Referral conditions for severe road traffic injuries and their influence on the occurrence of hospital deaths in Benin

Dos Santos, Bella Hounkpe; Ahanhanzo, Yolaine Glele; Kpozehouen, Alphonse; Daddah, Donatien; Ouendo, Edgard-Marius; Coppieters, Yves; Leveque, Alain · 2022 · Crossref

DOI: 10.4081/jphia.2022.2138

archive: archived pipeline: cataloged verified

Get this paper ↗ (DOI — opens at the source; we link to it, we don't host it)

Summary

This study investigates the referral conditions for severe road traffic injuries and their impact on in-hospital mortality in Benin, a low-income country where trauma care organization is often insufficient. Road traffic accidents are a leading cause of trauma-related death, yet in-hospital mortality rates for severe injuries in Benin were poorly documented. The research aimed to identify factors associated with hospital deaths to inform improvements in trauma management systems, specifically focusing on referral times, transport modes, and pre-hospital care. The researchers conducted an analytical prospective cohort study using data from the TraumAR cohort, which recruited 336 patients with severe injuries (Maximum Abbreviated Injury Score ≥3) from five hospitals in northern and southern Benin between July 2019 and January 2020. The study analyzed four groups of variables: referral conditions, sociodemographic characteristics, accident environment factors, and health service factors. Data processing and statistical analysis were performed using Stata 15, employing a top-down binary stepwise logistic regression to assess the association between independent variables and the dependent variable of hospital death. The results indicated that 9.8% of severe trauma patients died after hospital admission, with all deaths occurring within 24 days and a median survival time of 1.2 days. The final multivariate model identified several significant factors associated with increased mortality. Patients referred to the hospital more than one hour after the accident were 5.7 times more likely to die than those referred within the first hour. The mode of transport also significantly influenced outcomes; patients transported by ambulance were 4.8 times more likely to die, while those transported by police or fire departments were 7.4 times more likely to die compared to those transported by relatives or witnesses. Additionally, not wearing protective equipment (such as helmets or seat belts) increased the risk of death by 4.5 times. Injury severity played a critical role, with head injuries associated with a 34.8-fold increase in mortality risk, whereas the absence of upper extremity injuries was associated with a 20.1-fold increase in risk. Sociodemographic variables, accident environment factors, and health service characteristics did not show significant associations with mortality in the final model. The study concludes that rapid and medicalized referral is crucial for reducing in-hospital deaths among severe trauma patients in Benin. The high mortality rate compared to other countries highlights gaps in the current trauma care system. The findings suggest that interventions should focus on reducing referral times, ensuring appropriate emergency care during transport, and improving the availability of trained personnel for first aid. Furthermore, the authors emphasize the need for better data collection systems to accurately track trauma-related deaths and support evidence-based decision-making in public health policy.

Provenance

The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed.

Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.

Topics

Ranked by relevance to this paper. Hover a topic for its definition.

• fatality injury trends
• post crash care delays