Background About 1.25 million people die globally every year as a result of Road Traffic Crashes(RTC’s), and it is found to be the 9th leading cause of mortality amongst all age groups which is further predicted to become at the 7th leading cause of mortality by 2030. Around 90% of the world’s fatalities due to RTC’s occur in LMIC’s and there exists gross disparity amongst LMIC versus HMIC’s to the level of care received immediately post-crash.Pakistan is the 5th leading contributor Of Road traffic Crash Related deaths, worldwide and the rate of RTC’s in Pakistan is about 14.2 per100,000 population(2013).Transfer of RTC victims to the right hospital at right time in golden hour of trauma is vital in preventing Mortality and lifelong disability

Objective To Determine the difference in Impact of Direct Versus Interfacility Transfers on 30 day Mortality of Adult Road Traffic Crash Victims (>18 years of age), Presenting to ED settings of three Tertiary Care Hospitals in Karachi.

Methods We performed a Prospective Cohort study at three tertiary care hospitals in Karachi, from April-August, 2016. All adult patients presenting with Serious Injuries (AIS≥3), were included in the study Data was collected through structured questionnaire 24/7 in the Emergencies of study sites. The primary exposure was Interfacility transfer and primary outcome of the study was 30 day Mortality on on Follow up.

Results Out of 201 participants 14.2% had mortality in Exposed group and 15.4% had mortality in Unexposed group (a HR:1.01,CI:0.41–2.89). The Mean survival time amongst two groups turned out to be insignificant as well.

Conclusion There existed no difference in 30 day mortality of Road traffic Crash victims with respect to Mode of transfer(exposure status) and the results can be implied in planning post-crash interventions while developing our trauma care systems.