The changing epidemiology of trauma in child-bearing age women.

BACKGROUND: In the last two decades, there have been major improvements in the trauma system in the United Arab Emirates (UAE). We aimed to study the changes in the incidence, type, severity, and outcome of trauma of hospitalized child-bearing age women in Al-Ain City, UAE, during that time. METHODS: Data from two separate trauma registries of Al-Ain Hospital, which were prospectively collected from March 2003 to March 2006 and January 2014 to December 2017, were analyzed retrospectively. All women aged 15-49 years were studied. The two periods were compared. RESULTS: Trauma incidence of hospitalized child-bearing age women was reduced by 47% during the second period. There were no significant differences in the mechanism of injury between the two periods. Road traffic collision was the main cause of injury (44% and 42%, respectively) followed by fall down (26.1% and 30.8%, respectively). The location of injury was significantly different (p = 0.018), with a strong trend of more home injuries in the second period (52.8% compared with 44%, p = 0.06). There was a strong statistical trend of mild traumatic brain injury (GCS 13-15) in the second period (p = 0.067, Fisher's Exact test). Those who had normal GCS of 15 were significantly higher in the second period compared with those in the first period (95.3% compared with 86.4%, p < 0.001, Fisher's Exact test) despite having more anatomical injury severity of the head (AIS 2 (1-5) compared with 1 (1-5), p = 0.025). The NISS was significantly higher in the second period (median (range) NISS 5 (1-45) compared with 4 (1-75), p = 0.02). Despite that, mortality was the same (1.6% compared with 1.7%, p = 0.99) while the length of hospital stay was significantly less (mean (SD) 5.6 (6.3) days compared with 10.6 (13.6) days, p < 0.0001). CONCLUSIONS: The incidence of trauma in hospitalized child-bearing-age women was reduced by 47% over the last 15 years. Road traffic collisions and falls are the leading cause of injury in our setting. Home injuries increased over time. The mortality remained stable despite the increased severity of injured patients. More injury prevention efforts should target home injuries.

Reduction of motorcycle-related deaths over 15 years in a developing country.

BACKGROUND: There have been major improvements in the trauma system and injury prevention in Al-Ain City. We aimed to study the impact of these changes on the incidence, pattern, injury severity, and outcome of hospitalized motorcycle-related injured patients in Al-Ain City, United Arab Emirates. METHODS: This is a retrospective analysis of two separate periods of prospectively collected data which were retrieved from Al-Ain Hospital Trauma Registry (March 2003 to March 2006 compared with January 2014 to December 2017). All motorcycle-injured patients who were admitted to Al-Ain Hospital for more than 24 h or died in the Emergency Department or after hospitalization were studied. RESULTS: The incidence of motorcycle injuries dropped by 37.1% over the studied period. The location of injury was significantly different between the two periods (p = 0.02, Fisher's exact test), with fewer injuries occurring at streets/highways in the second period (69.1% compared with 85.3%). The anatomical injury severity of the head significantly increased over time (p = 0.03), while GCS on arrival significantly improved (p < 0.0001), indicating improvements in both prehospital and in-hospital trauma care. The mortality of the patients significantly decreased (0% compared with 6%, p = 0.002, Fisher's exact test). CONCLUSIONS: The incidence of motorcycle injuries in our city dropped by almost 40% over the last 15 years. There was a significant reduction in the mortality of hospitalized motorcycle-injured patients despite increased anatomical severity of the head injuries. This is attributed to improvements in the trauma care system, including injury prevention, and both prehospital and in-hospital trauma care.

It's time for a minimum synoptic operation template in patients undergoing laparoscopic cholecystectomy: a systematic review.

BACKGROUND: Despite the call to enhance accuracy and value of operation records few international recommended minimal standards for operative notes documentation have been described. This study undertook a systematic review of existing operative reporting systems for laparoscopic cholecystectomy (LC) to fashion a comprehensive, synoptic operative reporting template for the future. METHODS: A search for all relevant articles was conducted using PubMed version of Medline, Scopus and Web of Science databases in June 2021, for publications from January 1st 2011 to October 25th 2021, using the keywords: laparoscopic cholecystectomy AND operation notes OR operative notes OR proforma OR documentation OR report OR narrative OR audio-visual OR synoptic OR digital. Two reviewers (NOC, GMC) independently assessed each published study using a MINORS score of ≥ 16 for comparative and ≥ 10 for non-comparative for inclusion. This systematic review followed PRISMA guidelines and was registered with PROSPERO. Synoptic operative templates from published data were assimilated into one "ideal" laparoscopic operative report template following international input from the World Society of Emergency Surgery board. RESULTS: A total of 3567 articles were reviewed. Following MINORS grading 25 studies were selected spanning 14 countries and 4 continents. Twenty-two studies were prospective. A holistic overview of the operative procedure documentation was reported in 6/25 studies and a further 19 papers dealt with selective surgical aspects of LC. A unique synoptic LC operative reporting template was developed and translated into Chinese/Mandarin, French and Arabic. CONCLUSION: This systematic review identified a paucity of publications dealing with operative reporting of LC. The proposed new template may be integrated digitally with hospitals' medical systems and include additional narrative text and audio-visual data. The template may help define new OR (operating room) recording standards and impact on care for patients undergoing LC.

Current changes in the epidemiology of fall-related injuries in Al Ain City, United Arab Emirates.

BACKGROUND: Falls in the Gulf countries are the second most common cause of injuries. The United Arab Emirates government implemented various preventive measures to decrease injuries in the country. We aimed to evaluate the changes in the epidemiology of fall-related injuries in Al-Ain City over the last decade. METHODS: Data of hospitalized patients who presented with fall-related injuries to the Al-Ain Hospital during the two periods of March 2003 to March 2006 and January 2014 to December 2017 were compared. This included patients' demographics, mechanism, location, anatomical distribution and parameters related to injury severity. Non-parametric tests were used for the statistical analysis. RESULTS: 882 in the first and 1358 patients in the second period were studied. The incidence of falls decreased by 30.5% over ten years. The number of elderly, female patients, and UAE nationals increased, (p < 0.001, p = 0.004, and p < 0.001). Falls from height decreased by 32.5% (p < 0.001) while fall on the same level increased by 22.5% (p < 0.001). Fall-related injuries at home have increased significantly by 22.6% (p <0.001), while falls in workplaces decreased by 24.4% (p <0.001). CONCLUSIONS: Our study showed that the overall incidence of falls decreased compared to a decade ago. The preventive measures were effective in reducing falls from height and workplace injuries. Future preventive measures should target falls at the same level and homes.

Epidemiological changes of geriatric trauma in the United Arab Emirates.

ABSTRACT: We aimed to study the epidemiological changes in geriatric trauma in Al-Ain City, United Arab Emirates, in the past decade to give recommendations on injury prevention.Trauma patients aged 65 years and above who were hospitalized at Al-Ain Hospital for more than 24 hours or died in the hospital after their arrival regardless of the length of stay were studied. Data were extracted from the Al-Ain Hospital trauma registry. Two periods were compared; March 2003 to March 2006 and January 2014 to December 2017. Studied variables which were compared included demography, mechanism of injury and its location, and clinical outcome.There were 66 patients in the first period and 200 patients in the second period. The estimated annual incidence of hospitalized geriatric trauma patients in Al-Ain City was 8.5 per 1000 geriatric inhabitants in the first period compared with 7.8 per 1000 geriatric inhabitants in the second period. Furthermore, mortality was reduced from 7.6% to 2% (P = 0.04). There was a significant increase in falls on the same level by14.9% (62.1%-77%, P = 0.02, Pearson χ2 test). This was associated with a significant increase of injuries occurring at home (55.4%-78.7% P = 0.0003, Fisher Exact test). There was also a strong trend in the reduction of road traffic collision injuries which was reduced by 10.8% (27.3%-16.5%, P = 0.07, Fisher Exact test).Although the incidence and severity of geriatric trauma did not change over the last decade, in-hospital mortality has significantly decreased over time. There was a significant increase in injuries occurring at homes and in falls on the same level. The home environment should be targeted in injury prevention programs so as to reduce geriatric injuries.

Trauma system developments reduce mortality in hospitalized trauma patients in Al-Ain City, United Arab Emirates, despite increased severity of injury.

BACKGROUND: Trauma is a leading cause of death in the United Arab Emirates (UAE). There have been major developments in the trauma system in Al-Ain City during the last two decades. We aimed to study the effects of these developments on the trauma pattern, severity, and clinical outcome of hospitalized trauma patients in Al-Ain City, United Arab Emirates. METHODS: This is a retrospective analysis of two separate sets of prospectively collected trauma registry data of Al-Ain Hospital. Data were collected over two periods: from March 2003 to March 2006 and from January 2014 to December 2017. Demography, injury mechanism, injury location, and clinical outcomes of 2573 trauma patients in the first period were compared with 3519 patients in the second period. RESULTS: Trauma incidence decreased by 38.2% in Al-Ain City over the last 10 years. Trauma to females, UAE nationals, and the geriatric population significantly increased over time (p < 0.0001, Fisher's exact test for each). Falls on the same level significantly increased over time, while road traffic collisions and falls from height significantly decreased over time (p < 0.0001, Fisher's exact test for each). Mortality significantly decreased over time (2.3% compared with 1%, p < 0.0001, Fisher's exact test). CONCLUSIONS: Developments in the trauma system of our city have reduced mortality in hospitalized trauma patients by 56% despite an increased severity of injury. Furthermore, the injury incidence in our city decreased by 38.2% over the last decade. This was mainly in road traffic collisions and work-related injuries. Nevertheless, falls on the same level in the geriatric population continue to be a significant problem that needs to be addressed.

Hey surgeons! It is time to lead and be a champion in preventing and managing surgical infections!

Appropriate measures of infection prevention and management are integral to optimal clinical practice and standards of care. Among surgeons, these measures are often over-looked. However, surgeons are at the forefront in preventing and managing infections. Surgeons are responsible for many of the processes of healthcare that impact the risk for surgical site infections and play a key role in their prevention. Surgeons are also at the forefront in managing patients with infections, who often need prompt source control and appropriate antibiotic therapy, and are directly responsible for their outcome. In this context, the direct leadership of surgeons in infection prevention and management is of utmost importance. In order to disseminate worldwide this message, the editorial has been translated into 9 different languages (Arabic, Chinese, French, German, Italian, Portuguese, Spanish, Russian, and Turkish).

Distraction-related road traffic collisions.

OBJECTIVES: We aimed to prospectively study distraction-related road traffic collision injuries, their contributory factors, severity, and outcome. METHODS: Data were prospectively collected on all hospitalized road traffic collision trauma patients in Al-Ain City who were drivers at the collision time over one and half years. Driver's inattentive behaviors preceding the collision were collected by interviewing the admitted drivers. RESULTS: There were 444 drivers, 330 of them were fully oriented patients, out of them only 44 (13%) were distracted. Nineteen (5.8%) drivers were distracted by using mobile phones, 12 (3.6%) were pre-occupied with deep thinking, six (1.8%) were talking with other passengers, four (1.2%) were picking things in the vehicle, and three (0.9%) were using entertainment systems. The maximum distraction occurred during the time of 6 am - 12 noon when the traffic was crowded. There were no significant differences between distracted and non-distracted drivers in demographical and physiological factors, injured regions, and outcomes. CONCLUSION: Distraction of alert drivers causes 13% of road traffic collisions in Al-Ain city. About 40 percent of the distracted drivers involved in road traffic collisions (RTC) were using mobile phones. Our study supports the ban of use of cell phones while driving.

Youth traffic-related injuries: a prospective study.

BACKGROUND: Traffic-related injuries are the most common cause of morbidity and mortality of the youth. Our aim was to study epidemiology, risk factors and outcome of hospitalized youth patients injured in road traffic collisions in order to give recommendations for prevention. METHODS: We prospectively studied all youth (15-24 years) patients having traffic-related injuries who were admitted to Al Ain or Tawam Hospitals, Al Ain City, or who died after arrival to these hospitals during an 18 months period. Demography, location and time of injury, injured body regions, severity, hospital and intensive care unit (ICU) stay and outcome were analyzed. RESULTS: Three hundred thirty-three patients having a mean age (SD) of 20 years (2.5) were studied. 87% were males and 72% were UAE nationals. Majority of injured patients were drivers or front-seat passengers (70%), followed by back seat passengers (16%), motorcyclists (5%) and pedestrians (4%). Rollover was the most common crash mechanism (35%), followed by front crash (34%). Twenty seven patients (8%) were ejected during the crash, 14 during roll-over, 7 from quadribikes and three during front crash. 20% of the patients were admitted to the ICU. Median Glasgow Coma Scale was 15 (range 3-15), median Injury Severity Score was 5 (range 1-41), and median total hospital stay was 3 days (range 1-73). Nine (3%) patients died. CONCLUSIONS: Young UAE-national males are at a higher risk of being injured at traffic. Rollover crash was frequent with high risk of ejection. Promotion of traffic safety and enforcement of safety legislation is necessary.

Epidemiology of isolated hand injuries in the United Arab Emirates.

AIM: To provide suggestions for hand injury prevention by study the demography and risk factors of casualties suffering from isolated hand injuries. METHODS: All trauma patients with isolated hand injuries who were admitted to Al Ain Hospital for more than 24 h during a period of 3 years were studied. Patient demographics, location, mechanism/time of injury, and length of hospital stay were all analyzed. RESULTS: Two hundred and ten patients were studied. Their mean age was 29.7 years. Males constituted 92%. Sixty-five point one percent of all cases were from the Indian subcontinent. The workplace was the most common location of injury (67.1%), followed by the home (17.1%) and road (6.2%). Machinery caused 36.2% of all injuries, followed by heavy object (20.5%) and fall (11%). Cases injured at home were young (P < 0.0001) with an associated higher incidence of females (P < 0.0001). CONCLUSION: Male workers in Al Ain city are at greater risk of sustaining hand injuries, predominantly from machinery. Safety education, personal protection, and the enforcement of safety standards are essential to the prevention and avoidance of hand injury.

Lower limb and associated injuries in frontal-impact road traffic collisions.

OBJECTIVES: To study the relationship between severity of injury of the lower limb and severity of injury of the head, thoracic, and abdominal regions in frontal-impact road traffic collisions. METHODS: Consecutive hospitalised trauma patients who were involved in a frontal road traffic collision were prospectively studied over 18 months. Patients with at least one Abbreviated Injury Scale (AIS) ≥3 or AIS 2 injuries within two AIS body regions were included. Patients were divided into two groups depending on the severity of injury to the head, chest or abdomen. Low severity group had an AIS < 2 and high severity group had an AIS ≥ 2. Backward likelihood logistic regression models were used to define significant factors affecting the severity of head, chest or abdominal injuries. RESULTS: Eighty-five patients were studied. The backward likelihood logistic regression model defining independent factors affecting severity of head injuries was highly significant (p =0.01, nagelkerke r square = 0.1) severity of lower limb injuries was the only significant factor (p=0.013) having a negative correlation with head injury (Odds ratio of 0.64 (95% CI: 0.45-0.91). CONCLUSION: Occupants who sustain a greater severity of injury to the lower limb in a frontal-impact collision are likely to be spared from a greater severity of head injury.

Epidemiology of spinal injuries in the United Arab Emirates.

AIM: To assess the risk factors, mechanism of injury, and clinical outcome of hospitalized patients with spinal injuries in order to recommend preventive measures. METHODS: Patients with spinal injuries admitted to Al Ain Hospital, United Arab Emirates (UAE) for more than 24 h or who died after arrival to the hospital were studied over 3 years. Demography, location and time of injury, affected body regions, hospital and ICU stay, and outcome were analyzed. RESULTS: 239 patients were studied, 90 % were males, and 84 % were in the productive years of 25-54. Majority were from the Indian subcontinent (56 %). Road was the most common location for spinal injury (47 %), followed by work (39 %). The most common mechanism of injury was traffic collisions (48 %) followed by fall from height (39 %) and fall from the same level (9 %). UAE nationals were often injured at road and home compared with non-UAE nationals, who were more injured at work (p < 0.0001). Patients falling from the same level were older (p = 0.001) and predominantly females (p < 0.0001) when compared with other mechanisms. Spinal fractures were more common in the lumbar region (57 %). Eleven patients (5 %) sustained paraplegia and five (4 %) patients died. INTERPRETATION: Traffic injuries and falls were the leading causes for spinal injuries in the UAE. Expatriate males are at high risk for fall from height, UAE national males for traffic injuries and females for falls at the same level at homes. Prevention should focus on traffic and home injuries for UAE nationals and occupational safety for expatriate workers.

Epidemiology of animal-related injuries in a high-income developing country.

BACKGROUND: The objective of this study was to investigate the incidence, mechanisms, types, anatomical distribution, and outcome of animal related-injuries in Al-Ain, the United Arab Emirates in order to improve preventive measures. METHODS: The study included all patients admitted to Al-Ain Hospital with animal-related injuries for more than 24 hours or the patients who died in the Emergency Department between March 2003 and March 2007. RESULTS: There were eighty-nine (2.3%) patients, of whom 99% were males. The median age of the patients was 30 (range, 5-89) years. Camel-related injuries were the most common (84.3%) injuries followed by cow-related injuries (6.7%). 88.7% of the injuries occurred at work. Animal kick was the most common mechanism of injury (32.6%) followed by falls (30.3%). Upper extremity was the most commonly injured region. The median Injury Severity Score (ISS) was 4 (range, 1-13) and the median hospital stay was 6 (range, 1-53) days. CONCLUSION: The majority of animal-related injuries were caused by camels. Experience in handling the animals, a good knowledge of animal behavior along with using safety devices and prevention education can reduce the toll of animal-related injuries.

Factors affecting injury severity of vehicle occupants following road traffic collisions.

AIM: We aimed to define factors affecting injury severity of vehicle occupants following road traffic collisions (RTC). PATIENTS AND METHODS: 422 vehicle occupants (343 males, 81.3%) with RTC-related injuries were prospectively studied over 18 months. General linear model was used to test the effect of age, gender, alcohol and drug use, time of injury, mechanism of injury, size and speed of the vehicle, position in the vehicle, seatbelt usage, and air bag deployment on the Injury Severity Score (ISS) of the vehicle occupants. RESULTS: The mean (range) age of patients was 28.2 (1-78) years and the mean (range) ISS was 7.9 (1-50). Front impact was the most common mechanism of injury (32.9%) followed by rollover (25.6%) and side impact (22.3%). 18.2% used seatbelts. The general linear model was highly significant and showed that mechanism of injury (p<0.0001), speed of the vehicle (p=0.02), and age of the vehicle occupant (p=0.03) significantly affected the Injury Severity Score. CONCLUSIONS: The mechanism of the RTC, the vehicle speed, and age of the vehicle occupant are the most important factors affecting the severity of road traffic collision injuries. A detailed history of the mechanism of injury is important for alerting clinicians to severity of injury, the need for admission, and workup of the patients. Furthermore, strict speed limit enforcement is an injury prevention priority in our community.

New Injury Severity Score is a better predictor of mortality for blunt trauma patients than the Injury Severity Score.

BACKGROUND: Trauma-related mortality depends on injury severity. Several trauma scores are used to evaluate injury severity. We compared the Injury Severity Score (ISS) and the New Injury Severity Score (NISS) in terms of predicting mortality among hospitalized blunt trauma patients. METHODS: The data of Al-Ain Hospital Trauma Registry were prospectively collected over 3 years. Data of blunt trauma patients were then analyzed retrospectively. Univariate analysis was used to compare patients who died with those who survived. Sex, age, mechanism of injury, heart rate, systolic blood pressure (SBP), and Glasgow Coma Score (GSC) on arrival at the hospital, ISS, and NISS were studied. Significant factors were then entered into a direct likelihood ratio logistic regression model. RESULTS: Of 2,573 patients in the registry, 2,115 (82.2 %) suffered blunt trauma at a mean (SD) age of 32 (15.3) years. Among them, 1,838 (87 %) were male. Main mechanisms of injury were road traffic collision (vehicle occupants) (32.8 %) and falling from a height (22.4 %). Fifty patients (2.4 %) died. Univariate analysis showed that GCS and SBP at hospital arrival, ISS, NISS, and mechanism of injury significantly affected mortality. Logistic regression model showed that mortality was significantly increased by low GCS (p < 0.0001), high NISS (p < 0.0001), and low SBP (p = 0.006) at hospital arrival. CONCLUSIONS: Mortality of blunt trauma in the UAE is significantly affected by high NISS, low GCS, and hypotension. NISS is better than ISS for predicting mortality of blunt trauma patients and may replace it.

Pedestrian injuries-related deaths: a global evaluation.

OBJECTIVE: Pedestrians are vulnerable road users who are at risk of injuries and death on the roads. We aimed to define factors affecting pedestrian injuries-related deaths worldwide and to give recommendations regarding their prevention priorities. METHODS: Data on pedestrian injuries-related deaths for years 2007 and 2010 were retrieved from the WHO global status reports on road safety. These included the country population, gross national income (GNI), number of registered vehicles, estimated pedestrian deaths rate, effectiveness of enforcement of law, and the presence of policies to promote walking or cycling. Correlations between studied variables were done using Spearman rank correlation. General linear models were used to define factors affecting pedestrian injuries-related deaths. RESULTS: The median (range) pedestrian death rates of different countries per 100,000 population significantly decreased in year 2010 compared with year 2007 [3.9 (0-13.5) compared with 4.2 (0-23.6), (p = 0.004, Wilcoxon signed rank test)]. There was a reduction of 8.1% of the global pedestrian death rate between 2007 and 2010. The estimated pedestrian lives saved annually worldwide of a population of 6.8 billion were 23,120 persons. A general linear model has shown that GNI (p = 0.001) and population density (p = 0.01) were the best predictors of pedestrian death rates in 2007, while national legislation (p = 0.03) was the best predictor of pedestrian death rates in 2010. CONCLUSIONS: There is a change in the factors affecting pedestrian mortality worldwide over time. GNI and population density became less significant than national legislation enforcement. Legislation and its enforcement are important to achieve the UN mission of reducing road traffic deaths by 5 million over the next decade.

Alcohol-related road traffic injuries in Al-Ain City, United Arab Emirates.

OBJECTIVE: We aimed to prospectively study the demography, severity of injury and outcome of alcohol-related road traffic collision (RTC) injuries in the United Arab Emirates. METHODS: Data of RTC Registry of Al-Ain City were prospectively collected from Al-Ain and Tawam hospitals during the period of April 2006 to October 2007. It included all RTC trauma patients who were admitted or those who died after arrival to these hospitals. Car occupants with complete data on alcohol use were included in the study. Patients were divided into two groups, those who reported using alcohol and those who did not. RESULTS: Out of the 771 car occupants, sixteen (16) used alcohol (2.1%), 15 (94%) of them were males. The median (range) age of the alcohol group was significantly higher than those without alcohol (35 (15-53) years compared with 26 (1-78) years, p = 0.02). The UAE nationals were significantly more (P = 0.01) and the revised trauma score was significantly less in the alcohol group (P = 0.03). Head/face was the most commonly injured region in the alcohol group (94%). CONCLUSION: Self reported alcohol-related car collisions in Al-Ain City had a low incidence. It affected older Emirati male nationals and was associated with lower revised trauma score, mainly due to head injury. There is a need for a national registry with data on alcohol abuse so as to assess its effects and strategies for its prevention.

Home and other nontraffic injuries among children and youth in a high-income Middle Eastern country: a trauma registry study.

A trauma registry in the United Arab Emirates was used to ascertain nontraffic injuries of 0- to 19-year-olds. The registry's value for prevention was assessed. A total of 292 children and youth with nontraffic injuries were admitted for >24 hours at surgical wards of the main trauma hospital in Al Ain region during 36 months in 2003-2006. Injuries were analyzed by external cause, location, body part, and severity. Nontraffic represented 60% (n = 292) of child and youth injuries. Incidence/100 000 person-years was 91 for males, 43 for females. Unintentional included falls 65% (n = 191), burns 17% (n = 49), animal-related (mainly camel) 3% (n = 10), and others 10% (n = 29). Intentional accounted for 4% (n = 13). Falls affected all ages, burns mainly 1- to 4-year-olds. Of the injuries, 70% occurred at home. Most frequent and severe injuries measured by the Injury Severity Score and Abbreviated Injury Scale involved extremities. Prevention of home falls for all ages and burns of 1- to 4-year-olds are priorities. Registries should cover pediatric wards and include data on fall locations and hazardous products.

Pedestrian injuries in the United Arab Emirates.

We aimed to study the anatomical distribution, severity, and outcome of hospitalised trauma pedestrian patients in Al Ain, United Arab Emirates (UAE), so as to improve preventive measures. All pedestrian trauma patients who were involved with a road traffic collision and admitted to Al Ain Hospital for more than 24 hours or who died in the hospital were included in the study. Data were prospectively collected during March 2003-October 2007. Three hundred and eighteen patients were studied, 279 (87.7%) were males. Median (range) age was 31 (1-75) years. UAE nationals were significantly younger than non-nationals (median (range) age of 14 (2-75) years compared with 33 (1-75) years, p = 0.001, Mann-Whitney U-test). The lower limb (57.2%) was the most common injured region followed by the head (46.9%). The median (range) Injury Severity Score of patients was 5 (1-45). The median (range) total hospital stay was 11.3 (1-130) days. Thirty patients died (overall mortality 9.4%). In conclusion, mortality of pedestrian injured patients in the UAE is high. Severe head injury was the main cause of death. Measures to improve pedestrian safety should be adopted so as to reduce morbidity and mortality. These include educating drivers and pedestrians on road safety and enforcement of traffic safety laws.

Injuries from falling objects in the United Arab Emirates.

Our aim was to study the demography, anatomical regions injured, severity, and outcome of hospitalised trauma patients who were injured by falling objects in order to give recommendations regarding their prevention in the UAE. All trauma patients who were injured by falling objects and were admitted to Al Ain Hospital for more than 24 hours, or died after arrival to the hospital were studied for over 3 years. One hundred forty nine patients having a mean age (SD) > 34 (12.1) years were studied. The annual incidence of hospitalisation was 10.7/100,000 persons per year. Majority (97.3%) were males and 73.2% from the Indian subcontinent. The most common location for injury was work (88.6%), followed by home (9.4%). Patients injured at home were younger (p < 0.0001), and were more females (p < 0.0001). Extremities and head/neck were the most common injured regions; 1.3% of patients died. Males from the Indian subcontinent are at a higher risk of being injured by falling objects especially at work. Safety education and programs, environmental changes, use of protective devices including helmets or special shoes, and proper enforcement of the safety guidelines could reduce hospitalisations, disability, and death from these injuries.