Prehospital Care and 24-hour Crash Injury Mortality Among Road Traffic Crash Victims in Addis Ababa, Ethiopia

Road traffic crash injuries are critical public health problems that demand on time post crash response to deliver pre-hospital care. Ethiopia is one of the African countries with the worst pre-hospital care delivery platform. This study describes the current practice of pre-hospital service provided for crash injured individuals. A cross-sectional study was conducted among 430 crash victims attending public hospitals in Addis Ababa. Participants were selected by random sampling upon their arrival to the selected hospitals from January 2019 to August 2020. The study described the data using the percentage, median, and interquartile range. The study used binary logistic regression to assess the relationship between pre-hospital care provided and 24-hour crash victim mortality. The median scene time was 20 minutes. More than half of respondents transported to hospital greater than 60 minutes. Among the 430 injured individuals, the fatal crash occurred on 21 (4.9%) individuals. The crash injured individuals received pre-hospital care involving wound care, resuscitations with IV (Intravenous) fluid, and immobilization. Using the binary logistic regression model crash injured patients who did not receive ambulance service were three times more chance of mortality during a 24-hour crash event ((P-value=0.002, AOR=3.1 (95%CI 1.5– 6.4). This study showed that 33.3% of crash-injured individuals received pre-hospital care. The majority of participants arrived at tertiary level trauma hospital with time greater than platinium 10 minutes scene time and golden an hour transport time. Being male, young, and not receiving pre-hospital care were significantly related to early crash injury mortality. A suitable basic and advanced life support strategy should be designed and implemented to enhance timely crash injury care.

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