Abstract
This study aimed to develop and evaluate a model of hospital-based injury surveillance and describe the epidemiology of injuries in adults. One-year prospective surveillance was conducted in two hospitals in Hetauda, Nepal. Data were collected electronically for patients presenting to emergency departments (EDs) with injuries between April 2019 and March 2020. To evaluate the model’s sustainability, clinical leaders, senior managers, data collectors, and study coordinators were interviewed. The total number of patients with injuries over one year was 10,154, representing 30.7% of all patients visiting the EDs. Of patients with injuries, 7458 (73.4%) were adults aged 18 years and over. Most injuries (6434, 86%) were unintentional, with smaller proportions due to assault (616, 8.2%) and self-harm (408, 5.5%). The median age of adult patients was 33 years (IQR 25–47). Males had twice the rate of ED presentation compared with females (40.4 vs. 20.9/1000). The most common causes were road traffic accidents (32.8%), falls (25.4%), and animal/insect related injuries (20.1%). Most injured patients were discharged after treatment (80%) with 9.1% admitted to hospital, 8.1% transferred to other hospitals, and 2.1% died. In Nepal, hospital-based injury surveillance is feasible, and rich injury data can be obtained by embedding data collectors in EDs.
Highlights
Injuries are among the leading causes of death and disability in the world, especially in low- and middle-income countries (LMICs), where more than 90% of the world’s injuryrelated deaths occur [1]
Over 12 months, 33,046 patients visited the emergency departments (EDs) of the two study hospitals (Figure 1)
A similar hospital-based injury surveillance study conducted in India reported that more than half of the patients admitted to the ED had road traffic injuries [17]
Summary
Injuries are among the leading causes of death and disability in the world, especially in low- and middle-income countries (LMICs), where more than 90% of the world’s injuryrelated deaths occur [1]. In such settings, preventive health initiatives are limited, and healthcare systems may be poorly prepared to meet this challenge [2,3]. LMICs, injuries are a leading cause of morbidity and mortality in Nepal. The injury mortality rate was estimated at 59 per 100,000 population in 2017, doubling the rate calculated from the 2001 Nepal census (30 per 100,000 population) [5]. Young and middle-aged adults experience a greater burden of injuries than other age groups, and there will be more young and middle-aged adults with disabilities secondary to injury in the future [6]
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