Outcome of Adolescent Bike Riders after Road Crash with and without Safety Measures in a Developing Country

Abstract

Background: Road traffic crash is of growing public health importance worldwide contributing significantly to the global disease burden. There is paucity of published data on road traffic crashes in our local circumstances. This study was carried out to describe the outcome in patients of traumatic brain injury after road traffic crash in our local setting and provide baseline data for establishment of preventive strategies for the well being of adolescent bike riders.
Methods: This was a prospective hospital based study of road traffic crash victims carried out at Department of Neurosurgery, Jinnah hospital Lahore from January 2015 to December 2015. After informed consent from patients or their attendants, all patients were consecutively enrolled into the study. A total of 1490 patients were enrolled in the study who presented in emergency after road crash and only the bike riders were observed for the outcome. Data was collected using a pre-tested questionnaire and analyzed using SPSS computer software version 15.0.
Results: A total of 1490 road traffic crash victims were studied. All patients were male. The patients ages ranged from 12 to 57 years with the mean and median of 22.5 and 26 years respectively. The patients were divided into five groups as GROUP-A 10-20yrs age, GROUP -B 21-30yrs, GROUP -C 31-40 yrs, GROUP-D 41-50yrs and GROUP-E 51-60yrs. Regarding the vehicle only bike was included. Number of patients in group A was 340 (22.8%), group B 650 (43.6), group C 80 (5.3), group D 320 (21.4%) and group E 100 (6.7%). Regarding the mechanism 618 (41.4%) patients came after bike skidding, 636 (42.6%) patients came after bike with bike crash and 236 (15.8%) patients came after bike with other vehicle crash. Among total number of patients 216 (14.4%) were those having severe traumatic brain injury (STBI). Mortality rate among STBI was 106 (49.07%). The highest mortality was noticed in group C was 37.7% and in group A(adolescent patients) was 24.5% and this was significant (P < 0.001) whereas regarding the outcome according to Glasgow outcome scale, Grade 5 was observed in 63.6% and Grade 4 & 3 in 13.02% & 14.4% respectively and Grade 2 in 1.7% of the patients. The stratification of patients was also done regarding the severity of injury and their outcome according to GOS. It showed that in group A 22.03% patients with mild TBI had GOS 5 & 6.78% with moderate TBI had GOS 5. Regarding severe TBI of group A 15.38% patients had GOS 2 & 24.53% had GOS 1 which was highest in all groups, same stratification was done for other groups as well which showed that the outcome in group A is devastating and its results are comparable with the elder age groups.
Conclusion: Road traffic crashes constitute a major public health problem in our setting and contribute significantly to unacceptably high morbidity and mortality especially for youth. Urgent preventive measures in the form of helmet wearing for bike riders and enforcement of traffic rules targeting at reducing the occurrence of road traffic crashes is necessary to reduce the morbidity and mortality resulting from these injuries. There should be uniform implementation of traffic rules and regulation of motorcycle industry all over the country.