V3I1P42

Injury Patterns in a Sri Lankan Base Hospital: A Comparative Analysis of Inpatient and Outpatient Surveillance Data from Base Hospital Kalmunai North

Dr Thahira Safiudeen^1*, Dr Baminy Navaratnam², Mr Aloysiyash Pragash³

Abstract

Background: Injuries contribute substantially to morbidity, mortality, and healthcare utilization in Sri Lanka. Understanding epidemiological patterns, mechanisms, and outcomes of injuries across care settings is essential for strengthening prevention strategies and improving the national injury surveillance system.

Objective: To compare the epidemiological characteristics, mechanisms, intent, and clinical outcomes of injury cases managed in the Outpatient Department (OPD) and Accident and Emergency (A&E) inpatient services at Base Hospital Kalmunai North.

Methods: A descriptive cross-sectional study was conducted using data extracted from the national injury surveillance form (H1258) for the period October–December 2024. All documented injury cases treated either as outpatients or admitted through A&E during the study period were included. Data were analyzed to compare demographic characteristics, injury mechanisms, body regions affected, intent, alcohol involvement, and temporal patterns of presentation.

Results: A total of 2,686 injury cases were recorded, of which 1,780 (66.3%) were managed as inpatients and 906 (33.7%) as outpatients. Males predominated in both inpatient (67.8%) and outpatient (57.4%) groups. Individuals aged ≥50 years accounted for 24.7% of inpatients and 27.4% of outpatients, while children under 10 years comprised 12.5% and 13.8%, respectively. Most outpatient injuries presented between 6:01 AM and 12:00 PM (59.4%), whereas inpatient presentations peaked between 12:01 PM and 6:00 PM (71.1%). Falls were the leading mechanism of injury in both settings. Acid or corrosive exposures (16.6%) and animal bites (11.1%) were disproportionately managed as inpatient cases. Upper limb injuries were most common among inpatients (33.7%), while lower limb injuries predominated among outpatients (48.0%). Among inpatient records with documented intent (n=369), deliberate self-harm accounted for 73.4%. Alcohol use was recorded in 0.9% of inpatient cases. Notably, documentation of intent and place of occurrence was incomplete in many records.

Conclusion: Injury patterns at Base Hospital Kalmunai North demonstrate a high burden among males, older adults, and economically active age groups, with falls as the predominant mechanism. Acid or corrosive exposures and animal bites frequently required inpatient care. Significant gaps in injury documentation highlight the need to strengthen surveillance practices and data quality. Targeted prevention strategies focusing on fall prevention, household safety, safe handling of corrosive substances, and mental health interventions are recommended.

Keywords:

Injury surveillance; Accident and Emergency; Outpatient Department; Sri Lanka; Falls; Deliberate self-harm