Ankara Med J. 2025; 25(3): 343-356 | DOI: 10.5505/amj.2025.36528

Clinical Characteristics and Predictors of Adverse Outcomes in Electrical Injuries: A Five-Year Retrospective Study in the Emergency Department

Melih Çamcý¹, Faruk Büyük², Erhan Þimþek^3
1Department of Emergency Medicine, Ankara Bilkent City Hospital, Ankara Yýldýrým Beyazýt University, Ankara, Türkiye
²Department of Emergency Medicine, Erciþ Þehit Rýdvan Çevik State Hospital, Van, Türkiye
³Department of Family Medicine, Ankara Yýldýrým Beyazýt University, Ankara, Türkiye

INTRODUCTION: Electrical injuries are critical emergencies with outcomes from local damage to systemic complications. Severity depends on current type, voltage, contact duration, resistance, and current path. Predictive data from initial emergency department (ED) presentations remain limited. This study aims to identify clinical and biochemical markers at ED admission that predict adverse outcomes (intensive care unit [ICU] admission, prolonged hospitalization, complications).
METHODS: This retrospective study analyzed electrical injury cases (ICD-10: T75.4, W86, W87) in a secondary-level ED between January 2020 and January 2025. Demographics, injury details, clinical findings (mental status, burns, electrocardiography [ECG], chest X-ray), and outcomes were collected. Ethical approval was obtained. Statistical methods included chi-square, t-test, Mann–Whitney U, Kruskal–Wallis, Spearman correlation, regression, and receiver operating characteristic (ROC) analysis (p<0.05).
RESULTS: Among 142 patients, 65.5% were male, with peak incidence in ≥21 (35.9%) and ≤5 (28.9%) years. Most injuries were domestic (85.9%) from appliances (54.9%) involving alternating current (AC; 95.8%). All non-normal sinus rhythm (non-NSR) ECG patients were admitted to the ICU. Other predictors included outdoor injuries, direct current (DC) exposure, foot/head contact, falls, unconsciousness, and severe burns. Creatine kinase (CK), CK-MB, and lactate levels showed high predictive value. Lactate and hemoglobin were associated with longer hospitalization. Positive chest X-ray findings and elevated lactate were independent predictors, while appliance-related injuries were protective.
DISCUSSION AND CONCLUSION: Early ECG and laboratory assessments (lactate, hemoglobin, CK, CK-MB), along with event and burn characteristics, help predict outcomes in electrical injuries. Prompt ED risk stratification is essential.

Keywords: Electric injuries, emergency department, risk factors, prognosis, retrospective study.

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