Prevalence, patterns and factors associated with musculoskeletal injuries in elderly trauma patients at Mulago Hospital

Abstract

Increased access to social services and healthcare has enabled the elderly to lead more active lives with consequent increase in susceptibility to injury. Trauma in the elderly has emerged as a major public health concern. However, data is lacking on injuries in elderly Ugandans. The objective of this study was to establish the prevalence, patterns and factors associated with musculoskeletal injuries (MSIs) in elderly trauma patients at Mulago hospital. A cross sectional descriptive study was carried out at Mulago National Referral hospital. Eighty seven elderly patients mean age 70.9 years (SD 7.5), range 60 to 95 years who presented to the hospital with traumatic injuries between January and May 2012 were enrolled into the study. Data was collected using a pretested coded questionnaire and analysed by STATA 10.1. The results indicate that the prevalence of musculoskeletal injuries in elderly trauma patients is 72.1%. Females are more affected than males (52.7% Vs 47.3%). Falls are the predominant mechanism of injury (56.8%) while assault accounts for the least (1.4%). Most injuries occur at home followed by the road/ highway (47.3% and 43.2% respectively). Fractures are the predominant musculoskeletal injuries occurring in 94.6%. Hip fractures account for 42.9% of all fractures. Pre existing medical conditions (PMCs) are present in 66.2% of those with musculoskeletal injuries. Osteopenia, older age, female sex, pre existing medical conditions, low level of activity and poor appetite are all associated with musculoskeletal injury. It can, therefore, be concluded that musculoskeletal injuries are very common among elderly trauma patients. Medical practitioners dealing with injured elders need to maintain a high index of suspicion and actively assess for musculoskeletal injuries in these individuals.