Patterns of injuries in road traffic accident fatalities seen at the Kenyatta National Hospital

Abstract

Few people can be ignorant of or unmoved b~ the enormous increase in the mortality and the morbidity caused by trauma caused by RTAs. The number of road traffic accidents has increased in recent years to pandemic proportions. The health, medical and legal problems posed affect all branches of surgery and medicine and fatal results are particularly relevant to the pathologist. In Kenya, it is estimated that over 13,000 accidents occur annually, killing 2,600 people and seriously injuring another 11,000. In terms of economic losses up to 14 billion shillings are lost annually not withstanding the human and emotional suffering (32). This study was carried out at the Kenyatta National Hospital. It was a descriptive cross sectional study that attempted to document the patterns of injuries, determine the cause of death, correlate the fatalities as seen in pedestrians, drivers and passengers, determine the proportion of those who die on the spot and those that die while undergoing treatment; and determine injury severity scores. One hundred (100) autopsies were performed after obtaining an informed consent over a period of 25 weeks. The study involved 81 males and 19 females with an age range of 4-80 years and a median age of33.5 years. 45% arrived at casualty dead while 55% were admitted for a period , ranging between 1-730 days with a mean of 14 days. Vulnerable groups were Pedestrians 62%, passengers 24%, drivers 9%, cyclists 4% and one case was not specified. Head injuries were commonest accounting for 76%, followed by chest injuries 70%, abdominal injuries 60%, lower limb injuries 57%, upper limb injuries 35%, neck injuries 29% and pelvic injuries 16%. The commonest cause of mortality was head injury 57%, followed by chest injury 33%, abdominal injuries 17%, other secondary injuries 8% and lower limb injuries was least accounting for 5%. Majority 48% had a severe injury severity score (ISS) ranging 50-75, 44% had moderate score of between 25-49 and 8% mild scores of up to 24.