Outcomes of road traffic injuries before and after the implementation of a camera ticketing system: a retrospective study from a large trauma center in Saudi Arabia

BACKGROUND: Road traffic injuries (RTIs) are the third leading cause of death in Saudi Arabia. Because speed is a major risk factor for severe crash-related injuries, a camera ticketing system was implemented countrywide in mid-2010 by the traffic police in an effort to improve traffic safety. There are no published studies on the effects of the system in Saudi Arabia. OBJECTIVE: To examine injury severity and associated mortality at a large trauma center before and after the implementation of the ticketing system. DESIGN: Retrospective, analytical. SETTING: Trauma center of a tertiary care center in Riyadh. PATIENTS AND METHODS: The study included all trauma registry patients seen in the emergency department for a crash-related injury (automobile occupants, pedestrians, or motorcyclists) between January 2005 and December 2014. Associations with outcome measures were assessed by univariate and multivariate methods. MAIN OUTCOME MEASURE(S): Injury severity score (ISS), Glasgow coma scale (GCS) and mortality. RESULTS: The study included all trauma registry patients seen in the emergency department for a crash-related injury. All health outcomes improved in the period following implementation of the ticketing system. Following implementation, ISS scores decreased (−3.1, 95% CI −4.6, −1.6) and GCS increased (0.47, 95% CI 0.08, 0.87) after adjusting for other covariates. The odds of death were 46% lower following implementation than before implementation. When the data were log-transformed to account for skewed data distributions, the results remained statistically significant. CONCLUSIONS: This study suggests positive health implications following the implementation of the camera ticketing system. Further investment in public health interventions is warranted to reduce preventable RTIs. LIMITATIONS: The study findings represent a trauma center at a single hospital in Riyadh, which may not generalize to the Saudi population.