# Risky Driving Behaviours and Their Association With Fracture Injury Severity in Road Traffic Accident Patients

## TL;DR

This study shows that risky driving behaviors are linked to more severe injuries in road accident patients in Pakistan.

## Contribution

The study identifies specific risky driving behaviors as predictors of injury severity in road traffic accident patients.

## Key findings

- Risky driving behaviors correlated strongly with higher injury severity scores.
- Males had higher risky driving and injury severity scores than females.
- Older age and risky driving increased injury severity, while valid licenses and experience were protective.

## Abstract

Background: Road traffic injuries (RTIs) are an increasingly significant population health problem in Pakistan. Such accidents cause fractures and are linked to unsafe driving behaviours. Determining the predictors of injury severity through behavioural means can reinforce the need for specific prevention methods. The study aimed to determine the correlation between risky driving behaviours and the severity of injuries in patients with road traffic-related fractures.

Procedures: The cross-sectional study was conducted from July 2024 to May 2025 at tertiary care hospitals in Islamabad, Rawalpindi, and Lahore, Pakistan. A convenience sampling method was used to enrol 400 adult patients with road traffic-related fractures. The data were collected using a structured questionnaire that included demographic information, the Driver Behaviour Questionnaire (DBQ), and the Injury Severity Score (ISS). Statistical tests were Pearson correlation, independent t-tests, one-way analysis of variance (ANOVA), and multiple linear regression.

Results: Of 400 respondents, 210 (53%) were male, and 190 (47%) were female, with the largest proportion aged 18-24 years (n = 180; 45%). DBQ and ISS scores were positively correlated (r = 0.612, p < 0.001). There were higher mean DBQ (M = 172.8 ± 13.2) and ISS (M = 24.1 ± 4.5) scores in males compared to females (M = 163.4 + 12.7 and M = 21.6 + 4.0, respectively; p < 0.001). Regression analysis showed that the risky driving behaviour and older age were associated with increased severity of injuries, whereas female gender, a valid driving licence, and a higher driving experience were protective (p < 0.01).

Conclusion: Risky driving behaviours have a significant impact on increasing the severity of injuries in road traffic fracture patients. Trauma-related outcomes may be associated with safer driving behaviours, adherence to licensing rules, and appropriate driver training.