Henry Tan Chor Lip,Jih Huei Tan,Yuzaidi Mohamad,Affirul Chairil Ariffin,Rizal Imran,Tuan Nur' Azmah Tuan Mat.[J].Chin J Traumatol,2019,22(2):69-74. [doi]
Clinical characteristics of 1653 injured motorcyclists and factors that predictmortality from motorcycle crashes in Malaysia
  
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KeyWord: MotorcyclesMortalityExsanguinationsAdultWounds and injuriesMalaysia
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Henry Tan Chor Lip Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia 
Jih Huei Tan Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia Department of General Surgery, Faculty of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia 
Yuzaidi Mohamad Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia 
Affirul Chairil Ariffin Faculty of Medicine and Allied Health, University Sains Islam Malaysia 
Rizal Imran Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia 
Tuan Nur' Azmah Tuan Mat Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Malaysia 
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Abstract:
      Purpose: Amongst the ASEAN countries, Malaysia has the highest road fatality risk (>15 fatalities per 100 000 population) with 50% of these fatalities involving motorcyclist. This contributes greatly to ward admissions and poses a significant burden to the general surgery services. From mild rib fractures to severe intra-abdominal exsanguinations, the spectrum of cases managed by surgeons resulting from motorcycle accidents is extensive. The objective of this study is to report the clinical characteristics and identify predictors of death in motorcycle traumatic injuries from a Malaysian trauma surgery centre. Methods: This is a prospective cross-sectional study of all injured motorcyclists and pillion riders that were admitted to Hospital Sultanah Aminah and treated by the trauma surgery team from May 2011 to February 2015. Only injured motorcyclists and pillion riders were included in this study. Patient demography and predictors leading to mortality were identified. Significant predictors on univariate analysis were further analysed with multivariate analysis. Results: We included 1653 patients with a mean age of (35 ± 16.17) years that were treated for traumatic injuries due to motorcycle accidents. The mortality rate was 8.6% (142) with equal amount of motorcycle riders (788) and pillion riders (865) that were injured. Amongst the injured were male predominant (1 537) and majority of ethnic groups were the Malays (897) and Chinese (350). Severity of injury was reflected with a mean Revised Trauma Score (RTS) of 7.31 ± 1.29, New Injury Severity Score (NISS) of 19.84 ± 13.84 and Trauma and Injury Severity Score (TRISS) of 0.91 ± 0.15. Univariate and multivariate analysis revealed that age 35, lower GCS, head injuries, chest injuries, liver injuries, and small bowel injuries were significant predictors of motorcycle trauma related deaths with p < 0.05. Higher trauma severity represented by NISS, RTS and TRISS scores was also significant for death with p < 0.05. Conclusion: Age, lower GCS, presence of head, chest, liver, small bowel injuries and higher severity on NISS, RTS and TRISS scores are predictive of death in patients involved with motorcycle accidents. This information is important for prognostic mortality risk prevention and counselling.
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