Pedestrian injuries in an ageing society: insights from hospital trauma registry.

Abstract

BACKGROUND: Traffic safety of the elderly is a growing public health issue. METHODS: This study makes use of a linked hospital and police database. A total of 4,290 traffic casualty records were analyzed. The proportions of serious injury and mortality for different age groups are compared between pedestrian and nonpedestrian injuries. Logistic regression analysis is used to examine the relative significance of age, injury pattern, gender, crash time, and vehicle type on each dependent variable of hospital stay > or = 7 days, injury severity score (ISS) > 15, ISS > 30, and mortality. RESULTS: The shares of pedestrian casualties with serious injury increased with higher age groups. Among pedestrian casualties, aged > or = 65 years was the only statistically significant variable in accounting for ISS > 30 and mortality. Aged > or = 65 years, lower extremity injury and heavy vehicles were important in accounting for long hospital stay. For ISS > 15, aged > or = 65 years, head or face injury, and thorax or abdomen injury were significant risk factors. After adjusting for confounding factors, the risk of hospital stay > or = 7 days, ISS > 15, ISS > 30, and mortality for an elderly pedestrian injury was 4.24 times (95% CI, 2.46-7.29), 2.77 times (95% CI, 1.17-6.55), 5.16 times (95% CI, 1.38-19.34), and 3.61 times (95% CI, 1.16-11.25) higher than a younger adult (aged 15-64 years). In contrast, age was not a significant independent risk factor for serious injury and mortality among nonpedestrian injuries. CONCLUSIONS: Most developed economies are facing the problem of ageing. To develop an effective strategy to deal with elderly pedestrian trauma, a good quality linked database is a prerequisite.