Traumatic Brain Injuries (TBIs) resulting from Road Traffic Crashes (RTCs) can have fatal and disabling effects on patients. In this study, we evaluated the TBIs outcomes of patients involved in RTCs and identify key contributing factors affecting these outcomes. Data on 207 patients recorded by physicians at a tertiary hospital in Bangladesh was collected. A random parameters multinomial logit model with heterogeneity in the means was utilized to assess patients outcomes in three categories: Non-surgical, Surgical, and Fatal. From the random parameters, the study found that male patients (55.48%) are more likely to experience surgical and fatal outcomes. Male motorcycle users have a higher probability of experiencing fatal consequences. Additionally, 60.94% of incidents on rural roads result in surgeries and fatalities, with nighttime crashes on these roads significantly increasing the likelihood of fatal outcomes. Key factors impacting the likelihood of TBIs outcomes include older age, pedestrian involvement, bus and truck crashes, speeding, wet pavements, overtaking, low visibility, and weekday crashes. The study identified two significant interaction variables that increase the probability of fatal outcomes from TBIs: the interactions between low visibility and bus involvement, and between overtaking and wet pavements. While these factors individually had a higher probability of leading to both surgical and fatal outcomes, together these factors increase the risks to fatalities. Overall, our findings provide more detailed insights about the impact of TBIs outcomes resulting from RTCs and emphasize the need to develop more effective measures to improve road safety and patient outcomes.

翻译：道路交通事故导致的创伤性脑损伤对患者可能产生致命和致残性影响。本研究评估了涉及道路交通事故患者的创伤性脑损伤结局，并识别了影响这些结局的关键因素。我们收集了孟加拉国一家三级医院医生记录的207名患者数据。研究采用具有均值异质性的随机参数多项Logit模型，将患者结局分为三类进行评估：非手术治疗、手术治疗和死亡。随机参数分析显示，男性患者（55.48%）更可能面临手术治疗和死亡结局。男性摩托车使用者遭遇致命后果的概率更高。此外，60.94%的乡村道路事故导致手术治疗或死亡，其中夜间事故显著增加了死亡结局的可能性。影响创伤性脑损伤结局概率的关键因素包括：高龄、行人卷入事故、巴士与卡车碰撞、超速行驶、湿滑路面、超车行为、低能见度以及工作日事故。研究发现了两个显著增加创伤性脑损伤死亡概率的交互变量：低能见度与巴士事故的交互作用，以及超车行为与湿滑路面的交互作用。虽然这些因素单独作用时已更易导致手术治疗或死亡结局，但其共同作用会进一步增加死亡风险。总体而言，我们的研究结果提供了关于道路交通事故所致创伤性脑损伤影响的更详细见解，并强调了制定更有效措施以提升道路安全和改善患者结局的必要性。