Abstract

Prehospital determinants of motorcycle related femoral fracture injury severity remain a poorly documented trauma entity in Uganda. Knowledge of most at risk of poor injury outcome in resource limited settings with no formal prehospital care system is not only mandatory for evidence based preventive policy formulation but also guidance of clinical practice. This cross sectional descriptive and analytical hospital based study determines prehospital factors associated with injury severity of motorcycle related femoral fractures at the accident and emergency departments of two university teaching hospitals in Uganda, using the Kampala Trauma Score II (KTSII). Ethical clearance was obtained from Mbarara University of Science and Technology Research and Ethics Committee (IRB No.19/10-16). We consecutively recruited patients between December 2016 and June 2017, using investigator-administered questionnaire, to obtain data including history, clinical examination and radiological findings. Multiple logistic regression analysis and Odds ratios were computed using IBM SPSS 20.0. statistics for windows (Armonk. NY: IBM Corp) at 95% Confidence Interval and P<0.05 as statisticaly significant.  Of 230 patients, the mean age was 32 years (Std. Deviation 18.5 years), with male to female ratio of 2.4:1.Being a passenger on a motorcycle (OR 1.636; 95% CI [1.261-3.417; P=0.007) and receiving no first aid before arrival (OR 2.106; 95% CI [1.818-2.495]; P<0.001)were pre-hospital factors significantly associated with a severe Kampala Trauma Score II amongst patients sustaining femoral fracture secondary to motorcycle accidents. There was no association between means of arrival, prehospital time; pre-existing comorbidities and severity of KTSII in this patient category. Road traffic legislative efforts should protect the passenger in the same manner as for riders and pedestrians. There is need to strengthen prehospital care system in Uganda through training motorcyclists, police officers and taxi drivers on basic long bone fracture splintage.