Identifying predictors of mortality among the hospitalized road traffic injury patients: a retrospective case-control study (2022–2024)
摘要
Road traffic injuries (RTIs) remain a major cause of trauma-related mortality worldwide. Although many patients die before reaching the hospital, mortality among hospitalized patients continues to impose a substantial public health burden. This study aimed to identify predictors of 30-day mortality among patients with road traffic injuries in Yazd, Iran. This retrospective case–control study included patients admitted to Shahid Dr. Rahnemoon Hospital between March 2022 and December 2024. The case group comprised 348 patients who died within 30 days of injury, while the control group included 698 randomly selected survivors. Data were extracted from hospital and prehospital records. Multivariable logistic regression analysis was performed to identify independent predictors of mortality. A total of 1,046 patients were included (mean age, 32.14 ± 19.69 years; 77.8% male), of whom 33.3% died within 30 days. Mortality was significantly associated with male sex, older age, comorbidities, suburban road accidents, and injuries occurring during holidays and warm seasons (P < 0.001). Deceased patients had lower Glasgow Coma Scale (GCS) scores, lower Mean Arterial Pressure (MAP), and lower Revised Trauma Score (RTS). In multivariable analysis, male sex, injuries occurring during warm seasons and holidays, interhospital transfer, head injury, and prolonged prehospital transport time were identified as independent predictors of mortality. Higher RTS was associated with a lower risk of mortality. Mortality among patients with road traffic injuries was associated with demographic, environmental, clinical, and prehospital factors. Prolonged prehospital transport time emerged as an important predictor of mortality. Strengthening trauma systems and reducing transport delays may contribute to improved trauma outcomes.