Predictors of pre-hospital vs. hospital mortality due to road traffic injuries in an Iranian population: results from Tabriz integrated road traffic injury registry.

BACKGROUND: Road Traffic Injuries (RTIs) is considered as one of the main health challenges and causes of mortality, worldwide and especially in Iran. Predicting the place where RTIs-related death takes place is vital in decreasing this type of mortality. The purpose of the present study was to identify the predictors of RTI fatalities with respect to the place of death (hospital vs. pre-hospital) during the recent decade in East Azerbaijan Province, Iran. METHODS: Overall, 7347 RTI fatalities were retrieved from the road traffic injuries registry which is supported by the Forensic Medicine Organization in East Azerbaijan. Among these cases, 2758(37.5%)) were hospital deaths. The registered variables of these cases were analysed using bivariate and multiple logistic regression (STATA version 15). RESULTS: Out of 7347 deaths, 5862 (79.8%) were men and the rest were women 1485 (20.2%).The mean age was 40.3 (SD = 20.8). Of the total number of cases, 2758 (37.5%) died in hospital death and the rest 4589 (62.5) were pre-hospital death. According to the results of the present study, inter-city RTI (OR = 1.7, CI 95% = (1.5-2)) and RTIs inside the city of Tabriz (OR = 1.4, CI 95% = (1.2-1.6)) increases the chance of hospitals death. In addition, having a heavy counterpart vehicle compared to no counterpart vehicle decreased the chances of hospitals death (OR = 0.46, CI 95% = (0.39-0.55)) while motorcycle or bike counterpart vehicle compared to no counterpart vehicle increased the chances of hospital death (OR = 2.26, CI 95% = (1.59-3.22)). Also the users of the motorcycle or bike vehicle compared to the pedestrians increased the chances of hospital death (OR = 1.43, CI 95% = (1.19-1.71)) while any the other vehicle users compared to the pedestrians have significantly lower chances for hospital death. Other factors that increased hospitals death were transferring injured people by ambulance (OR = 1.3, CI 95% = (1.1-1.6)) and being elderly (OR = 1.5, CI 95% = (1.2-1.7)). Moreover, it was found that the annual trend of change in hospital death is strongly affected by the above-identified factors. CONCLUSIONS: The effective predictors in hospital death were RTI location, type of counterpart vehicle, used vehicles and lighting condition. The identified factors related to the location of deaths by RTI can be divided into the RTI severity-related factors as well as factors related to the services quality and speed of delivery. According to the present results, through professional training of people in the field and providing immediate assistance in RTIs pre-hospital mortality can be significantly prevented.

Analysis of Provincial Mortalities Among Bus/Minibus Users Over Twelve Years, East Azerbaijan, Iran.

Objective: The aim of this study was to investigate the epidemiological features of bus/minibus users' road traffic injury mortalities during 2006-2017, in the East Azerbaijan province of Iran. Methods: All 245 bus/minibus users' mortalities, registered in the forensic medicine database, were analyzed by STATA 13 statistical software package. Results: The majority of victims (mean age: 41.5±18.6 years) were men (70%), adults (79.18%), illiterate (22.4%) and self-employed (25.3%). Passersby and police played an almost null role in transporting victims since 2014. A decreasing trend of bus/minibus users' fatalities was observed over the study time. Head-neck-face trauma was more common among those who died prior to hospitalization. Rollover was significantly prevalent among bus users and falling among minibus users. Lorries, vans, and trailers as crash counterpart vehicles caused 59% of deceases, excluding the cases when no other vehicle was engaged. Victims were more likely to die at the hospital when crashes happened in the city's inner roads (OR: 4.17; 95%CI:1.7-9.9). The elderly were 2.78 times more likely to die at the hospital when compared to the other age groups (95%CI: 1.23-6.26). Conclusions: To identify a target group for interventions on traffic-related knowledge, attitude and behaviors, male adults, illiterate and self-employed bus/minibus users could be of priority. Type vehicles involved in the crash should be considered as an important factor affect on crash fatalities. Further investigations are needed in this regard in the future.