Road traffic injuries among older adults before and after a major earthquake: a single-center retrospective study

Abstract

Road traffic injuries are a major cause of morbidity and mortality among older adults, frequently leading to prolonged hospitalization, functional decline, and loss of independence. Large-scale disasters, such as earthquakes, may act as important modifiers of mobility patterns and environmental risk exposure, potentially reshaping road traffic injury characteristics. This study aimed to compare road traffic injury patterns and short-term clinical outcomes among older adults between the pre- and post-earthquake periods. This single-center, retrospective, hospital-based study included patients aged ≥ 65 years who presented with road traffic injuries to a tertiary emergency department during two equal 25-month periods before and after February 6, 2023. Injury mechanisms, anatomical distribution, and clinical outcomes were compared. A total of 427 older adults were included (pre-earthquake: 174; post-earthquake: 253), corresponding to a 1.45-fold increase in absolute case volume and an increase in the rate of traffic injury presentations from 2.3 to 2.8 per 10,000 emergency department visits in the post-earthquake period. Motorcycle-related injuries increased from 10.3% to 18.2% ( p = 0.026), while in-vehicle incidents decreased from 58.0% to 47.0% ( p = 0.025). Although head and neck trauma remained most common, lower extremity injuries rose significantly (29.9% vs. 41.1%; p = 0.018), as did femoral fractures (1.1% vs. 5.1%; p = 0.028). In-hospital mortality and length of stay did not significantly differ between periods. The post-earthquake period was associated with a measurable shift in road traffic injury patterns among older adults, characterized by increased motorcycle-related trauma and a higher orthopedic injury burden without deterioration in short-term clinical outcomes. These findings underscore the need for geriatric-focused trauma preparedness, adaptive healthcare strategies, and targeted injury prevention measures during disaster recovery phases.