Gender differences in patterns of injuries and trauma in emergency department at kigali university teaching hospital, rwanda.

Abstract

Introduction: Gender roles, norms and behaviors influence traumatic injuries, the 3rd leading cause of morbidity in Rwanda. We assessed the gender differences and similarities in injured patients presenting to the emergency department of the busiest trauma center in Rwanda. Method: We collected retrospective data using an emergency department database and enrolled 1387 trauma patients between 2013 and 2016. We did a prospective observational study of 145 trauma patients who presented to KUTH emergency department over a 4-week period. We collected data on demographics, mechanism of injuries, diagnosis, and outcomes. We analyzed differences between genders using appropriate statistical testing in the software R. Results: For the retrospective population: the mean age for men was 34 years while for women it was 39 years. The most common mechanism of injury was road traffic accidents (50%). Overall, trauma was much more common among men than women (p<0.001). Male patients were more likely to present intoxicated with alcohol as compared to female patients (p=0.02). Long bone fracture was the most common type of injury for both sexes (58%). From the prospective analysis: we found that half of the patients were referred from lower level district hospitals, women were more likely to be involved in gender-based violence as compared to men (p=0.02). Of the enrolled patients, 20.6% died. There was no association between mechanism of injury, diagnosis or outcome of injury with gender. Conclusion: Men are more likely to experience trauma and present with multiple injuries. Gender-based violence is more common in women. Road traffic accidents in a young population was identified as a major burden in both men and women. Further research is necessary to evaluate for targeted measures that can reduce traumatic injuries and improve outcomes from trauma in both men and wom