Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
Injury. 2023 Oct;54(10):110980. doi: 10.1016/j.injury.2023.110980. Epub 2023 Aug 14.
Injury accounts for nearly 4 million deaths and 63 million disabilities annually. The injury burden is disproportionally large in low- and middle-income countries (LMICs), including Lebanon. This study aims to examine the characteristics and patterns of adult injuries presenting at multiple emergency departments (ED) in Lebanon and further identifies factors associated with hospital admission.
A retrospective cross-sectional study was conducted on adult patients (aged≥16) who presented with an injury to one of the five participating EDs from June 2017 to May 2018. Pan-Asia Trauma Outcomes Study (PATOS) variables were adopted for data collection. A descriptive analysis was performed, followed by bivariate and multivariate logistic regression to identify injury risk factors for hospital admission.
A total of 3,716 patients' records were included. Most injuries were sustained by males (62.7%), patients aged between 16 and 35 years (16-25: 28%; 26-35: 22.7%), and above 65 years (15.6%). Most injuries were unintentional (94.9%). Falls were highly prevalent across all age groups (38.8%), more proclaimed among the older adults' population (56-65:52.8%; ≥66:73.7%), followed by struck-by object (23.6%) and transport injuries (10.1%). Upper and lower extremity injuries were common across all ages. Most patients (80.9%) were treated and discharged at the ED, 11.4% were admitted to the hospital, 4.3% were transferred to other trauma care facilities, and 2 patients died in the ED. Factors positively associated with hospital admission included: older age (≥ 56 years); private insurance; spine and lower extremity injuries; fractures, cuts/open wounds, concussion, and organ injuries (p-value≤0.05; OR>1).
Injury is a neglected public health problem in many LMICs, including Lebanon. While youth and the elderly are most affected, injuries occur across all age groups. This study lays the foundation for establishing a population-based injury surveillance system, crucial for designing tailored injury prevention programs to reduce injury-related deaths and disabilities.
每年全球有近 400 万人死亡，6300 万人残疾，这与损伤有关。低中等收入国家（LMICs）的损伤负担不成比例，包括黎巴嫩。本研究旨在检查黎巴嫩五个急诊部（ED）就诊的成年损伤患者的特征和模式，并进一步确定与住院相关的因素。
2017 年 6 月至 2018 年 5 月，对在五个参与的 ED 因损伤就诊的成年患者（年龄≥16 岁）进行回顾性横断面研究。采用泛亚创伤结局研究（PATOS）变量进行数据收集。进行描述性分析，然后进行单变量和多变量逻辑回归，以确定住院的损伤危险因素。
共纳入 3716 名患者的记录。大多数损伤发生在男性（62.7%）、16-35 岁之间的患者（16-25 岁：28%；26-35 岁：22.7%）和 65 岁以上的患者（15.6%）。大多数损伤是意外的（94.9%）。跌倒在所有年龄段都很常见（38.8%），在老年人中更为常见（56-65 岁：52.8%；≥66 岁：73.7%），其次是被物体撞击（23.6%）和交通伤（10.1%）。上、下肢损伤在所有年龄段都很常见。大多数患者（80.9%）在 ED 接受治疗和出院，11.4%的患者住院，4.3%的患者转至其他创伤治疗机构，2 名患者在 ED 死亡。与住院相关的因素包括：年龄较大（≥56 岁）；私人保险；脊柱和下肢损伤；骨折、切割/开放伤口、脑震荡和器官损伤（p 值≤0.05；OR>1）。
损伤是许多低中等收入国家（包括黎巴嫩）忽视的公共卫生问题。虽然年轻人和老年人受影响最大，但损伤发生在所有年龄段。本研究为建立基于人群的损伤监测系统奠定了基础，这对于设计有针对性的损伤预防计划以减少与损伤相关的死亡和残疾至关重要。
