road speed in residential areas could reduce all-age pedestrian injury in Australia.