Kumar Kantesh, Hassan Sheza, Musharraf Muhammad Bazil, Rahim Komal Abdul, Sheikh Sijal Akhtar, Atiq Huba, Ahmed Muhammad Waqas, Siddiqui Rameez-Ur-Rehman, Naseer Rizwan, Akhter Shahnaz, Shafiq Yasir, Razzak Junaid
Centre of Excellence for Trauma and Emergencies, The Aga Khan University, Karachi, Sindh, Pakistan.
Department of Emergency Medicine, Weill Cornell Medicine, New York, NY, USA.
Int J Emerg Med. 2025 Aug 1;18(1):140. doi: 10.1186/s12245-025-00898-0.
Every year, 1.3 million lives are lost to road traffic injuries (RTIs). 90% of these deaths disproportionately occur in Lower-Middle Income Countries (LMICs). Due to frailty and reduced physiological resilience, elderly populations are at higher risk of RTIs and poor outcomes, versus younger populations. Further, according to the World Health Organization (WHO), the global elderly population will double by 2050, indicating that this group will be at an even higher risk of RTIS.
Our study aims to utilize Emergency Medical Services (EMS) data to better understand the trends, types, injuries, patient characteristics, and outcomes of RTIs involving the elderly, ultimately contributing to more targeted and effective road safety policies and interventions.
We analyzed secondary EMS data during 2022 and 2023 from the Emergency Services Department (Rescue 1122) in the province of Punjab, Pakistan. RTI data in patients aged ≥ 65 years was extracted from the database for age, gender, education, response time, injury type, RTI victim type, location of injury, and victim outcome. Multivariable analysis was carried out using multiple logistic regression to obtain an adjusted odds ratio with a 95% confidence interval for on-scene mortality.
From 4.2 million EMS activations, data on 34,345 RTIs in elderly patients was analyzed. Patients had a mean age of 70.12 years, and 77% (26,608) were males. The most common injury type was soft tissue injury (24,166; 70.36%), followed by limb injury (5,126; 14.9%), and head injury (2,590; 7.5%). Most victims suffered injuries as passengers (11,396; 37.2%). The mean response time was 7.19 minutes, and the on-scene mortality rate was 1.3% (443). The odds of on-scene mortality increased with increasing response time (AOR: 1.05, CI: 1.04-1.07), while an increase in the degree of urbanization was associated with decreasing odds of on-scene mortality (AOR: 0.99, CI: 0.98-0.99). Head injuries (OR: 24.49, CI: 20.11-29.93) and pedestrian injuries (Adjusted OR: 1.40, CI: 1.06-1.84) were strongly associated with on-scene mortality.
Our study revealed that head and pedestrian injuries emerged as key factors for on-scene mortality in elderly patients of Punjab, Pakistan. These findings necessitate targeted interventions to encourage a rapid pre-hospital response to lower on-scene mortality rates.
每年有130万人死于道路交通伤害（RTIs）。其中90%的死亡在低收入和中等收入国家（LMICs）不成比例地发生。由于身体虚弱和生理恢复力下降，老年人群比年轻人群面临更高的道路交通伤害风险和更差的预后。此外，根据世界卫生组织（WHO）的数据，到2050年全球老年人口将翻倍，这表明该群体将面临更高的道路交通伤害风险。
我们的研究旨在利用紧急医疗服务（EMS）数据，更好地了解涉及老年人的道路交通伤害的趋势、类型、损伤情况、患者特征和预后，最终有助于制定更有针对性和有效的道路安全政策及干预措施。
我们分析了2022年和2023年巴基斯坦旁遮普省紧急服务部（救援1122）的二级EMS数据。从数据库中提取年龄≥65岁患者的道路交通伤害数据，包括年龄、性别、教育程度、响应时间、损伤类型、道路交通伤害受害者类型、受伤地点和受害者结局。使用多元逻辑回归进行多变量分析，以获得现场死亡率的调整优势比及95%置信区间。
在420万次EMS出动中，分析了34345例老年患者的道路交通伤害数据。患者平均年龄为70.12岁，77%（26608例）为男性。最常见的损伤类型是软组织损伤（24166例；70.36%），其次是肢体损伤（5126例；14.9%）和头部损伤（2590例；7.5%）。大多数受害者作为乘客受伤（11396例；37.2%）。平均响应时间为7.19分钟，现场死亡率为1.3%（443例）。现场死亡率的几率随响应时间的增加而增加（调整优势比：1.05，置信区间：1.04 - 1.07），而城市化程度的提高与现场死亡率几率的降低相关（调整优势比：0.99，置信区间：0.98 - 0.99）。头部损伤（优势比：24.49，置信区间：20.11 - 29.93）和行人损伤（调整优势比：1.40，置信区间：1.06 - 1.84）与现场死亡率密切相关。
我们的研究表明，头部和行人损伤是巴基斯坦旁遮普省老年患者现场死亡率的关键因素。这些发现需要有针对性的干预措施，以鼓励快速的院前反应，降低现场死亡率。
