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The incidence of peripheral nerve injury in trauma patients in Iran
Soheil Saadat1, Vahid Eslami, Vafa Rahimi-Movaghar
1Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Peripheral nerve injuries (PNI) are more common in young males due to sharp lacerations and road traffic crashes. Further research is needed on PNI outcomes and disabilities.
Area of Science:
- Trauma surgery
- Neurology
- Public health
Background:
- Injury is a leading cause of mortality, disability, and healthcare costs in young individuals (1-34 years).
- Peripheral nerve injuries (PNI) affect 2-3% of Level I trauma patients.
Purpose of the Study:
- To analyze the epidemiology of peripheral nerve injuries (PNI) in trauma patients.
- To identify common causes, locations, and demographics associated with PNI.
Main Methods:
- Data from the Iran National Trauma Registry (August 1999-February 2004) were analyzed using ICD-9 codes.
- Information on demographics, injury mechanisms, PNI characteristics, and costs was collected.
Main Results:
- Of 16,753 patients, 219 (1.3%) had PNI; 83.1% were male.
- Sharp lacerations (61%) and road traffic crashes (22%) were the leading causes of PNI.
- The elbow to hand region was the most frequent PNI site, with the ulnar nerve most commonly injured.
Conclusions:
- PNI predominantly affects young males, often resulting from sharp lacerations and road traffic accidents.
- Clinicians should suspect PNI in cases of open wounds from the elbow to the hand during triage.
- The long-term outcomes and disabilities associated with PNI warrant further investigation.
Background:
In patients aged 1-34 years, injury is the leading cause of mortality, disability and health care costs. Two to 3% of Level I trauma patients have peripheral nerve injury (PNI).
Methods:
Data were collected from the Iran National Trauma Registry database, compiled according to the International Classification of Diseases, 9th revision (ICD9) codes, from August 1999 to February 2004. The information included demography, mechanism, levels and regions of PNI, associated injuries, Abbreviated Injury Scale, duration of hospital stay, and costs.
Results:
Of 16,753 patients, 219 (1.3%) had PNI; 182 (83.1%) were male. The mean age of the patients with PNI was lower than of those without nerve injury (28.6±14.45 vs. 33±21.08 years; p<0.001). The most common cause of PNI was direct laceration from a sharp object (61%) followed by road traffic crashes (22%). Penetrating trauma was more common than non-penetrating injuries (5.6% vs. 0.4%, p<0.001). The most frequent PNI location was from the elbow to the hand (10%). The ulnar nerve was the most commonly injured nerve. The most common area of ulnar nerve injury was at the forearm (15.3%).
Conclusion:
Sharp laceration and road traffic crash have the highest rates of PNI, which are more common in young males. Open wounds from the elbow to the hand should raise suspicion of PNI in triage. Although injuries leading to PNI are rare, their outcomes and disabilities require further research.
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