Abstract
Background: Integrated trauma systems (ITS) have shown potential in reducing traffic crash-related injuries and mortality, yet their structure and impact can vary. This study assesses the effectiveness of ITS in Guilan, Iran.
Study Design: A retrospective observational study.
Methods: A descriptive-analytical study utilizing a cross sectional analysis was conducted in Northern Iran from 2015-2019. It compared 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 analysis to evaluate changes in RTC, injury, and mortality rates.
Results: Before the 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 a positive impact of the ITS. Mazandaran, in contrast, saw 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 both mortality and injury incidence in Guilan at the time of the intervention, with a marked decrease observed post-intervention (P-value<0.001).
Conclusion: The study demonstrates that RTC prevention is feasible in Iran, with ITS in Guilan significantly reducing RTCs, injuries, and mortalities. It underscores the importance of ongoing efforts to expand ITS components nationally.