493 Disability following road traffic injury: findings at six months after hospital discharge

Background Ninety-three percent of road traffic injuries (RTIs) occur in low- and middle-income countries (LMICs), where health systems are weak. Disability following RTI is widespread, affecting up to 50 million people annually; there is limited research describing the long-term consequences of RTIs in terms of level of disability. Objective The purpose of this study was to describe the epidemiology of RTI patients and the level of RTI-related disability at one, three six months after the discharge from the hospital. Methods This was a prospective observational study with adult patients who sustained moderate to severe RTIs and were admitted to hospital for at least 24 hours in select hospitals in Bangladesh, Cambodia, Ethiopia, Mexico, and Zambia. Patients were followed-up with at one, three, and six months after discharge from the hospital to determine their level of disability using the WHO disability assessment schedule 2.0 (WHODAS 2.0) to measure activity limitations and participation restrictions. Descriptive statistics were summarized as means and percentages to generate a profile of RTI patients and their disability level. Results The majority of RTI patients were men, aged 18–34 and vulnerable road users, either pedestrians in Ethiopia and Zambia or motorcycle and auto-rickshaw riders in Bangladesh, Cambodia, and Mexico. Seatbelt use (18%) and helmet use (30%) among patients were low and varied considerably by country. At six months post-discharge, 74% of RTI patients experienced some disability with an average WHODAS disability score of 14 (country range 6–20). Fifty-four percent of RTI patients reported they had not returned to normal life at six months and 11% had an unmet need for assistive devices. Conclusions The findings confirm the considerable long-term consequences of RTIs and persistence of a high disability level at six months that translates to important activity limitations and participation restrictions in everyday life. Reducing speed in urban areas, legislation and enforcement of the use of protective equipment, and policies that promote rehabilitation services and access to assistive devices are recommended to decrease RTIs and their consequences and improve recovery to pre-injury activities.