Risk Factors for Road Traffic Injury-Related Mortality in Iran; a Systematic Review and Meta-Analysis
Introduction: Gathering information regarding the risk factors of mortality and disability due to road traffic injuries can provide evidence for adopting effective interventions to reduce the burden of the injury. Therefore, the present study intends to identify the most important risk factors of r...
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Format: | Article |
Language: | English |
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Shahid Beheshti University of Medical Sciences
2021-09-01
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Series: | Archives of Academic Emergency Medicine |
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Online Access: | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1329 |
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doaj-0451eae0714e4acb91b5209d7fc0f757 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mahmoud Yousefifard Amirmohammad Toloui Koohyar Ahmadzadeh Mohammed I M Gubari Arian Madani Neishaboori Fatemeh Amraei Saeed Safari Alireza Baratloo Vafa Rahimi-Movaghar Mostafa Hosseini |
spellingShingle |
Mahmoud Yousefifard Amirmohammad Toloui Koohyar Ahmadzadeh Mohammed I M Gubari Arian Madani Neishaboori Fatemeh Amraei Saeed Safari Alireza Baratloo Vafa Rahimi-Movaghar Mostafa Hosseini Risk Factors for Road Traffic Injury-Related Mortality in Iran; a Systematic Review and Meta-Analysis Archives of Academic Emergency Medicine Accidents Traffic Mortality Wounds and Injuries Risk factors |
author_facet |
Mahmoud Yousefifard Amirmohammad Toloui Koohyar Ahmadzadeh Mohammed I M Gubari Arian Madani Neishaboori Fatemeh Amraei Saeed Safari Alireza Baratloo Vafa Rahimi-Movaghar Mostafa Hosseini |
author_sort |
Mahmoud Yousefifard |
title |
Risk Factors for Road Traffic Injury-Related Mortality in Iran; a Systematic Review and Meta-Analysis |
title_short |
Risk Factors for Road Traffic Injury-Related Mortality in Iran; a Systematic Review and Meta-Analysis |
title_full |
Risk Factors for Road Traffic Injury-Related Mortality in Iran; a Systematic Review and Meta-Analysis |
title_fullStr |
Risk Factors for Road Traffic Injury-Related Mortality in Iran; a Systematic Review and Meta-Analysis |
title_full_unstemmed |
Risk Factors for Road Traffic Injury-Related Mortality in Iran; a Systematic Review and Meta-Analysis |
title_sort |
risk factors for road traffic injury-related mortality in iran; a systematic review and meta-analysis |
publisher |
Shahid Beheshti University of Medical Sciences |
series |
Archives of Academic Emergency Medicine |
issn |
2645-4904 |
publishDate |
2021-09-01 |
description |
Introduction: Gathering information regarding the risk factors of mortality and disability due to road traffic injuries can provide evidence for adopting effective interventions to reduce the burden of the injury. Therefore, the present study intends to identify the most important risk factors of road accident-related mortality in Iran by conducting a systematic review and meta-analysis.
Methods: Search was done in English and Persian electronic databases, for articles published until the end of 2020. Cross-sectional, cohort and case-control studies were included. Risk factors were divided into age and sex, road related factors, exceeding speed limit, road user behaviors, vehicle related factors, weather condition, and light condition. Data were reported as adjusted odds ratio (OR) of death with 95% confidence interval (95% CI).
Results: 20 studies were included (2,682,434 traffic accident victims and 23,272 deaths; mortality rate=1.28%). The risk of death in road traffic injuries in men was 1.66 times higher than women (OR = 1.66; 95% CI: 1.03, 2.68) and with each year increase in age, the risk increased by 1% (OR = 0.01; 95% CI: 1.00, 1.01). In addition, accident in urban streets (OR = 1.76; 95% CI: 1.08, 2.88), roadway defects (OR = 2.15, 95% CI: 1.59, 2.91), and not driving on a flat and straight road (OR = 1.60; 95% CI: 1.14, 2.24) were the most important road-related risk factors for mortality. Exceeding the speed limit was another risk factor of death (OR = 3.16; 95% CI: 2.83, 3.54). However, regarding exceeding safe speed, only three studies have been included, which greatly reduces the power of analysis. Not maintaining focus on the road (OR = 2.99; 95% CI: 1.49, 6.04), not fastening seatbelt (OR = 3.11; 95% CI: 1.08, 8.91), and reckless overtaking (OR = 4.04; 95% CI: 3.34, 4.89) were independent road user-related risk factors for mortality. Risk of pedestrian mortality in comparison with drivers and passengers is 2.07 times higher (OR = 2.07; 95% CI: 1.53, 2.58). In addition, risk of death in accidents occurring during daylight hours (OR = 0.26; 95% CI: 0.18, 0.37) is lower than that of other hours. No significant relationship was present between mortality and vehicle types (four-wheeled vehicle: OR = 0.99; 95% CI: 0.050, 1.97; two-wheeled vehicle: OR = 0.75; 95% CI: 0.48, 1.16). In the case of vehicle-related factors, only 2 studies were included, which also dealt only with the type of vehicle (two-wheeled/four-wheeled). Vehicle-related factors such as the car model, its safety rating, and safety standards were not mentioned in any study.
Conclusion: Low to very low-level evidence shows that there is a significant relationship between factors related to age, sex, road, road user, exceeding the speed limit, and light condition with the mortality of traffic accident victims. However, all studies included in the present study were retrospectively designed and the analyses were not adjusted for most of the key potential confounders. Therefore, it seems that despite years of effort by researchers in the field of traffic accidents in Iran, there is still no comprehensive and reliable picture of the most important risk factors for road accident mortalities in Iran.
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topic |
Accidents Traffic Mortality Wounds and Injuries Risk factors |
url |
https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1329 |
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doaj-0451eae0714e4acb91b5209d7fc0f7572021-09-12T07:51:48ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042021-09-019110.22037/aaem.v9i1.1329Risk Factors for Road Traffic Injury-Related Mortality in Iran; a Systematic Review and Meta-AnalysisMahmoud Yousefifard0Amirmohammad Toloui1Koohyar Ahmadzadeh2Mohammed I M Gubari3Arian Madani Neishaboori4Fatemeh Amraei5Saeed Safari6Alireza Baratloo7Vafa Rahimi-Movaghar8Mostafa Hosseini9Physiology Research Center, Iran University of Medical Sciences, Tehran, IranPhysiology Research Center, Iran University of Medical Sciences, Tehran, IranPhysiology Research Center, Iran University of Medical Sciences, Tehran, IranCommunity Medicine, College of Medicine, University of Sulaimani, Sulaimani, Iraq.Physiology Research Center, Iran University of Medical Sciences, Tehran, IranEmergency Medicine Specialist, Tehran University of Medical Sciences, Tehran, Iran.Emergency Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Prehospital and Hospital Emergency Research Center, Tehran University of Medical Sciences, Tehran, Iran.Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.1- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran | Email: mhossein110@yahoo.com Introduction: Gathering information regarding the risk factors of mortality and disability due to road traffic injuries can provide evidence for adopting effective interventions to reduce the burden of the injury. Therefore, the present study intends to identify the most important risk factors of road accident-related mortality in Iran by conducting a systematic review and meta-analysis. Methods: Search was done in English and Persian electronic databases, for articles published until the end of 2020. Cross-sectional, cohort and case-control studies were included. Risk factors were divided into age and sex, road related factors, exceeding speed limit, road user behaviors, vehicle related factors, weather condition, and light condition. Data were reported as adjusted odds ratio (OR) of death with 95% confidence interval (95% CI). Results: 20 studies were included (2,682,434 traffic accident victims and 23,272 deaths; mortality rate=1.28%). The risk of death in road traffic injuries in men was 1.66 times higher than women (OR = 1.66; 95% CI: 1.03, 2.68) and with each year increase in age, the risk increased by 1% (OR = 0.01; 95% CI: 1.00, 1.01). In addition, accident in urban streets (OR = 1.76; 95% CI: 1.08, 2.88), roadway defects (OR = 2.15, 95% CI: 1.59, 2.91), and not driving on a flat and straight road (OR = 1.60; 95% CI: 1.14, 2.24) were the most important road-related risk factors for mortality. Exceeding the speed limit was another risk factor of death (OR = 3.16; 95% CI: 2.83, 3.54). However, regarding exceeding safe speed, only three studies have been included, which greatly reduces the power of analysis. Not maintaining focus on the road (OR = 2.99; 95% CI: 1.49, 6.04), not fastening seatbelt (OR = 3.11; 95% CI: 1.08, 8.91), and reckless overtaking (OR = 4.04; 95% CI: 3.34, 4.89) were independent road user-related risk factors for mortality. Risk of pedestrian mortality in comparison with drivers and passengers is 2.07 times higher (OR = 2.07; 95% CI: 1.53, 2.58). In addition, risk of death in accidents occurring during daylight hours (OR = 0.26; 95% CI: 0.18, 0.37) is lower than that of other hours. No significant relationship was present between mortality and vehicle types (four-wheeled vehicle: OR = 0.99; 95% CI: 0.050, 1.97; two-wheeled vehicle: OR = 0.75; 95% CI: 0.48, 1.16). In the case of vehicle-related factors, only 2 studies were included, which also dealt only with the type of vehicle (two-wheeled/four-wheeled). Vehicle-related factors such as the car model, its safety rating, and safety standards were not mentioned in any study. Conclusion: Low to very low-level evidence shows that there is a significant relationship between factors related to age, sex, road, road user, exceeding the speed limit, and light condition with the mortality of traffic accident victims. However, all studies included in the present study were retrospectively designed and the analyses were not adjusted for most of the key potential confounders. Therefore, it seems that despite years of effort by researchers in the field of traffic accidents in Iran, there is still no comprehensive and reliable picture of the most important risk factors for road accident mortalities in Iran. https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1329AccidentsTrafficMortalityWounds and InjuriesRisk factors |