Motorcycle crash-related trauma in a conflict zone: Determinants of mortality and injury severity in the Middle East

The aim of this study was to evaluate the impact of clinical and demographic factors on patient outcomes among motorcycle crash victims and to investigate their associations with injury severity, intensive care unit admission, and in-hospital mortality in a conflict-affected region of the Middle East. This retrospective study was conducted in the emergency department of a tertiary hospital located in a conflict-affected area of the Middle East. Data were collected for all patients presenting with motorcycle-related injuries between April 2023 and April 2024. Variables included demographic characteristics, accident mechanisms, trauma severity, Glasgow Coma Scale scores, and clinical outcomes. Logistic regression and receiver operating characteristic analyses were performed to identify predictors of mortality. A total of 721 patients were included. The majority were male (88.1%), and the most frequently affected age group was 11 to 20 years (37.4%). Crashes occurred most often during the summer months and evening hours. The overall in-hospital mortality rate was 4.2%, with deaths predominantly associated with severe trauma (96.7%), low Glasgow Coma Scale (≤8), intensive care unit admission, and head, thoracic, or abdominal injuries. Trauma severity demonstrated moderate accuracy in predicting mortality (area under the curve: 0.723). Motorcycle crashes in conflict zones place a significant burden on emergency healthcare systems and predominantly affect young males. These injuries often result in fatal head and thoracic trauma. Our study highlights the critical role of helmet use and vital signs at hospital admission in predicting outcomes and guiding triage decisions. The findings underscore the need to strengthen emergency response systems and implement context-specific trauma management protocols to improve survival in resource-limited conflict settings.