Effectiveness of Integrated Trauma System Implementation on Road Traffic Fatalities and Injuries in the North of Iran Using an Interrupted Time Series Analysis.
Enayatollah Homaie Rad: Guilan Road Trauma Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran. ORCID
Farideh Sadeghian: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Zahra Ghodsi: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Shahrokh Yousefzadeh-Chabok: Guilan Road Trauma Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran.
Mohammad Hosein Ranjbar Hameghavandi: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Shahriar Ghashghaee: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Zahra Mohtasham-Amiri: Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran.
Hamid Heidari: Guilan Road Trauma Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran.
Gerard O'Reilly: School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Seyed Mohammad Ghodsi: Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. ORCID
Vafa Rahimi-Movaghar: Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. ORCID
BACKGROUND: Integrated Trauma systems (ITS) have shown potential in reducing traffic crash-related injuries and mortality, although their structure and impact can vary. This study assessed the effectiveness of ITS in Guilan, Iran. A retrospective observational study. METHODS: Utilizing a cross-sectional analysis, this descriptive-analytical study was conducted in Northern Iran from 2015 to 2019 to compare road traffic crash (RTC) data in Guilan (with ITS) against Mazandaran (without ITS), considering weather as a confounder. The study involved pre- and post-ITS intervention analyses to evaluate changes in RTC, injury, and mortality rates. RESULTS: Before ITS implementation, Guilan's daily RTC mean was 38.4 (SD=16.7), which significantly decreased to 30.8 (SD=13.7) after the intervention. Conversely, in the control province of Mazandaran, the daily average number of RTCs increased from 37.29 (SD=14.1) to 42.55 (SD=16.4) post-ITS implementation in Guilan. Furthermore, the mortality rate in Guilan showed a marginal decline from 27.74 (SD=12.6) pre-ITS to 26.60 (SD=11.9) post-ITS, indicating the positive impact of the ITS. In contrast, Mazandaran demonstrated a significant increase in mortality from 32.16 (SD=14.5) to 51.75 (SD=15.7). The statistical analysis confirmed a significant reduction in mortality and injury incidence in Guilan at the time of the intervention, with a marked decrease observed post-intervention (<0.001). CONCLUSION: The findings revealed that RTC prevention is feasible in Iran, with ITS in Guilan significantly reducing RTCs, injuries, and mortalities, underscoring the importance of ongoing efforts to expand ITS components nationally.
