Clinical Characteristics and Predictors of Adverse Outcomes in Electrical Injuries: A Five-Year Retrospective Study in the Emergency Department
Melih Çamcı1, Faruk Büyük2, Erhan Şimşek31Department of Emergency Medicine, Ankara Bilkent City Hospital, Ankara Yıldırım Beyazıt University, Ankara, Türkiye2Department of Emergency Medicine, Erciş Şehit Rıdvan Çevik State Hospital, Van, Türkiye
3Department of Family Medicine, Ankara Yıldırım Beyazıt 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.
Makale Dili: İngilizce
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