Abstract

Background. Injury-related deaths constitute a significantly higher proportion of all mortalities in Estonia compared to the remaining European Union. The purpose of this investigation was to study demographics, injury-profile and outcomes of automobile versus pedestrian accidents.

Methods. All pedestrians injured by motor vehicles, who were admitted to major national trauma facilities and died in prehospital settings between 1/1/2015 and 31/12/2015, were retrospectively reviewed using ICD-10 codes (V02-V09) for hospitalized patients and autopsy reports for the prehospital deaths, respectively. Data collection included demographics, injury-profile, in-hospital complications, and mortality. Primary outcome was mortality.

Results. A total of 116 cases were included: 94 hospital admissions and 22 autopsy cases. Mean age was 42.8 ± 26.9 years, respectively, and 56.0% were male. Most of the injuries occurred in November and December and between 4:00pm and 7:00pm. Rib fractures and tibial fractures were the predominating injuries in 31.9 and 28.4% of the cases, respectively. Overall mortality was 23.4% and 81.5% of the deaths occurred in prehospital settings. In-hospital mortality was 5.3%. Severe head injuries were the most frequent cause of death. Complication rate was 8.5%.

Conclusions. Overall, almost a quarter of the pedestrians hit by motor vehicles died after injury. Most of the deaths occurred in prehospital settings. Impaired road safety due to seasonal and circadian effects require further national traffic-safety efforts.