{
  "abstract": "Introduction This study examined the factors linked to all-cause mortality and morbidity from neurological and musculoskeletal injuries during motorcycle accidents in Uganda.Methods The study was part of a two-armed, parallel, multi-period, cluster-randomised controlled trial of 1003 motorcycle crash victims. Morbidity was assessed using various scoring systems, and mixed effects regression models were employed for analysis.Results Ninety-day all-cause mortality was 9.2% (82/887). Factors associated with mortality included referral-to-dispatch >1 hour (OR 4.215 (1.802–9.858), p=0.001), Kampala Trauma Score (KTS) ≤6 (OR 7.696 (1.932–30.653), p=0.004), GCS 9–12 (OR 3.432 (1.194–9.870), p=0.022), GCS ≤8 (OR 6.919 (2.212–21.645), p=0.001), intra-axial lesions (OR 78.647 (9.871–626.587), p<0.001), extra-axial lesions (OR 11.933 (1.386–102.750), p=0.024), skull fracture (OR 11.366, (1.197–107.977), p=0.034) and craniotomy (OR 0.260 (0.095–0.706), p=0.008).A percentage of 14.5% had unfavourable Glasgow Outcome Scale (1–3); associated factors included increasing age (OR 1.02 (1.013–1.045, p<.001), multiple injuries (OR 4.559 (1.185–17.531), p=0.027), KTS 7-8 (OR 2.755 (1.285–5.906), p=0.009), KTS ≤6 (OR 7.551 (2.815–20.255), p=0.001), GCS 9-12 (OR 4.07 (1.901–8.719), p=0.001), GCS ≤8 (OR 13.779 (5.643–33.645), p<0.001) and craniotomy (OR 0.149 (0.075–0.295), p<0.001).Factors associated with unfavourable patient-reported musculoskeletal outcomes included being married (OR 1.984 (1.322–2.976), p=0.001), multiple injuries (OR 1.762 (1.001–3.100), p=0.049) and enrolment after the onset of the COVID-19 pandemic (OR 2.095 (1.199–3.659), p=0.009].Conclusions The key determinants of mortality and adverse neurological and musculoskeletal injury outcomes observed in this study are essential for establishing core outcome sets in future research and predictive models.Trial registration number Pan African Clinical Trial Registry (PACTR202308851460352).",
  "authors": [
    {
      "affiliations": [
        "Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Department of Clinical Neurosciences, Turku University Hospital and University of Turku Faculty of Medicine, Turku, Finland",
        "Center for Health Equity in Surgery and Aanaesthesia (CHESA), University of California San Francisco (UCSF) School of Medicine, San Francisco, California, USA"
      ],
      "name": "Herman Lule"
    },
    {
      "affiliations": [
        "Department of Public Health Sciences, California Baptist University, Riverside, California, USA"
      ],
      "name": "Micheal Mugerwa"
    },
    {
      "affiliations": [
        "Research Centre for Child Psychiatry, University of Turku Faculty of Medicine, Turku, Finland",
        "INVEST Research Flagship Centre, University of Turku Faculty of Medicine, Turku, Finland"
      ],
      "name": "Anne Abio"
    },
    {
      "affiliations": [
        "Department of Public Health, Botswana Harvard Health Partnership (BHP), Gaborone, Botswana",
        "Department of Surgery, Jinja Regional Referral Hospital, Jinja, Uganda"
      ],
      "name": "Benson Oguttu"
    },
    {
      "affiliations": [
        "Department of Surgery, Hoima Regional Referral Hospital, Hoima, Uganda",
        "Department of Surgery, Fort Portal Regional Referral Hospital, Fort Portal, Uganda"
      ],
      "name": "Andrew Kakeeto"
    },
    {
      "affiliations": [
        "Department of Surgery, Kampala International University - Western Campus, Bushenyi, Uganda",
        "Department of Surgery, Mubende Regional Referral Hospital, Mubende, Uganda"
      ],
      "name": "Daniel Asiimwe"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Mulago National Referral Hospital, Kampala, Uganda",
        "Department of Human Structure and Repair (GE38), Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium"
      ],
      "name": "Hervé Monka Monka Lekuya"
    },
    {
      "affiliations": [
        "Department of Surgery, Mengo Hospital, Kampala, Uganda"
      ],
      "name": "Robinson Ssebuufu"
    },
    {
      "affiliations": [
        "Department of Surgery, Uganda Martyrs University School of Medicine, Kampala, Uganda"
      ],
      "name": "Patrick Kyamanywa"
    },
    {
      "affiliations": [
        "Heidelberg Institute of Global Health (HIGH), University Hospital and University of Heidelberg, Heidelberg, Germany",
        "Department of Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA"
      ],
      "name": "Till Bärnighausen"
    },
    {
      "affiliations": [
        "Injury Epidemiology and Prevention (IEP) Research Group, Turku Brain Injury Centre, Department of Clinical Neurosciences, Turku University Hospital and University of Turku Faculty of Medicine, Turku, Finland",
        "Section for Oral Health, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany"
      ],
      "name": "Michael L Wilson"
    },
    {
      "affiliations": [
        "Neurocenter, Department of Neurosurgery and Turku Brain Injury Center, Turku University Hospital and University of Turku Faculty of Medicine, Turku, Finland"
      ],
      "name": "Jussi P Posti"
    }
  ],
  "title": "Factors associated with all-cause mortality and morbidity of motorcycle crash-related neurological and musculoskeletal injuries in Uganda: the MOTOR cluster randomised trial ancillary study",
  "uid": "24ce2444-e0f1-5f19-a8f3-a58517ff38e9"
}