Survival and Predictors of Patient Mortality during Road Traffic Accidents in the Democratic Republic of Congo: Historical Cohort Study

Background and Purpose: Road accidents are now a serious public health problem in the Democratic Republic of Congo, but the impact in terms of accident survivorship is not known. The purpose of this study is to study survival and the socio-economic and clinical factors predicting mortality. Methods: This was a historical cohort study that took place from 2011 to 2016 and focused on the files of patients who suffered road traffic accidents in the city of Kinshasa. The variable of interest studied was the occurrence of a fatal road traffic accident. The explanatory variables were socio-demographic, clinical and environmental characteristics. Cox's regression looked for independent predictors of mortality. Results: Of all the casualties seen in the two hospitals, 19.6% had died. The annual incidence was 3.1% person-year with a survival time between admission and discharge of 18.6 days. The mean age of the accident victims was 33.4 ± 15.9 years, the majority was under 50 (81.2%), and the men were slightly dominant with an M/F sex ratio of 1.13. The majority of accident victims had a low socioeconomic level (66.1%). These accident victims had more than one attack of two organs (56.5%). The predictors of mortality were low socioeconomic level (aHR: 3.64; 95% CI: 2.00 - 5.01, p < 0.001) and medium (aHR: 6.04; 95% CI: 3.60 - 10, 13, p < 0.001), involvement of the head (aHR: 1.56; 95% CI: 1.14 - 2.13, p = 0.005), thorax (aHR: 2.98; 95% CI: 2, 15 - 4.13, p < 0.001) and abdomen (aHR: 1.93; 95% CI: 1.39 - 2.68, p < 0.001). Conclusion: The death toll from accident victims is heavy in the DRC as in developing countries where accident victims continue to die for often avoidable causes.