Trends in injury incidence among the adult population of Ukraine and the Lviv region during the period of 2015–2024

Abstract

Purpose. The objective of the study was to conduct a dynamic analysis of hospital-based indicators of injury incidence among the adult population in Ukraine and the Lviv region. Materials and methods. A retrospective analysis of hospitalized injury cases for the period of 2015–2024 was conducted to analyze injury indicators. The selected absolute injury indicators (number of treated patients, number of bed days spent in inpatient care, number of deaths) underwent statistical processing using methods of structural and logical analysis and calculation of time-series indicators. Results. The study established that during the analyzed period (2015–2024) the number of hospitalized patients with fractures of the skull bones, spine, bones of the trunk, and fractures in multiple body parts tended to decrease from 2015 to 2020 and increase from 2021 to 2024 both in Ukraine (+18.25% and +19.55% in 2023 and 2024, respectively) and in the Lviv region (+13.10% in 2022). This fact can be explained by the impact of the full-scale invasion of the russian federation into Ukraine. Mortality rates in patients with fractures of the skull bones, spine, trunk bones, and fractures in multiple body parts (S02, S12, S22, S32, T02, T08) in the Lviv region were, on average, at least 2.82 times lower annually than the corresponding mortality rates in Ukraine. It was established that the number of intracranial injuries (S06) in Ukraine increased by +68.43% in 2022 based on growth rate analysis, and an increase in the number of hospitalized patients with intracranial injuries in the Lviv region was recorded in 2022 and 2024 by +11.07% and +13.86%, respectively, which suggests the impact of active full-scale hostilities in the country and military aggression by the russian federation. It should be noted that mortality rates due to intracranial injuries (S06) in the Lviv region in 2022, 2023, and 2024 were 2.31, 2.64, and 1.92 times higher, respectively, than the corresponding indicators in Ukraine. Assessment and analysis of the main trends of injuries to other internal organs, the thoracic cavity, abdominal cavity, and pelvis (S26, S27, S36, S37) demonstrated an annual decrease in Ukraine from 2015 to 2024, except for 2022 (+72.50%), and a yearly reduction in the Lviv region from 2016 to 2024. It was determined that hospital mortality rates due to injuries to other internal organs, the thoracic cavity, abdominal cavity, and pelvis (S26, S27, S36, S37) in the Lviv region were annually lower than national indicators by an average factor of 2.03. Conclusions. Lower mortality rates in the Lviv region due to fractures of the axial skeleton and trunk, including skull, spinal, thoracic, and pelvic fractures (S02, S12, S22, S32, T02, T08) and injuries to other internal organs, the thoracic cavity, abdominal cavity, and pelvis (S26, S27, S36, S37) compared with mortality rates in Ukraine can be interpreted as reflecting both a higher level of medical care provision in healthcare facilities of the Lviv region and less severe types of injuries among patients admitted for treatment to hospitals of the Lviv region compared to those injured in all healthcare facilities across Ukraine. At the same time, the longer duration of inpatient stay for patients with intracranial injuries (S06) and their higher mortality in healthcare facilities of the Lviv region compared with general indicators for healthcare facilities in Ukraine may be caused by the severity of intracranial injuries or potential limitations in the provision of medical care in hospitals of the Lviv region for this type of pathology. Ongoing war-related conditions in Ukraine substantiate the need for adaptation, strengthening, optimization, and improvement of trauma care at both national and regional levels, with the involvement of international specialists, application of principles of interdisciplinary interaction, and telemedicine, and improvement of the prehospital level of trauma medical care.