Moving beyond mortality measurements after road traffic injuries: Ten-year death risk after road traffic injuries.

Abstract

Road traffic injuries (RTIs) represent a significant global public health issue, particularly in low- and middle-income countries like Brazil. Despite the high mortality rates and associated costs, there is limited comprehensive literature addressing long-term mortality resulting from RTIs. Most research tends to focus on rates and hospitalization figures while neglecting the connection between hospitalizations and causes of death, partly due to the challenges of follow-up studies. This study employed record-linkage methodology to create a database that includes both hospitalization and mortality records. The aim was to estimate all-cause and cause-specific relative risks (RR) of death among inpatients due to road traffic accidents, compared to those hospitalized for other reasons, over a time span of three months to ten years. A retrospective cohort study examined hospitalization data for RTIs and mortality from 2000 to 2015 using Brazil's Unified Health System (Sistema Único de Saúde - SUS in Portuguese), excluding any obstetrics-related admissions and deaths, and calculated RR stratified by sex and age over 15 years old. The findings indicated a significantly higher mortality risk of 3.23 (95% Uncertainty Interval: 3.08- 3.39) for individuals previously hospitalized for RTIs compared to others during follow-up. Males aged 15- 29 and 30- 59, especially those with motorcycle, vehicle, or pedestrian injuries, exhibited an elevated mortality risk compared to other inpatients. Furthermore, individuals with prior RTIs experienced increased mortality risks from substance use disorders, violence, and suicide. This research may enhance our understanding of the complex factors associated with road traffic injuries, underscoring the importance of recognizing how RTIs contribute to long-term mortality to inform better prevention strategies and policies.