2D.005 Older pedestrian injury Outcomes: a systematic review, meta-analysis, and GRADE assessment

Background Older pedestrians 60+ (OP) have worse health outcomes due to pedestrian trauma. There is no available systematic evaluation of OP injury outcomes. This becomes increasingly important as the global population ages. We conducted a systematic review, meta-analysis and GRADE assessment of OP injury severity and compare them with those of younger age groups. Methods We searched PubMed, Embase, Scopus, CINAHL, PsycInfo, AMED, Web of Science, LILACS and TRID to identify studies assessing OP crashes and falls. Reporting was evaluated using STROBE, and GRADE was used to assess evidence quality. Random-effect model meta-analysis served to obtain pooled estimates. The review is registered in PROSPERO(#CRD42019140786). Results We included 60 studies (1,012,041 pedestrians). The pooled incidence proportion of OP crashes was 25% (95% CI: 22.3 – 28.5). OP were found to have higher severe injury, more critical care admissions, and higher fatality than younger pedestrians. OP also have higher incidence rates and severe injury from pedestrian falls. The overall quality of the evidence supporting the findings was low. Conclusions OP risks may offset some of the health gains from active ageing strategies, especially for developing economies with high numbers of vulnerable road users and with rapid population ageing. Learning Outcomes There is a need for research to improve the quality of evidence in regard to short and medium-term health outcomes and address long-term health outcomes for OP trauma.