An Epidemiological Study of Injuries in Karnali, Nepal

Trauma, a major public health concern in remote highlands of Nepal, has led to considerable morbidity and mortality. The study elucidates the pattern and characteristics of trauma at the only tertiary care hospital in the Karnali province, Nepal.

Case records of all injured patients who presented to the emergency department from January to December 2018 were analyzed for demographic data, types of injuries, body parts injured, the outcome of the treatment, and distribution of injuries with respect to age and sex.

A total of 460 injured patients (age: 26.5 ± 19.67 years, range: 0.5-84) were studied consisting of 282 (61.3%) males and 178 (38.7%) females, with a male-to-female ratio being 1.58:1 (P = 0.001). Unintentional injuries were the predominant form of trauma (n = 383, 84.1%), with fall (n = 194, 42.2%), road traffic crashes (RTC) (n = 161, 35%), and physical assaults (n = 73, 15.9%) being the top three leading causes in order. Fall injury and RTC were most prevalent in children, accounting 12.8% (59) and 9.3% (43) of the total injuries, respectively. The physical assaults were predominant (n = 23, 5%) in adults (20-29 years). Male patients significantly outnumbered females for all types of injuries. Soft tissue followed by head and extremities was the most common site of injuries.

Trauma in Karnali is a predominantly early age male occurrence, with fall injury being the leading etiological factor, followed by injuries due to RTC and physical assaults. Soft tissue, head, and extremities were the major sites of injuries. Reducing fall injuries, RTC, and physical assaults will likely reduce mortality and morbidity due to trauma in this province.