الفهرس 
Introduction and Aim of the study
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Abstract
Injuries are among the most serious of all major health problems (88) and it is estimated that 90% of them are preventable (89).
This study was conducted to identify the magnitude, pattern and trend of casualties throughout the period from 2002-2009 at Trauma Unit, Assiut University Hospital. Also, the socio-demographic background of casualties and the outcome of injuries had been investigated.
This study is a descriptive, included all registered casualties at Trauma Unit of Assiut University Hospital during the period from January 2002 to December 2009.
Data about registered casualties were obtained from the database office at Trauma Unit of Assiut University Hospital.
After correcting spelling errors and quality control of the data, coding of causes of injuries was done by the study team according to the International Classification of Diseases (ICD10) codes, the tenth revision.
Data analysis was done through using SPSS version 16 program and results were presented as follows:
Results:
A. Casualties attended Emergency Department of Trauma Unit:
The study results revealed that 213,835 casualties were attended Trauma Unit of Assiut University Hospital during the period from 2002-2009. The numbers of casualties rise annually throughout the eight years from 2002-2009 to reach the peak in 2009 with a high statistical significant difference (p=0.000).
More than two thirds of casualties were treated in emergency department and then discharged (145,817), nearly one third of them were admitted in Trauma Unit (68,018).
The numbers of injuries were the highest among young adult ages 20-29 years (22.2%) followed by old adolescence ages 15-19 years (12.3%) and adult ages 30-39 years (12.2%). The numbers of males were three times that of females in ratio of 3:1.
The students have the highest percentage of injuries (24.9%), followed by under age (16.0%) and house wives (13.0), while semiskilled and unskilled workers (8.5% and 8.1% respectively), public employee (7.2%) and farmers (7.1%) were the most common affected workers.
Falls were the first cause of injuries (49.6%), the second cause was exposure to inanimate mechanical forces (19.6%) and transport accidents were the third cause (18.3%).
The majority of transport accidents were duo to motor car (64.8%) which annually increased from 9.2% in 2002 up to 16.7% in 2009 with a high statistical significant difference (p=0.000). While the majority of fall injuries was occurred on ground (78.1%).
B. Casualties admitted in Trauma Unit:
Falls were the first cause of admission (43.6%), followed by transport accidents (31.1%) and exposure to inanimate mechanical forces (12.9%).
Average daily admission was increased annually from 18.0 patients/day in 2002 up to 31.0 patients/day in 2009 with statistically significant strong positive correlation (r=0.981), while average length of stay in Trauma Unit was decreased annually from 5.5 days in 2002 into 4.1 days in 2009 with a high statistical significant difference (p<0.0001, F=35.304).
The higher average length of stay was due to self-inflected injuries (22.6 days), followed by gunshot injuries (6.7 days), transport accidents (5.7 days) and falls (4.4 days).
Most of injuries among registered admitted casualties were fractures (46.2%), followed by wound (28.9%) and organ injury (13.2%).While most of body regions affected by injuries were the upper limbs (26.8%), followed by lower limbs (23.2%) and head (20.6%).
Most of admitted casualties suffered from orthopedic injuries, accounted for 41.5% of all injuries, followed by injuries related to general surgery (25.1%) and neurosurgery injuries (13.5%).
Fall injuries were responsible for 46.1% of all orthopedic injuries followed by transport accidents 31.3%. While most of injuries related to general surgery were due to transport accidents 42.8% and fall injuries 30.6%.
The need for surgical treatment became more than conservative treatment in the period from 2004-2009. While in the period from 2002-2003, conservative treatment was more than surgical treatment, with a high statistical significant difference (p=0.000).
C. Deaths of casualties
The majority of admitted casualties were discharged home with improvement in their condition (79.3%), while 3.9% (2,641) were died in Trauma Unit as a result of injuries.
Transport accidents were the first cause of death, accounting for more than half (56.4%) of deaths, followed by falls (29.5%), interpersonal violence (5.7%), exposure to inanimate mechanical forces (4.2%), gunshot injuries (3.7%) and the last one was exposure to animate mechanical forces (0.5%).
Transport accidents were ranked as the first leading cause of death throughout the whole period from 2002-2009. Also the first leading cause of death among all age groups except ages 0-4 years and 70 years and over which was the second cause after falls (fall from height was the first cause of death in age group 0-4 years while fall on ground was the first cause of death in ages 70 years and over).
As regarding to the severity of injuries, gunshot injuries were the first (4.5%), while the second was transport accidents (3.7%) and the third was interpersonal violence (1.1%).
Motor car accident was responsible for the majority of deaths from transport accidents (89.6%), represents nine out of ten deaths, the numbers increased from 11.6% in 2002 up to 15.1% in 2009 with a high statistical significant difference (p=0.000). While fall from height responsible for most of deaths from fall injuries (53.4%).
The highest percentage of deaths were among ages 50-59 years (14.0%), followed by ages 20-29 years (13.1%) and ages 70 years and older (12.0%). also the highest percentage of deaths were among farmers (18.6%), followed by house wives (12.8%), under age (10.8%) and students (10.6%).
About 76.4% of injury deaths were males while 23.6% were females. The most common causes of death in males were transport accidents (61.4%), followed by falls (23.0%) and interpersonal violence (7.0%), while the most common causes of death in females were falls (50.6%), followed by transport accidents (40.3%) and exposure to inanimate mechanical forces (4.5%).
Most of male deaths were among aged 20-29 years (15.3%), followed by aged 50-59 years (14.2%), while most of female deaths were among aged 0-4 years (16.1%), followed by aged 70 years and older (15.6%).
The most common body regions affected by injuries among deaths were the head (34.6%), followed by the chest (17.7%), lower limbs (15.0%) and abdomen and pelvis (11.2%).
Years of Potential Life Lost (YPLL) throughout the eight years from 2002-2009 due to all injuries accounted for 78,499 years. The highest number of YPLL (14,507) was in young adult aged 20-29 years, followed by 14,160 YPLL was in children of pre-elementary school aged 0-4 years.