• Russell Seth Martins, Sabah Uddin Saqib, Mishal Gillani, Syeda Ramlah Tul Sania, Muhammad Umer Junaid, and Hasnain Zafar.
• Medical College, Aga Khan University Hospital, Karachi, Pakistan.
• Traffic Inj Prev. 2021 Jan 1; 22 (2): 162-166.

ObjectiveMotorcyclists are frequently involved in road traffic accidents and may suffer polytraumatic injuries, contributing a substantial burden on healthcare systems particularly in lower-middle-income countries. This study aimed to describe patterns of injury, in-hospital course, and outcomes of road accident trauma in motorcyclists, including polytrauma, at a Trauma Facility in Pakistan.MethodsA retrospective review was conducted by using relevant trauma codes to extract data from records for all victims presenting with motorcycle trauma between January 2018 and June 2019, to a tertiary care hospital in Pakistan. Data collected included victim characteristics, mechanism of accident, patterns of traumatic injury, management, in-hospital complications, and outcomes. Polytrauma was defined as traumatic injuries in two or more anatomic regions with abbreviated injury scale (AIS) ≥ 3. Multivariable logistic regression, adjusted for age, gender, and mechanism of accident, was performed to identify in-hospital complications and outcomes associated with polytrauma.ResultsA total of 514 victims, 90.9% male and 39.5% aged between 18-30 years, were included in this study. The victim was the motorcycle driver in 94.6% of cases. The most common mechanism of accident was motorcycle vs. other motor vehicle (56.2%). Patients were mostly admitted under the services of Orthopedic Surgery (50.8%) and Neurosurgery (30%), with common sites of injury being the lower extremity (42.6%), head (38.1%), and upper extremity (26.8%). Polytrauma occurred in 19.5% of victims. Patients were managed surgically in 77.3% of cases, with the most common procedure being open reduction of fractures (48.1%). Blood transfusion was required in 4.1% of patients. The commonest in-hospital complication was acute kidney injury (23.7%). The median length of stay was 3 days, and 4.1% of patients expired in the hospital. Polytrauma was significantly associated with the need for blood transfusion (2.642 [1.053-6.630]), AKI (2.212 [1.339-3.652]) and hospital length of stay (1.059 [1.025-1.094]), but not with mortality.ConclusionAlthough orthopedic injuries occur most frequently in motorcycle trauma, polytrauma necessitating multi-disciplinary management and complicating hospital stay is also common. Understanding patterns of injuries and management in motorcycle trauma will enable trauma teams in a developing country like Pakistan to devise evidence-based management protocols, especially for cases of polytrauma.

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