Department of Preventive Medicine and Family Medicine, Faculty of Medicine, Burapha University, Chonburi 20131, Thailand.
Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok 10210, Thailand.
Int J Environ Res Public Health. 2021 Sep 17;18(18):9823. doi: 10.3390/ijerph18189823.
Road traffic injury (RTI) is a leading cause of death in developing countries. This burden affects not only locals, but also international travelers. Data on international travelers with RTIs in Thailand, especially from a medical perspective, are limited. This study aimed to analyze the factors associated with severe health outcomes following RTIs among international travelers at a university hospital emergency center in Thailand from January 2015 to December 2019. The retrieved data consisted of demographics, risks, preventive factors, and health outcomes. The severity of outcome was classified as fatality, hospitalization, or non-severe. A multinomial logistic regression model was used to identify the possible determinants of severity of health outcome among international travelers with RTI. A total of 720 travelers with RTIs (69% males; 82.5% were Southeast Asian) were included, with a mean age of 28.5 years. Of these, 144 (20%) had severe health outcomes: 64 (9%) fatalities and 80 (11%) hospitalizations. The level of severity of outcome was not associated with travelers' demographics, but was associated with conventional risk factors, i.e., motorcycle use, alcohol/drug use, night-time driving, and less use of seatbelt/helmet. In a multinomial logistic regression analysis, alcohol drinking (adjusted odds ratio (AOR) 2.53, 95% confidence interval (CI) 1.41-4.55) and night-time driving (AOR 2.54, 95% CI 1.36-4.75) were associated with hospitalization. Patients who had a history of tetanus vaccination were less likely to die (AOR 0.37, 95% CI 0.17-0.81). In conclusion, one-fifth of RTIs resulted in severe health outcomes, and 9% were fatal. Road safety campaigns in Thailand should target travelers of all nationalities. Interventions that enhance travelers' safety practices and proper preparation for road accidents should be explored further.
道路交通事故伤害（RTI）是发展中国家的主要死亡原因。这种负担不仅影响当地人，也影响国际旅行者。关于泰国国际旅行者 RTI 的数据，特别是从医学角度来看，是有限的。本研究旨在分析 2015 年 1 月至 2019 年 12 月期间在泰国一所大学医院急诊中心的国际旅行者 RTI 后严重健康后果的相关因素。检索到的数据包括人口统计学、风险、预防因素和健康结果。结果的严重程度分为死亡、住院和非严重。使用多项逻辑回归模型来确定 RTI 国际旅行者健康结果严重程度的可能决定因素。共纳入 720 名 RTI 旅行者（69%为男性；82.5%为东南亚人），平均年龄为 28.5 岁。其中 144 人（20%）出现严重健康后果：64 人（9%）死亡，80 人（11%）住院。结果严重程度与旅行者的人口统计学特征无关，但与常规风险因素有关，即摩托车使用、酒精/药物使用、夜间驾驶以及安全带/头盔使用较少。在多项逻辑回归分析中，饮酒（调整后的优势比（AOR）2.53，95%置信区间（CI）1.41-4.55）和夜间驾驶（AOR 2.54，95%CI 1.36-4.75）与住院有关。有破伤风疫苗接种史的患者死亡的可能性较低（AOR 0.37，95%CI 0.17-0.81）。总之，五分之一的 RTI 导致严重的健康后果，其中 9%是致命的。泰国的道路安全运动应针对所有国籍的旅行者。应进一步探索增强旅行者安全行为和为道路事故做好适当准备的干预措施。
