Document Type : Original Article
Authors
- . Jency Antony
- . Venkatachalam Jayaseelan
- . Jeby Jose Olickal
- . Joseph Alexis 1
- . Manikandanesan Sakthivel 2
1 Department of Emergency Medicine and Trauma, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
2 ICMR-National Institute of Epidemiology, Chennai, Tamil Nadu, India
Abstract
BACKGROUND: In India, most of the deaths due to road traffic accidents (RTAs) occur within
24 h of the accident. Hence, this study aimed to assess the proportion of RTA victims reaching the
health‑care facilities within the golden hour.
MATERIALS AND METHODS: This cross‑sectional study was conducted in a tertiary care center in
South India between August and September 2017. All RTA victims who were admitted for treatment
in the emergency department during the study period were included. Data were collected using
structured, pretested, and validated pro forma. Hospital exit outcomes between those who reached
within 1 h and those who did not were expressed as proportion with a 95% confidence interval (CI).
The factors associated with hospital exit outcomes were analyzed using a Chi‑square test.
RESULTS: Among 626 RTA victims, the mean (standard deviation) age was 37.4 (2.6) years,
and about 83% (n = 521) were male. More than one‑third (37%) of the RTAs occurred on urban
roads (n = 235, 37.5%). A total of 424 (67.7%) were referred from other hospitals. The mean
time taken for RTA victims to reach any health‑care facility was 3 h. More than half (n = 346,
55% [95% CI: 51.3–59.2]) of the RTA victims had reached a health‑care facility within the
golden hour. Among those who reached beyond the golden hour, one‑fourth (n = 77, 27.5%)
were delayed due to the unavailability of transporting vehicles. Delay in communication (n = 59,
21.1%), prolonged travel (n = 41, 14.6%), lack of knowledge about nearby facilities (n = 39,
13.9%), nonavailability of attenders (n = 35, 12.5%) and financial issues (n = 29, 10.4%) were
the other reasons for the delay.
CONCLUSION: Almost half of the RTA victims reached the health‑care facilities after the golden
hour. Unavailability of ambulances or vehicles for transport and delay in communication were the
important factors that played a role in the delay.
Keywords
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