High trauma mortality and severe injury burden in Pakistan: epidemiology, surgical interventions, and in-hospital care from a digital hospital-based trauma registry.
| Publication Type | Academic Article |
| Authors | Shaukat N, Musharraf M, Rahim K, Merchant A, Ahmad T, Atiq H, Khan U, Khan N, Mushtaq S, Razzak J, Haider A |
| Journal | Eur J Trauma Emerg Surg |
| Volume | 51 |
| Issue | 1 |
| Pagination | 312 |
| Date Published | 10/28/2025 |
| ISSN | 1863-9941 |
| Keywords | Wounds and Injuries |
| Abstract | BACKGROUND: Low- and middle-income countries (LMICs) face a high burden of trauma-related deaths, yet lack prospective, standardized data to guide care. In Pakistan, in-hospital trauma management and outcomes remain poorly documented. PURPOSE: The aim of this study was to examine injury epidemiology, post-emergency department care, and hospital outcomes using a pilot digital trauma registry in Pakistan. METHODS: This study was conducted from December 2021 to February 2023 at two leading tertiary care hospitals in Karachi, Pakistan. We included all admitted adult trauma patients (≥ 18 years). We prospectively collected data on demographics, injury details, inter-hospital case management, in-hospital care, and discharge outcomes. RESULTS: A total of 3,087 patients were enrolled, mostly male (79.82%), with 24.33% under 25 years old and 42.38% of Muhajir ethnicity. Road traffic injuries (RTIs) (56.43%), primarily amongst riders of two-wheelers (56.74%), were the leading cause, of whom only 8.66% wore helmets. Most arrived by ambulance (77.12%), and one third (33.66%) were transferred from another hospital. Extremity (55.17%) and head/neck injuries (41.72%) were most common. Severe injuries (ISS > 15) were seen in 30.26%, while 90.86% had a GCS > 12. X-rays (92.81%), CT scans (56.04%), and ultrasounds (16.55%) were common investigations. Surgery was performed in 50.28% of cases. The in-hospital mortality rate was 15.10%, and the median length of stay (LOS) was five days. CONCLUSION: Our findings show high in-hospital trauma mortality, often among patients transferred from other facilities, emphasizing the role of timely care. This study highlights the potential of trauma registries to inform preventive policies and clinical care, particularly in low-income settings. |
| DOI | 10.1007/s00068-025-02978-5 |
| PubMed ID | 41148345 |