Epidemiology of injury: Results from injury registration at a district level hospital in Bangladesh – implications for prevention in low-income countries

Abstract

Background. Although only a small percentage of injury patients are hurt seriously enough to be hospitalized, examination of data on these serious injuries can aid in identifying priority injuries for future research, in recognizing risk groups and environment, and in developing intervention strategies and evaluating the effectiveness of injury interventions. This paper describes the characteristics of injuries in patients admitted to Sherpur Sadar Hospital – a rural hospital in Bangladesh – and is also aimed at determining the incidence and causes of major injuries in a rural area of Bangladesh. Methods. Data from the injury registration that has been developed in Sherpur Sadar Hospital in Bangladesh were used in this study. Information on all injury patients admitted to this hospital between 1 st May 1997 and 30 th April 1998 was analyzed. The registration included both unintentional and intentional injury cases. The rate of injury was calculated as the number of cases divided by the population reported in the 1991 census. Total rates and rates by cause, age, and gender were calculated. Results. During the study period, 1383 injured patients were hospitalized, of which 1027 (74%) were inhabitants of Sherpur sadar thana. The male:female ratio was 2.7:1. The mean age of injury patients admitted to the hospital was 29.6 years. Half of all injuries occurred in the home or residential area, and almost half (48%) of the injuries were caused by being struck or hit through contact with an object, other person, or animal. The leading causes of injury were violence (49%), traffic-related injuries (20%), falls (13%), and poisoning (10%). The estimated crude annual rate of injury admission for Sherpur sadar thana residents was 269.3/100,000 for all types of injuries. The age-specific injury rates were highest for adults and young adults (15–59 years). The rate for men (429/100,000) was more than twice that for women (210/100,000). Males sustained higher rates in each age group except among children under five years old. Overall hospital mortality was 15 of 1383 hospitalized cases, with no significant difference between major causes of injuries. Eighty-one cases (6%) were referred to a specialized hospital. The mean duration of the hospital stay for all admitted injury patients was 4.9 SD 4.3 days and the median duration of stay was 4 days. Conclusions. Analysis of data from hospital injury registration as part of an injury surveillance system can be an aid in the depiction of the overall severe injury situation in the area and, in this way, will be essential for the implementation, planning, and evaluation of preventive interventions aimed at reducing major injuries. Hospital injury registry data are also useful in developing further research questions and intervention programs.