Association of Road Type of Traffic Accident with Mortality and Disability of Passengers Transported by 119 Fire Department Ambulance due to Motor Vehicle Collision

ABSTRACT

PURPOSE: The environment of traffic accident sites could affect the outcomes of injured patients during emergency care. The goal of this investigation is to assess the association between the road type during motor vehicle collision and mortality or disability of severe trauma patients. METHODS: We used an emergency medical service based on severe trauma database operated by the Korean Center for Disease Control and Prevention. The database collected information on injured patients with abnormal prehospital revised trauma score transported by fire department during 2012 in 6 provinces of South Korea. Among the cases collected, we distinguished between drivers and passengers of motor vehicle collision. We divided the road types into two categories highway and non-highway. We collected the demographics, injury related information, prehospital indicator, and clinical outcome. Primary outcome was in-hospital mortality and secondary outcome was disability. We assessed the association using a multivariate logistic regression. RESULTS: During the study period, 1,122 cases with 131 highway types and 991 non-highway types were analyzed. Patients in the highway type showed delayed time of arrival at the scene from EMS activation and delayed hospital arrival from departing the scene. Hospital mortality was higher in the highway group (43.5% vs 31.6%, p<0.05). According to multiple logistic regression, the highway group showed higher mortality (OR 1.86, 95% CI 1.26-2.75). Higher proportion of disability was also associated with the highway group (OR 1.53, CI 1.04-2.25). CONCLUSION: We assessed the association of road type and clinical outcome of patients injured due to traffic accident. Cases associated with the highway type were showed 1.86 times higher mortality and 1.53 times higher disability compared with the non-highway type.