Evaluating the burden of head injuries on a rural emergency department in South Africa

Abstract

Background: Head injuries place a significant burden on the emergency department (ED) workload. This is prominent in low-middle income countries (LMICs), which have low resourced health systems and a skewed burden compared to global data. A large paucity of data exists among LMICs, therefore limiting comparisons on a global perspective. This study aimed to evaluate the ED burden of head injuries in a rural setting, within a LMIC. Methods: A retrospective chart review of all ED patients presenting with head injuries was conducted over a 3-month period. Relevant data was extracted using a data collection tool, followed by descriptive statistical analysis. Results: A total of 263 patients were identified, with a median age of 27 years and male predominance (78.7%). Interpersonal violence (IPV) was the mechanism of injury in 59.7% (n = 157) of cases, followed by road traffic injuries (23.2%) and non-intentional trauma (17.1%). Most injuries were because of blunt trauma (71.1%) and common types were soft tissue (46.2%) and scalp injuries (35.0%). In the paediatric subgroup, the most common mechanism of injury was falls, accounting for 52.0% of all falls in the study. The majority (71.5%) of patients were discharged, while 22.8% were admitted and 2.67% demised in the ED. Conclusion: At this rural centre, there is a high ED burden of minor head injuries because of IPV, with a strong male predominance. This study serves to add to limited reported data from a LMIC setting, which appears to have a skewed burden compared to the global data.