Motorcycle Road Traffic Injuries in a Tertiary Hospital in Nigeria: A Reflection of the Trauma Care Crisis.

Abstract

Motorcycle is a popular and growing form of intracity transportation in many Nigerian cities owing mainly to poorly developed transport systems.It contributes significantly to road traffic injuries (RTIs), which are a leading cause of death and disabilities in low- and middle-income countries. There is a lack of information on the quality of care received and the treatment outcome in patients with motorcycle RTIs in Ibadan and many cities in Nigeria. This study evaluated the characteristics of motorcycle-related RTIs, the quality of care received, and the outcome of the patients managedin a trauma reference center in Ibadan, Nigeria. This is a prospective cohort study. All patients involved in motorcycle road traffic crashes who presented to the emergency department of the University College Hospital, Ibadan, between August 2020 and May 2021, were included in the study. Data on patients' demographics, history of the crash, injuries sustained, definitive care, and the outcome of in-hospital care were obtained from patients (and/or their carers)and the medical records. A total of 156patients were seen, out of which 74.4% were males. About 76.2% were less than 45 years with a mean age of 35.7 ± 16.3 years, and the peak age group was 18-44 years. About 37 (23.7%) patients were involved in motorcycle/motorcycle collisions, whereas 67 (42.9%) were involved in motorcycle/car collisions. Riders accounted for 59.6% (93), and although 62% (97) of the patients presented within six hours of the crash, only 10.9% (17) presented within one hour. About 48% received some form of prehospital care rendered by officials of the Federal Road Safety Corps, police officers, or passers-by, and none was attended by a dedicated emergency ambulance team. The head and the limbs were the most affected anatomical areas, while orthopedic and neurosurgical procedures were the most required emergency surgical interventions. About 66.7% were discharged home with only 21.2% of them fit to return to pre-trauma function at discharge, and the mortality rate was 17.3%. Patients who presented at 7-24 hours (AOR = 2.99; 95% CI = 1.04-8.62; p-value = 0.043) and >24 hours after the accident (AOR = 5.65; 95% CI = 1.64-19.53; p-value = 0.006) were 2.99 and 5.65 times, respectively, more likely to die from motorcycle-related accident compared to those who presented within the first six hours. This study identified the growing burden of disabilities and mortalities related to motorcycle RTIs. It highlights the lack of prehospital trauma care, which is a reflection of the deficiency of a national,regional, or jurisdictional trauma systemand the critical need to develop a functional trauma system.