Trauma patterns in patients attending the Emergency Department of Jazan General Hospital, Saudi Arabia

doi:10.5847/wjem.j.1920-8642.2015.01.009

Abstract

Abstract:

BACKGROUND: Modern civilization and the sharp rise in living standards have led to dramatic changes in trauma pattern in Saudi Arabia. This study aimed to describe the different patterns of injuries of patients attending the Emergency Department of Jazan General Hospital (JGH) in the southwest corner of Saudi Arabia.
METHODS: A total number of 1 050 patients were enrolled in the study. A pre-organized data sheet was prepared for each patient attended the Emergency Department of JGH from February 2012 to January 2013. It contains data about socio-demographics, trauma data, clinical evaluation results, investigations as well as treatment strategies.
RESULTS: The mean age of the patients was 25.3±16.8 years. Most (45.1%) of the patients were at age of 18-30 years. Males (64.3%) were affected by trauma more common than females. More than half (60.6%) of the patients were from urban areas. The commonest kind of injury was minor injury (60%), followed by blunt trauma (30.9%) and then penetrating trauma (9.1%). The mean time from the incident to arrival at hospital was 41.3±79.8 minutes. The majority (48.2%) of the patients were discharged after management of trivial trauma, whereas 2.3% were admitted to ICU, 7.7% transferred to inpatient wards, and 17.7% observed and subsequently discharged. The mortality rate of the patients was 2.6%.
CONCLUSION: Trauma is a major health problem, especially in the young population in Saudi Arabia. Blunt trauma is more frequent than penetrating trauma, with road traffic accidents accounting for the majority.

Key words: Trauma, Injury, Emergency, Saudi Arabia

Emad Hokkam, Abdelaziz Gonna, Ossama Zakaria, Amany El-shemally. Trauma patterns in patients attending the Emergency Department of Jazan General Hospital, Saudi Arabia[J]. World Journal of Emergency Medicine, 2015, 6(1): 48-53.

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Variables		Number	%
Age (years)
	< 18	290	27.6
	18-	473	45.1
	30-	179	17.1
	50-	69	6.5
	≥ 60	39	3.7
	Mean±SD	25.3±16.8
	Range	1-80
Sex
	Male	675	64.3
	Female	375	35.7
Residence
Rural	414	39.4
Urban	636	60.6

Variables				Number	%
Types of trauma
		Blunt		324	30.9
		Penetrating		96	9.1
		Minor injury		630	60
Causes of trauma
	Blunt
			Motor car accident	207	19.7
			Falling down	48	4.6
			Violence	69	6.6
	Penetrating
			Stabbing 62		5.9
			Firearm 34		3.2
	Minor injury
			Cut wound 420		40
			Contused wound 210		20
Interval between trauma and hospitalization
		< 30 minutes		323	30.8
		30-60 minutes		548	52.2
		1-2 hours		126	12
		≥ 2 hours		53	5
		Mean±SD		41.3±79.8

Variables		Results
Heart rate (beats/minute)
	Mean±SD	88.4±10.2
	Range	40-140
Systolic BP (mmHg)
	Mean±SD	120.7±15.1
	Range	50-210
Diastolic BP (mmHg)
	Mean±SD	76.7±10.9
	Range	20-120
Respiratory rate (cycle/minute)
	Mean±SD	14.5±1.9
	Range	10-33
Consciousness level shown by AVPU scale (n, %)
	Alert	972 (92.6)
	Response to verbal stimuli	30 (2.9)
	Response to painful stimuli	3 (0.3)
	Unresponsive	45 (4.3)
Consciousness level by GCS (n, %)
	13-15	975 (92.9)
	9-12	30 (2.9)
	6-8	0 (0)
	4-5	21 (2)
	3	24 (2.2)

Characteristics		Blunt trauma	Penetrating trauma	Pvalue
Age (years)
	< 18	58 (17.9)	11 (11.5)	0.003^*
	18-	156 (48.1)	43 (44.7)
	30-	56 (17.3)	28 (29.2)
	50-	31 (9.6)	14 (14.6)
	≥ 60	23 (7.1)	0 (0)
Sex
	Male	178 (54.9)	86 (89.6)	0.001^*
	Female	146 (45.1)	10 (10.4)
	Total	324	96
Residence
	Rural	115 (35.5)	39 (40.6)	0.4 (NS)
	Urban	209 (64.5)	57 (59.4)	0.4 (NS)
Interval between trauma and hospitalization
	≤ 30 minutes	81 (25)	35 (36.5)	0.001^*
	30-60 minutes	153 (47.2)	50 (52.1)
	1-2 hours	71 (21.9)	7 (7.3)
	≥ 2 hours	19 (5.9)	4 (4.2)
Duration of stay in emergency room
	≤ 30 minutes	59 (18.2)	24 (25)	0.003^*
	> 30-60 minutes	83 (25.6)	37 (38.5)
	60-180 minutes	135 (41.7)	17 (17.7)
	> 3 hours	47 (14.5)	18 (18.8)
Fate
	Discharged after treatment of trivial trauma	69 (21.3)	14 (14.6)	0.001^*
	Kept under observation then discharged	43 (13.3)	6 (6.3)	0.001^*
	Admitted to inpatient wards	14 (4.3)	1 (1)	0.04^*
	Transferred to operation room	124 (38.3)	56 (58.3)	0.003^*
	Admitted to ICU	18 (5.6)	6 (6.3)	0.9 (NS)
	Discharged upon request or escaped	0 (0)	3 (3.1)	0.6 (NS)
	Referred to tertiary hospital	36 (11.1)	3 (3.1)	0.002^*
	Died	20 (6.2)	7 (7.3)	0.3 (NS)

Variables	Minor injury (n=630)					Blunt injury (n=324)					Penetrating injury (n=96)
Variables	< 30minutes	30-60 minutes	1-2 hours	≥ 2 hours	Total	< 30minutes	30-60 minutes	1-2 hours	≥ 2 hours	Total	< 30minutes	30-60 minutes	1-2 hours	≥ 2 hours	Total
Discharged after management of trivial trauma	140	231	32	20	423	17	33	15	4	69	5	7	1	1	14
Kept under observation then discharged	45	75	10	7	137	11	20	9	3	43	2	3	0	1	6
Admitted to inpatient ward	22	36	5	3	66	4	6	3	1	14	0	1	0	0	1
Transferred to operation room	0	0	0	0	0	31	59	27	7	124	21	28	5	2	56
Admitted to ICU	0	0	0	0	0	4	9	4	1	18	2	3	1	0	6
Discharged upon request or escaped	0	3	1	0	4	0	0	0	0	0	1	2	0	0	3
Referred to tertiary hospital	0	0	0	0	0	9	16	9	2	36	1	2	0	0	3
Died	0	0	0	0	0	5	10	4	1	20	3	4	0	0	7
Total	207	345	48	30	630	81	153	71	19	324	35	50	7	4	96