Road traffic crashes in South Africa: the burden of injury to a regional trauma centre.

BACKGROUND Globally, 90% of road traffic crash (RTC) deaths occur in low- and middle-income countries. OBJECTIVE To document the mortality and morbidity associated with RTCs managed at a busy regional hospital in South Africa and investigate potentially preventable factors associated with RTCs. METHODS This was a prospective study of all patients presenting to Edendale Hospital following a RTC over a 10-week period from late 2011 to early 2012. All fatalities recorded at the police mortuary for the same period were included. Medical records were reviewed and all admitted patients were interviewed about the circumstances of the accident. We calculated an injury pyramid to compare our data with European data. RESULTS A total of 305 patients were seen over the study period, 100 required admission and there were 45 deaths due to RTCs in the area. Of the patients admitted, 41 were pedestrians involved in pedestrian vehicle crashes (PVCs) and 59 motor vehicle occupants involved in motor vehicle crashes (MVCs). The majority (n=58) of crashes involved a private vehicle. Only 17% of MVC patients were wearing a seatbelt and 8 were allegedly under the influence of alcohol. On average, RTC patients spent 19 days in hospital and 62 patients required at least 1 operation. According to our injury pyramid, the number of severe and fatal injuries was higher than in Europe. CONCLUSION Our results demonstrate a high incidence of RTCs associated with a high injury score and significant morbidity. Most crashes were associated with a number of high-risk behaviours.