The changing epidemiology of trauma in child-bearing age women

Ethical considerations

This study was approved by the Human Research Ethics Committees of Al-Ain Health District Area (Ethical approval NO: RECA/02/44) and Al-Ain Hospital (Ethical approval NO: AAHEC-03–20-008), Al-Ain, UAE. Patients or their caregivers gave their written informed consent to use the patients' data in research.

Data collection

Data from two separate trauma registries of Al-Ain Hospital were prospectively collected from March 2003 to March 2006, while the second period was from January 2014 to December 2017. The gap between these two periods occurred because of lack of funding. The current study is a retrospective analysis of these data. Trauma patients who were included in the registry were those who were hospitalized for more than one day and those who died on arrival at the hospital.

Study population

This study included all women of child-bearing age (reproductive age) in the trauma registry. The child-bearing age is defined to be 15–49 years [15, 16].

Studied variables

The variables we compared included age, nationality, method of transportation, physiological markers of injury severity including systolic blood pressure, heart rate, respiratory rate, Glasgow Coma Scale (GCS), mechanism and location of injury, anatomical markers of injury severity including new injury severity score (NISS), injury severity score (ISS), injured body regions and their Anatomical Injury Score (AIS), ICU admission, length of hospital stay, and mortality.

Calculations

In 2006, 19.76% of the UAE population were females of child-bearing age. In comparison, 62.42% were males of the same age group (15–49 years). Only 1.2% of the population were females of 50 years old or more [17]. Al-Ain City had an estimated population of 460 000 during the first study period [18]. Accordingly, the estimated number of females aged 15–49 years in Al-Ain City during this period was 90,896 inhabitants, the estimated number of females of 50 years old or more was 5520, the estimated number of males aged 15–49 years was 287 132; while the estimated number of males of 50 years old or more was 20 654. In comparison, in 2016, Al-Ain City had a population of 766 936 inhabitants, of whom 315 182 were females (41%). Out of them 211,485 (67%) were of child-bearing age while the number of females of 50 years old or more was 21,455, the number of males aged 15–49 years was 334 984, while the number of males of 50 years old or more was 33 682 [19]. During the study periods, Al-Ain Hospital was the main trauma center in Al-Ain City, treating about 80% of the in-hospital trauma patients. Accordingly, the standardized annual incidence of hospitalized trauma child-bearing age women per 100 000 population was calculated as follows: (1.25 X annual hospital admissions)/ city population in 100 000 s.

Statistical analysis

Continuous data were presented as mean (SD), ordinal data were presented as median (range), and categorical data were presented as number (%). Occasionally, ordinal data were also presented as mean (SD) when the comparison was statistically significant, and the median was the same in the two groups. The categorical data of the two periods were compared using Pearson's Chi-square because the number of subjects was large, with expected cell values of more than 5. Fisher's Exact test was used for comparisons when the expected value of any cell was less than 5. The continuous or ordinal data of the two periods were compared using Mann–Whitney U test. The overall significance of tables of categorical data of more than 2 × 2 was first tested. If this overall analysis was significant, then a pairwise comparison for individual categories of the two groups was done to explain the findings but not to accept overall significance. We have used Statistical Package for the Social Sciences (IBM-SPSS version 26, Chicago, Il) to perform the analysis. A p-value < 0.05 was accepted as significant.

留言 (0)

沒有登入
gif