Road accidents are collisions occurring on the road network between a rolling machine and any other thing or person [1]. They can cause injury and loss of life, as well as material damage [2].

Many factors contribute to the risk of collision, to its severity, and beyond the collision itself, to the survival or otherwise of the victims [3] [4] [5]. While road transport has probably contributed significantly to the development of isolated or even industrialized areas in the past, road accidents now represent a serious public health problem at the global, regional and national levels. They were the 9th leading cause of death, all causes and all ages in 2011, with an estimated mortality of 1.261 million annual deaths (i.e. 18 deaths per 100,000 inhabitants). This figure represents 2.8% of total mortality and is increasing (it was 1.017 million in 2000) according to WHO estimates [6] [7] [8] [9]. Another 20 to 50 million people survive accidents that cause crippling trauma all over the world. These road accidents represent a significant cost for countries (estimated between 1% to 3% of GDP), but they are also often strongly linked to the economic activity to which road traffic contributes [10] [11] [12].

The groups most affected by road crashes are pedestrians and motorcyclists in very low and low income countries [11]. Mortality varies by age, but this age structure does not appear to be affected by the income level of countries. However, other confounding factors can disturb this relationship. The effects of income on road mortality must therefore be analyzed, all other things being equal, as demonstrated by road network experts. In our country the survival of patients during road traffic accidents is not known despite the number of road traffic accidents recorded in our cities. This is why this study aims to study survival and the socio-economic and clinical factors predicting mortality.

Of all the patients who were admitted in emergency, there were 878 who had usable records during our investigation. These 878 were the data for this study.

In the Democratic Republic of Congo, all vehicles can be used for public transport, sometimes without the approval documents. Also since 2008, motorcycles are introduced as a means of public transport. Mototaxis drivers, often young, are unfamiliar with the rules of the road, overload and speed to make the most of their working day. They are thus exposed to four-wheeled vehicles and more particularly to their direct competitors, taxis with whom they compete for customers. This reality justifies the multiple bodily injuries recorded in this study. Also the absence of a public transport system serving the interior of the country

forces users to use goods transport vehicles, which in the event of an accident are buried by goods causing multiple and serious injuries.

More than three quarters of accident victims are polytraumatized. This rate is higher than those observed in the series of Abdou Raouf et al. [13] and Hoekman et al. [14] which are respectively 12.41% and 12.8%. This could show that road traffic accidents would be more serious here. The majority of cases of trauma were located in the limbs followed by thoraco-abdominal and cranio-encephalic trauma. These two parts of the body are the most exposed, especially in road traffic accidents involving motorcycles. Our rates are similar to those of Allode et al. [15] and Bousso et al. [16] who reported 51.61% and 53.65% respectively for limb lesions.

In this study, men and accident victims under the age of 50 were more frequently affected. Nevertheless, the literature shows that, in three out of four cases, the people who died in the road traffic accident were men and those of an economically productive age. The economic weight of road accidents is therefore not negligible [17].

Hospital mortality is very high in our series (19.6%). It is justified by the fact that accidents involving goods transport vehicles leave victims buried, but also by speeding which leads to violent shocks responsible for serious injuries. Also the victim support services are not equipped to take care of seriously injured people. In addition, the country does not have health insurance. Victims pay for medical costs and consumables, expenses unforeseeable in an accident.

The annual mortality incidence in our study was 3.1 person-years. The incidence of road traffic fatalities per person year is lower than 17.3; 8.8; 7.9; 33.2 and 7.2 person-years from Ethiopia, Rwanda, Senegal, Sierra Leone and Uganda respectively. Our incidence of death per 100,000 inhabitants is comparable to that reported in Syria in the Middle East, Morocco and Tunisia in the Maghreb Mediterranean which is in the order cited 4.5; 3.3 and 2.6 [18].

Among the predictors of this mortality, the low and average socioeconomic level, emerged as a major predictor of the mortality of accident victims. This risk persisted after adjusting for risk factors alongside organ damage such as head, thorax and abdomen. It has already been shown, however, that individuals with the lowest incomes had a risk of mortality compared to those with higher incomes [19]. The factors correlated with the socio-economic status which could explain the death are numerous, poverty having reduced the hospital care service, insufficient medication intake and lack of access to paraclinical explorations. As for lesions of the head, thorax and abdomen as predictors of mortality, it is appropriate to indicate that serious lesions of these organs could lead to death by haemorrhages, especially the hollow organs of the abdomen and thorax. or subarachnoid hemorrhages due to rupture of internal vessels in the brain.

However, this study has limitations that should be noted. The first relates to methodology, with the inclusion of only 2 hospitals out of the large number of health structures that receive casualties in the city. Interesting data must have escaped during data collection. Moreover, this study has the merit of finding the risk factors for accident mortality, on which particular attention should be drawn.

The frequency of deaths during road traffic accidents is high and the predictors of mortality are the low and average socioeconomic level on the one hand and the location of the lesions in the head, thorax and chest abdomen.

We thank all who participated in the study.

JMN and ANN designed and analyzed the statistical data for the study. MLN, DMK, LMB, GN, AKK, DMB and LMB supervised the study. All authors have read and approved the final and revised version of the manuscript.

The authors declare no conflict of interest.

Ndongila, J.M., Natuhoyila, A.N., Nkumu, M.L., Batane, L.M.B., Kulimba, D.M., Nsambi, G., Kapay, A.K., Bolamba, D.M. and Mbenza, B.L. (2021) Survival and Predictors of Patient Mortality during Road Traffic Accidents in the Democratic Republic of Congo: Historical Cohort Study. Open Access Library Journal, 8: e8059. https://doi.org/10.4236/oalib.1108059