Profile of injured patients presenting to a tertiary hospital in a developing country.

BACKGROUND: In most developing countries including Lebanon, trauma research is lacking and warranted. Objectives of the current study were to describe trauma patients referred to a tertiary care center during one year and identify outcomes and patterns of injury. METHODS: Review of hospital charts of every 12th consecutive patient presenting to the emergency unit (ED) after a traumatic event during the year 2001-2002. Data collected include: demographics, injury description, and hospital data. RESULTS: A total of 736 patients were included, 212 pediatric, 455 young, and 62 geriatric patients. The most common body regions injured were the extremities followed by the face. The most encountered mechanism of injury was fall from less than 15 feet (38.2%) followed by penetrating/gunshot injury (14.8%), and road traffic accidents (11.8%). The rates of hospital admission and surgical intervention were highest among geriatric patients (p = 0.03 and p < 0.001). Most injuries occurred during the evening shift and the average time spent in the ED was 86 minutes. The police was informed in 6.6% of the cases. CONCLUSIONS: Falls represent a worrisome mechanism across all age groups. This may be an indication for unaddressed occupational hazards for the working young and lack of awareness about the need for more children supervision. More rigorous investigation of intentional and unintentional firearm injuries, and their predisposing factors are needed.

Risk estimates for hip fracture from clinical and densitometric variables and impact of database selection in Lebanese subjects.

Bone mineral density (BMD) and fracture incidence vary greatly worldwide. The data, if any, on clinical and densitometric characteristics of patients with hip fractures from the Middle East are scarce. The objective of the study was to define risk estimates from clinical and densitometric variables and the impact of database selection on such estimates. Clinical and densitometric information were obtained in 60 hip fracture patients and 90 controls. Hip fracture subjects were 74 yr (9.4) old, were significantly taller, lighter, and more likely to be taking anxiolytics and sleeping pills than controls. National Health and Nutrition Examination Survey (NHANES) database selection resulted in a higher sensitivity and almost equal specificity in identifying patients with a hip fracture compared with the Lebanese database. The odds ratio (OR) and its confidence interval (CI) for hip fracture per standard deviation (SD) decrease in total hip BMD was 2.1 (1.45-3.05) with the NHANES database, and 2.11 (1.36-2.37) when adjusted for age and body mass index (BMI). Risk estimates were higher in male compared with female subjects. In Lebanese subjects, BMD- and BMI-derived hip fracture risk estimates are comparable to western standards. The study validates the universal use of the NHANES database, and the applicability of BMD- and BMI-derived risk fracture estimates in the World Health Organization (WHO) global fracture risk model, to the Lebanese.