The most common mechanism of accident was motorcycle vs. other motor vehicle (56.2%). 
THERM
Patterns of traumatic injuries and outcomes to motorcyclists in a developing country: A cross-sectional study.OBJECTIVE
 Motorcyclists 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.


 A 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.


 A 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%).  The commonest in-hospital complication was acute kidney injury (23.7%).  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.


 CONCLUSION
 Although 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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