Fall‐Related Injuries in Malawi: Outcomes and Trends Over Time

Author:

An Selena J.1,Ngwira Natasha2,Davis Dylane3,Gallaher Jared1,Charles Anthony12

Affiliation:

1. Department of Surgery University of North Carolina at Chapel Hill 4001 Burnett Womack Building, CB 7050 27599 Chapel Hill NC USA

2. Department of Surgery Kamuzu Central Hospital Private Bag 149 Lilongwe Malawi

3. School of Medicine University of North Carolina at Chapel Hill 1001 Bondurant Hall, CB 9535 27599 Chapel Hill NC USA

Abstract

AbstractBackgroundFall‐related injury (FRI) is a leading cause of injuries worldwide. Data on injury patterns and trends over time are lacking in resource‐limited settings.MethodsWe performed a retrospective analysis of FRI at Kamuzu Central Hospital in Malawi from 2009 to 2021. Outcomes were compared between patients presenting with FRI and those with other injury mechanisms. Bivariate and multivariate regressions were used to determine predictors of presentation following falls and mortality. We also analyzed time trends.ResultsA total of 166,047 patients were included, of which 41,695 were patients presenting after falls (25.7%). Most FRI patients were between 5 and 45 (67.2%) and male (66.9%). Most falls occurred at home (67.3%) and resulted in extremity injuries (51.6%). The predicted probability of hospital presentation after falling is highest for children ≤  5 years and adults >  60 years and decreases over time. On multivariate analysis, patients between 5 and 15 [adjusted odds ratio (AOR) 1.70, 95% confidence interval (CI) 1.63–1.77] and > 60 (AOR 1.14, 95% CI 1.07–1.22) and women (AOR 1.13, 95% CI 1.10–1.16) are more likely to present with FRI. Compared to patients with non‐FRI, those with FRI were more likely to have been injured at school (AOR 2.16, 95% CI 2.01–2.32) and during sports and recreation (AOR 4.53, 95% CI 4.24–4.85).ConclusionFRI is the most common injury presentation after motor vehicle injury in this low‐resource setting. This study provides essential information about FRI in Malawi over time. Our findings can help inform resource allocation and injury prevention initiatives.

Funder

Fogarty International Center

Publisher

Wiley

Subject

Surgery

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