Background: Traffic incidents are still a major contributor to hospital admissions and trauma-relatedmortality. The aim of this nationwide study was to examine risk-adjusted traffic injury mortality todetermine whether hospital type was an independent survival factor.
Methods: Data on all patients admitted to Swedish hospitals with traffic-related injuries, basedon International Classification of Diseases codes, between 2001 and 2011 were extracted fromthe Swedish inpatient and cause of death registries. Using the binary outcome measure of deathor survival, data were analysed using logistic regression, adjusting for age, sex, comorbidity,severity of injury and hospital type. The severity of injury was established using the InternationalClassification of Diseases Injury Severity Score (ICISS).
Results: The final study population consisted of 152,693 hospital admissions. Young individuals(0–25 years of age) were overrepresented, accounting for 41% of traffic-related injuries. Menwere overrepresented in all age categories. Fatalities at university hospitals had the lowest mean(SD) ICISS 0.68 (0.19). Regional and county hospitals had mean ICISS 0.75 (0.15) and 0.77 (0.15),respectively, for fatal traffic incidents. The crude overall mortality in the study population was 1193,with a mean ICISS 0.72 (0.17). Fatalities at university hospitals had the lowest mean ICISS 0.68(0.19). Regional and county hospitals had mean ICISS 0.75 (0.15) and 0.77 (0.15), respectively, forfatal traffic incidents. When regional and county hospitals were merged into one group and itsrisk-adjusted mortality compared with university hospitals, no significant difference was found. Acomparison between hospital groups with the most severely injured patients (ICISS ≤0.85) also didnot show a significant difference (odds ratio, 1.13; 95% confidence interval, 0.97–1.32).
Conclusions: This study shows that, in Sweden, the type of hospital does not influence risk adjustedtraffic related mortality, where the most severely injured patients are transported to the universityhospitals and centralization of treatment is common.