Abstract
Background
Trauma presentations to emergency departments (EDs) encompass a wide range of injury mechanisms and clinical outcomes. Mechanisms of injury may influence both hospital admission and length of stay (LOS). This study examined the association between injury mechanisms and hospital admission as the primary outcome and evaluated LOS as a secondary and exploratory outcome among trauma patients presenting to the ED in Riyadh, Saudi Arabia.Methods
A retrospective cohort study was conducted at King Khalid University Hospital, including patients aged 14 years and older who presented with traumatic injuries between January 2019 and April 2025. Hospital admission following the initial ED evaluation was the primary outcome, while LOS among admitted patients was considered a secondary and exploratory outcome. From a database of 10,722 trauma-related records available for screening, patients were randomly selected and assessed against predefined eligibility criteria, with ineligible records replaced by additional randomly selected records until a final sample of 218 eligible ED encounters was obtained. Data were extracted from electronic medical records and analyzed using descriptive and inferential statistics. A pre-specified multivariable logistic regression model was used to assess factors associated with hospital admission.Results
A total of 218 patients were included, with a median age of 29.5 years (IQR 22-39); 66.5% were male. Falls were the most frequently documented injury mechanism (49.1%), followed by traffic-related incidents (22.0%). Overall, 32 patients (14.7%) required hospital admission. Among the 30 admitted patients included in the LOS analysis, the median LOS was 5 days (IQR 2-14). Traffic-related injury was associated with higher odds of hospital admission after adjustment for age, sex, and any comorbidity (adjusted OR 3.41, 95% CI 1.49-7.83; p=0.004), whereas age, sex, and the presence of any comorbidity were not significantly associated with admission. Poisoning was associated with longer LOS (median 15 vs 4 days; p=0.042), although this finding was based on only three admitted patients with poisoning.Conclusions
Falls were the most frequently documented injury mechanism in this single-center ED cohort, whereas traffic-related injuries were independently associated with higher odds of hospital admission. Poisoning was associated with longer LOS, although this finding was based on a small number of cases and should be interpreted cautiously. These findings highlight the distinction between injury mechanisms contributing to ED presentation volume and those associated with greater inpatient utilization.