Epidemiology of Injuries Presenting to The Emergency Department of The Korle Bu Teaching Hospital: A 2024 Review

Abstract

Background: Injuries are a leading cause of morbidity and mortality globally, with low and middle-income countries (LMICs) bearing a disproportionate burden. Injuries directly lead to 5 million deaths every year, accounting for 9% of all deaths worldwide. Annually, about 800,000 deaths are recorded among children and adolescents under 20 from injuries of any kind. Low and middle-income nations account for 95% of childhood injury mortality. The highest injury rate is 94 per 100,000 in low-income countries of Sub-Saharan Africa. In the Volta Region of Ghana, a study analyzing transport-related injuries reported to health facilities from 2019 to 2023 found a cumulative incidence of 387 injuries per 100,000 population, with the highest incidence recorded in 2021. Most cases involved males (66.0%), and the highest proportion of injuries (35.8%) occurred among individuals aged 20–34 years. Methodology: This study utilized a retrospective cross-sectional study design to analyze a complete enumeration of 2,874 de-identified patient records presenting with injuries to the Korle Bu Teaching Hospital's Emergency Department from January 1 to December 31, 2024. The methodology relied on secondary data retrieved from hospital records. Variables collected included patient’s socio-demographics (age, sex, place and location of injury), clinical data (mechanism of injury and diagnosis), severity, mode of transportation and clinical outcome as well as referral and temporal patterns. The data was then subjected to descriptive and inferential statistical analysis after a rigorous data cleaning process. Results: Data from the Emergency Department revealed distinct demographic and mechanism patterns in injury presentations. Males were disproportionately affected across most injury types, accounting for 80.8% of assault cases and 68.9% of road traffic accident (RTA) cases. The highest proportion of injuries occurred in the 25-44 age group, particularly for assaults (60.6%) and RTAs (42.1%). The most common mechanisms of injury were RTAs, followed by falls, assaults, burns, and other forms of trauma. The most frequent diagnoses were lacerations (30.9%) and fractures (19.0%). The mortality rate for patients was 1.7%. Injury severity, primarily assessed by triage, indicated a high volume of green cases (78.3%). Temporally, presentations peaked significantly during weekends and in the afternoons (12-5:59pm). Monthly case flow was highest in September (10.5%) and August (10.1%). Furthermore, the mode of transport highlighted low utilization of ambulance services (1.6%), and most patients (56.9%) were able to walk to the wards upon arrival. Conclusion: This study provides crucial and up-to-date epidemiological data on injuries at the Korle Bu Teaching Hospital's Emergency Department, highlighting the significant burden of trauma. The findings reinforce that young adult males and road traffic accidents are the most affected and common causes, respectively. The low mortality rate underscores the effectiveness of current trauma management systems and the importance of prompt care. This research successfully fills a significant knowledge gap and offers foundational data for evidence-based interventions and policies. Ultimately, the study's implications can be used to improve hospital preparedness and support the development of a more responsive and effective trauma system in Ghana.