Emergency Room Mortality Patterns and Associated Factors among Road Traffic Crash Victims at Adult Emergency Department of Tertiary Level Trauma Centers in Addis Ababa Ethiopia From January 1st 2016 To December 31st 2017.
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Date
2018-06
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Addis Ababa Universty
Abstract
Background: Road Traffic Accidents (RTAs) are ever increasing public health hazards worldwide, the most common
cause of deaths among all trauma victims and leading cause of deaths in the Emergency room and projected to become
the third most important health problem by 2020. Road traffic accidents were the leading cause of permanent disability
and mortality among those in productive age in developed countries but currently the developing countries are also
faced by a similar challenge as they undergo what has been termed as the “epidemiology of transition”.
Objective: the objective of this study is to analyze mortality patterns and associated factors among road traffic crash
victims at adult emergency departments of tertiary level trauma centers in Addis Ababa Ethiopia, 2017/8.
Methods: the study was conducted using Hospital based retrospective chart review study design. Data was collected
from registration books, patients’ charts, records and death certificates by including all traffic crash victims who died in
adult ED of tertiary level trauma Centers in Addis Ababa, in the last two years from January 1, 2016 to December 31,
2017 G.C. Collected data was checked for completion and entered to SPSS version 20 then analyzed usingdescriptive
statistics, and finallypresented using ratios, percentages, frequencies; tables, charts and graphs.
Results: there were 162 RTA deaths during the study period of which 76 (46.91%) were being treated at ER of Tikur
Anbessa specialized hospital while 83(51.2%) victims were affected in the accidents happed out of Addis among which
the majority (58, 69.9%) were from Oromia. 79(48.8%) in Addis and The majority of victims, 135(83.33%) were males
with a sex ratio of 5:1. The age range of victims was 14 to 76 years with the mean value of 36.84(±16.1) years. The
modal age group was 21–30 (61, 37.65%) of the total mortality figure. The majority of victims (97(59.9%)) were
Referred from other health facilities while only 7(4.3%) and 25(15.4%) victims were brought by Ambulance& Police
Car, respectively.However 80.0% of the victims had presented to ED within 24 hours, only25(15.4%) victims were
arrived ED within golden hour. The time from Accident to ED Arrival ranges from 20 minutes to 9 days with the mean
of 15.9(±37.4) hours.
Conclusion: Road traffic crash is a significant cause of death for young adults and adolescents in emergency room,
affecting more males than females and most fatalities occurring in the young adult age group of 21-30 years. Pedestrians
are the most affected road users’ category. The first 24 hours after accident in ED is a quite crucial for survival of RTA
victims. Early referral for severe RTA victims has a paramount importance. Coordinated pre-hospital and in hospital
Emergency Medical Services can reduce RTA mortality figure in Emergency Room by reducing duration of accident
before ED arrival and providing early & adequate resuscitation. Increased age, lack of pre-hospital care, delayed
presentation,delayed resuscitation measures and multiple referrals are the major contributors to road traffic crash-related
mortality in the emergency room.
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Keywords
road traffic crash, mortality, emergency room, Addis Ababa, Ethiopia