A decade of road traffic fatalities among the elderly in north-West Iran

BACKGROUND Iran has a uniquely catastrophic status for road traffic injury incidence and fatality. The elderly account for a substantial number of the hospitalizations and fatalities due to traffic injuries. The aim of this study was to investigate the crash mechanisms and medical outcomes of traffic fatalities among the elderly in East Azerbaijan province of Iran during the period 2006-2016. METHODS A total of 9435 fatalities registered in East Azerbaijan forensic medicine database, Iran, during 2006-2016, were investigated. Of these, 1357 were elderly persons (age > 65). Both victim- and crash-related variables were compared for the elderly and other age groups. Bivariate and multivariate analysis methods were applied using Stata statistical software package version 13. RESULTS Of the 9435 fatalities, 1357 victims (14.4%) were elderly persons. The mean age of the elderly traffic fatalities was 75.3(SD = 6.2) years. About 78% of the elderly versus 80% of those in other age groups were males. A decreasing trend of fatal traffic accidents was observed over the study period both for the elderly and other age groups. The elderly were nearly seven times more likely to die as a pedestrian compared to other age groups. By exclusively analyzing pedestrians, it was found that motorcycles were responsible for pedestrian deaths in 9.1% of the fatalities while this figure was 5.5% for pedestrians in other age groups killed in a traffic accident (P < 0.05). About 56% (N = 761) of the elderly died in hospital which was higher than the proportion for other age groups (39%). Ambulance was the main vehicle for transferring the injured victims in four-fifths of the cases both for the elderly and other age groups. Although, in the present study, head injuries were the most common type of injury regardless of the age group, the elderly had a lower percentage of head injuries and a higher percentage of injuries to the torso, pelvis and limbs compared to younger victims. CONCLUSIONS Pedestrian inner-city crashes in East Azerbaijan province of Iran are a major cause of road injury fatalities among the elderly and should be considered as a priority in road safety interventions.