Injury epidemiology and emergency department length of stay in trauma hospital in Addis Ababa, Ethiopia

Abstract

Background Injuries are a major cause of health problems in low- and middle-income countries than in high-income nations. This study aimed to describe injuries and identify factors associated with the emergency department (ED) length of stay (LoS). Methods This study was conducted at the Addis Ababa Burn, Emergency, and Trauma (AaBET) hospital in Addis Ababa, Ethiopia. All injured patients who visited the ED between April 1, 2021, and March 30, 2022, were included in the study. Data were collected through a retrospective medical record review. Descriptive statistics were used to present the data and a multivariable binary logistic regression model was used to assess factors associated with LoS in the ED. Results A total of 6991 (86.8%) injured patients were studied out of 8055 patients who visited the ED. The majority of the patients were male, 5184 (74.2%), and aged between 18–44 years, 4368 (62.4%). The most common mechanism of injury was road traffic accidents, 2693 (38.5%), followed by falls, 1523 (21.8%). The most commonly reported injured body parts were the head (2179, 31.2%). Of the total injured patients, 101 (1.8%) died. The LoS in the ED was greater than 24 hours for 24.4% (95% CI: 23.3–25.5) of the injured patients, with a mean duration of 2.51 (SD = 5.18) days. Factors significantly associated with a prolonged LoS (>24 hours) in the ED included being residing in outside Addis Ababa in Oromia [AOR: 1.61, 95% CI (1.38–1.88)], Amhara [AOR: 1.56, 95% CI (1.14–2.14)] and other [AOR: 3.93, 95% CI (2.73–5.64)], male [AOR: 1.30, 95% CI (1.09–1.54)], aged 60 years or older [AOR: 1.38, 95% CI (1.03–1.85)]; sustaining injuries from road traffic accident [AOR: 2.43, 95% CI (1.19–4.94)], being triaged to orange [AOR: 3.03, 95% CI (2.40–3.83)] and red zones [AOR:3.37, 95% CI (2.65–4.28)]; having fracture injuries [AOR: 1.95, (1.34–2.83)]; and experiencing contusions and crushing injuries [AOR: 2.63 (1.57–4.42)]. Conclusions Injuries are the major share of cases among ED patients at AaBET hospital. Patients were staying in the ED for longer than the recommended 24 hours by the Ethiopian health system. Intervention measures focusing on injury prevention are necessary to reduce the patient burden on the hospital and strengthen the hospital’s capacity to reduce prolonged LoS.