• Ruchita Bhoyar, Nitin Borle, Monty Khajanchi, and Sanjay Nagral.
• Department of Surgery, K.B. Bhabha Municipal General Hospital, Bandra (West), Mumbai 400050, Maharashtra, India.
• Natl Med J India. 2020 Jul 1; 33 (4): 201-204.

Background. India has one of the largest railway networks, with a high incidence of railway-related accidents and fatality rate of 150/million passengers per year. We evaluated the pre-hospitalization period, pattern of injury and outcome of train accident victims in a metropolitan city.Methods. For this prospective observational study, we included victims of railway accidents presenting to a public hospital of Mumbai (a metropolitan city) from November 2014 to September 2016. We documented a detailed history of the victims and patterns of injury. Injuries were assessed using the revised trauma score, injury severity score (ISS) and trauma score-ISS. The outcome of surviving persons was assessed using the European quality of life questionnaire (EQ-5D-5L) and visual analogue scale (EQ-VAS).Results. Eighty-one accident victims were admitted during the study period, of which 37 (46%) were seriously injured. The victims were predominantly male (85%), in the age group of 14-45 years (91%), 23 (28%) were in an intoxicated state. Most accidents happened during morning and evening peak hours (60%). The average time for victims to reach hospital was 38.1 minutes and 77 (95%) were transported by an ambulance accompanied by a doctor, while 8 (10%) received first aid at the railway station or in the ambulance. Ten (12%) accident victims died while 71 (88%) were discharged.Conclusions. We found a high incidence of people in their productive age group losing their lives to railway accidents, which can be prevented with the help of a robust transport system and training the first responder emergency medical care providers.

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