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