Incidence and Predictors of Inpatient Mortality among Road Traffic Accident Patients Admitted to Trauma Centers of Hospitals in Addis Ababa, Ethiopia (2020-2024): A Retrospective Cohort Study
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Date
2025-06
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Addis Ababa University
Abstract
Introduction: Road traffic accidents (RTAs) result in the deaths, injuries, and disabilities of millions of people each year globally. Despite having fewer vehicles, low and middle-income countries (LMICs) account for a disproportionately higher share of road traffic fatalities and injuries. In Ethiopia, although the country experiences high mortality rates due to RTA, there is a lack of comprehensive data on the incidence and predictors of mortality among RTA patients admitted to hospitals.
Objective: To determine the incidence and predictors of inpatient mortality among road traffic accident patients admitted to trauma centers of hospitals in Addis Ababa, Ethiopia.
Methods: Institution-based retrospective cohort study was conducted among 482 RTA patients. A simple random sampling technique was used to select study participants. Data were collected using a pre-tested and structured data abstraction form through Open Data Kit (ODK). Descriptive statistics were used to summarize data. Kaplan-Meier survival analysis and the log-rank test were applied to assess the presence of differences in mortality incidence among different categories of predictor variables. Cox proportional hazards regression was employed to identify predictors. The model’s fitness was evaluated using the Cox-Snell residual. Variables with a p-value of < 0.25 in the bivariate analysis were included in multivariable analysis. Statistical significance was determined using a 95% confidence interval (CI) for the adjusted hazard ratio (AHR) and a p-value of < 0.05.
Results: The cumulative incidence of mortality among RTA patients was 10.8% (95% CI: 12.00%, 18.03%), and the incidence density rate was 7.2/10,000 person-hours of observation. The mean survival time was 6.24 days. Factors significantly associated with mortality include Glasgow coma scale (GCS) < 8 (AHR 3.41; 95% CI: 1.09,10.71), developing complications (AHR 2.89; 95% CI: 1.22,6.85), systolic blood pressure (SBP) < 90mmHg (AHR 5.98; 95% CI: 2.30,15.51), a history of loss of consciousness (AHR 2.46; 95% CI: 1.12,5.40), and admission to the intensive care unit (ICU) (AHR 2.34; 95% CI: 1.18, 4.63).
Conclusion: The Incidence of mortality among RTA patients was high. RTA patients with GCS < 8, developing complications, experiencing loss of consciousness, admission to the ICU, and SBP < 90 mmHg at admission were at high risk of mortality compared to their counterparts.
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Incidence, mortality, road traffic accidents, Retrospective study, Ethiopia.