Risk factors associated with severity of hospitalised injury outcome for vulnerable-road users in New South Wales, Australia: A population-based study

Vulnerable road users (VRU) – pedestrians, cyclists and motorcyclists account for a large proportion of road fatalities and injuries. The current study identifies injury risk factors associated with the severity of injury outcomes for VRUs. A retrospective analysis was conducted of transport injuries using linked hospitalisation and mortality records during 1 January 2010 to 30 June 2014 in New South Wales, Australia. Of the 73,314 land transport injuries identified, 37,428 (51.1%) consisted of injuries sustained by VRUs. Univariate and multi-variable logistic regression was conducted to examine factors associated with injury severity for each VRU. There were 6,007 pedestrians, 12,619 pedal cyclists, and 18,802 motorcyclists identified. All VRUs ≥65 years and those that collided with a motor-vehicle had a higher-odds of sustaining a serious compared to a minor injury. Pedestrians with a head or neck injury had almost 9 times the odds (OR:8.87, 95%CI: 4.13-19.06) and pedestrians with a trunk injury had 10 times the odds (OR: 10.01, 95%CI: 4.55-22.03) of sustaining a serious compared to minor injury. For pedal cyclists, the odds of sustaining a serious compared to minor injury was four times higher (OR:4.11, 95%CI: 1.70-9.93) for trunk injuries. Thirty-day mortality was higher for pedestrians (2.9%) compared to motorcyclists (0.5%) and pedal cyclists (0.4%). The total hospital treatment cost for VRUs was AUD $349.8 million, with serious injuries accounting for 62.4% of the total cost. Injury preventive initiatives, such as improved infrastructure, educational awareness campaigns to promote safe travel are advocated to reduce injury among VRUs.