Road traffic injuries in Pakistan: challenges in estimation through routine hospital data

ABSTRACT

Injuries are becoming one of the most important public health challenges at the dawn of the new century. It is estimated that almost one fifth of the total global burden of disease is due to injuries. Road traffic injuries [RTIs] are a leading cause. This is a cross-sectional survey based on hospital records of Rawalpini General Hospital for reference year 2005. The yearly hospital record showed that a total of 119,214 persons visited the emergency during 2005. Twenty-four percent [28,679] of these cases were retained in the emergency department for treatment and 64% 18229 cases of the retained cases were shifted to concerned wards for further management. Injuries amounted to a total of 1,244 [6.8%] cases were recorded in the ER as RTIs. The proportion of injured males was [71%]. The surgical/orthopaedics presentations were 33% of the total ER cases with injuries. The amount of missing information was [11%] and the deficiency of the data regarding emergency admissions indicated flaws in the information systems. The findings surprisingly showed that RTIs have a very low proportion in the total presentations and this leads to doubts about the information systems at the hospital. The inability to follow the progress of these cases indicates that the data is under reported. Furthermore the small percentage of cases requiring retention in ER and even smaller requiring admission leads to the conclusion that a majority of the presenting cases in the ER may be outpatient cases, who for lack of an evening outpatient clinic, are coming to the ER. Further investigation is required involving other public/private sector hospitals to estimate the magnitude of the problem and comprehensiveness of the relevant data is also required