Factors associated with severity and hospital admission of motor-vehicle injury cases in a southern European urban area

Objectives: To describe the characteristics of motor-vehicle (MV) injury cases admitted to Emergency departments (ED), and to assess factors related to injury severity and hospital admission. Setting: Subjects were MV injury patients, aged 16 or more, admitted to four EDs in the city of Barcelona (Spain), from July 1995 to June 1996. Methods: Cross-sectional design. The data analyzed were obtained from the information routinely transmitted from the EDs to the Municipal Institute of Health, based on the processing of ED logs. Severity was assessed with the Abbreviated Injury Scale and the Injury Severity Score. Univariate and bivariate descriptive statistical analyses were performed, as well as multiple logistic regressions. Results: For the 3791 MV-injury cases included in the study period, a larger contribution of cases was noted for males (63.1%), for cases younger than 30 years (55.3%) and for motorcycle or moped occupants (47.1%). After adjusting for age, sex and the presence of multiple injuries, pedestrians, followed by moped and motorcycle occupants were at a higher risk of a more severe injury (OR: 1.77, 1.61 and 1.50 respectively). Correspondingly, these user groups also showed a higher likelihood of a hospital admission (OR: 2.03, 1.92 and 2.00 respectively), when attended to in an ED. Injury cases attended to in the ED during night hours (OR: 2.06) were also at a higher risk of a hospital admission. Conclusions: In Barcelona, pedestrians and two-wheel MV occupants, besides accounting for two-thirds of MV injury cases, are the user groups with a greater risk of a more severe injury, as well as a higher chance of a hospital admission, independently of demographic and health care factors.