Burden and Pattern of Road Traffic Injuries Managed in Emergency Departments: A Retrospective Analysis

Abstract

Background: Road traffic injuries are a leading cause of preventable morbidity and mortality worldwide, with a disproportionate burden in low- and middle-income countries. In Pakistan, rapid urbanization and a motorcycle-dominated vehicle fleet have intensified the demand on emergency care, yet multicenter emergency department data remain scarce. Objective: To determine the burden, demographic and clinical pattern, and emergency department outcomes of road traffic injuries presenting to three tertiary care hospitals in Lahore, Pakistan. Methods: A retrospective, cross-sectional record review was conducted across the emergency departments of three public-sector tertiary hospitals in Lahore over a twelve-month period. All patients presenting with road traffic injuries and meeting inclusion criteria were consecutively sampled, yielding 400 records for analysis. Data on demographics, road-user category, injury mechanism, anatomical distribution, injury type, severity, and emergency department outcome were extracted using a structured proforma. Associations were tested using Chi-square statistics. Results: Road traffic injuries accounted for 1,336 (31.6%) of all injury-related presentations and 8.4% of total emergency department visits. Among the 400 reviewed records, the mean age was 32.8 ± 13.9 years and 76.5% were male. Motorcyclists constituted 64.8% of victims; motorcycle-to-motorcycle collisions were the most frequent mechanism (29.5%). Lower limb (34.0%) and upper limb (22.0%) injuries predominated, and fractures were the most common injury type (30.3%). Severe and critical injuries comprised 20.5% and 6.5% of cases, respectively. Following emergency department management, 58.5% were discharged, 32.3% were admitted, and 3.5% died. Age group was significantly associated with emergency department outcome (p=0.031), and road-user category with injury severity (p=0.010). Conclusion: Road traffic injuries exert a heavy and persistent burden on Lahore's tertiary emergency departments, disproportionately affecting young male motorcyclists. The strong associations between motorcyclist status and severe injury, and between advancing age and worse outcomes, highlight critical targets for trauma system strengthening, helmet law enforcement, and age-sensitive clinical pathways.

Keywords: Road traffic injuries, emergency department, injury severity, motorcyclists, Pakistan, retrospective study