Characteristics and outcomes of geriatric injuries presenting to an urban emergency department in Ghana

Abstract

Introduction

The elderly population is rapidly increasing in sub-Saharan Africa. Yet, their trauma care needs are often overlooked, and the epidemiology of their injuries remains poorly understood. This study aimed to describe the characteristics and outcomes of injuries in elderly patients treated at an urban emergency department (ED) in Ghana. Additionally, it aimed to identify the predictors of mortality that require focused attention.

Methods

A prospective cross-sectional survey of patients ≥ 60 years presenting with traumatic injuries between November 2021 and March 2022 was conducted at the ED of Komfo Anokye Teaching Hospital (KATH), Ghana’s second-largest hospital. Eligible patients were identified upon arrival in triage. Following initial resuscitation, trained research assistants obtained informed consent and collected patient data, including sociodemographic information, comorbidities, injury characteristics, and in-patient complications.

Results

Of the 2242 ED patients evaluated, 101 (4.7 %) were included. The median age was 69 years and sex distribution was even. Hypertension (48.5 %) was the most prevalent comorbidity. Falls (52.5 %) and motor vehicle collisions (40.6 %) were the predominant injury mechanisms, and isolated lower extremity injuries (39.6 %) were the most common. The majority of injuries were mild (65.4 % had an Injury Severity Score < 9). Venous thromboembolism was the most common in-patient complication. Median length of stay was 6 days, but patients with complications stayed longer. The overall hospital mortality rate was 11.9 %. Predictors of mortality were triage score, admission Glasgow Coma Score, admission pulse rate and Kampala Trauma Score.

Conclusion

Geriatric injuries constitute a small fraction of trauma admissions in this hospital. Triage score, Glasgow Coma Scale, pulse rate and Kampala Trauma Score predicted mortality and could form the basis for a simple screening protocol in low-resource EDs.