An epidemiological of Injured patients

Our experience from a tertiary care hospital - emergency department.

Dr. Srihari. C.Fellowship Trainee in Emergency Medicine,

Department of Accident and Emergency Medicine,Christian Medical College, Vellore.

Objectives

• To study epidemiological profile of injured patients registered in emergency department.

• Identify population at risk from a particular injury.

 Methods

• Study design: Prospective, descriptive study.

• Setting: Emergency department, CMC- Vellore.

• Duration: 3 months – 1st August to 31st October 2006.

• Study Population: All injured patients attending emergency.

Methods (Cont..)

• Sampling technique: Consecutive sampling.

• Sample Size: 2058 (24% predictive value and 1% deviation).

• Instrument: Pre-formatted Questionnaire.

Operational Definitions

Injury

A bodily lesion at the organic level, resulting from acute exposure to physical energy in amounts that exceed the threshold of physiological tolerance.

* W.H.O. 2002.

MethodologyInclusion criteria:

All patients registered with injury to emergency.

Exclusion criteria: a. Old Injuries b. Burns

Observation – Patient profile

26092311 2274

647686 7280

500

1000

1500

2000

2500

3000

3500

August September OctoberMonths

Inju

ries

Other I llness7169 I njury 2058

n = 922721%

22% 24%

Weekly distribution of Injury

Wednesday145

Thursday 230

Friday 374

Saturday 300 Sunday 346

Monday 240

Tuesday 140

n = 2058

Injury – Triage priority

0

200

400

600

800

1000

1200

Priority 1 Priority 2 Priority 3

Inju

ries

FemaleMale

n = 2058

Priority 1: Life - threateningPriority 2: Potential Life - threateningPriority 3: Non – Life - threatening

8%

43%48%

Injury - Age and Gender Distribution

050

100150200250300350400450

0 - 9

10 - 19years

20 - 29

30 - 39

40 - 49

50 - 59

60 - 69

70 &M

ore

Age

Inju

ries

FemaleMale

n = 2058

Intent of Injuryn = 2058116 56

1886

Accidental 91.6%Suicidal 5.6%Homicidal 2.72%

Injury - Place of Occurrence

Fields Home School Street Work Total

Female 10 230 (50%) 4 172

(37%)40 (8%)

456

Male 50 450 (28%) 2 924

(57%)176 (10%) 1602

Total 60 680 (33%) 6 1096

(53%)216 (10%) 2058

Activity during Injury

998

122

400

348

190

Travelling49%

Walking19%

Working17%

Playing9%

Others6%

n = 2058

Aetiology of Injury

0 200 400 600 800 1000 1200

Road trafficAccidents - 1008

Fall - 406

IndustrialAccidents - 264

Bites/ Stings -148

Poison - 110

Assault - 56 n = 20583%

7%

5%

13%

20%

49%

Road Traffic Accidents - Age and Gender

0

50

100

150

200

250

300

0 - 9 10 - 19years

20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 &More

Inju

ries

FemaleMale

n = 1008

Road Traffic Accidents - Mechanism

590

216156

660

100

200

300

400

500

600

Inju

ries

Skid and Fall Motor VehicleCollision

Pedestrian Bicycle

n = 100859%

21%15%

6%

Road Traffic Accidents - Victim profile

0

100

200

300

400

500

600

Rider Passenger Pedestrian Driver Cyclist

MaleFemale

n = 100856%

20%15%16%

4%

Road Traffic Accidents - Vehicle

0

100

200

300

400

500

600

700

2 Wheeler

4 Wheeler

Pedestrian

AutoBicycle

FemaleMale

n = 100857%

23%16%

5%9%

Profile of Injuries due to fall

0

50

100

150

200

250

300

Slip and Fall246

Fall fromHeight 138

Fall from Stairs22

Female 118Male 288

60%

34%

6%

n = 406

Injury – Fall - Gender and Age

020406080

100120140160180200

0 - 9 10 - 19years

20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 &More

FemaleMale

n = 406

551611

450

834915

350

0

100

200

300

400

500

600

700

800

900

1000

Head Face Chest Abdomen Extremities Superficial

Num

ber o

f inj

urie

s

n = 2058

Anatomical distribution of Injury

Disposition after Initial Treatment

0

200

400

600

800

1000

1200

Discharged1046

Admitted637

DAMA 251 Expired 26

n = 2058

31%

52%

12%

1.28%

Injury Pyramid

1 Death

24Hospitalised

78Treated and Discharged

CONCLUSION• About 23% presented with injuries to emergency.

• Accidental injuries accounted for 92% of all injuries.

• Road traffic accidents were 54.8%.

• Death rate of 1.28% observed.

• Male predominance was 87.5%.

• Half of them belonged to 2nd & 3rd decade of life.

Benefit of the Study• Quantitative insight into injury load on the

emergency department and on the society.

• Scope for societal education of injury prevention.

• Developing injury registry.

Prevent injuryfor

Better Health