Multi–facility hospital–based surveillance of injury patterns and in–hospital mortality among the adult population in Ghana

Background Injuries are significant public health concern, contributing to substantial morbidity and mortality among adults worldwide. In Ghana, limited studies have examined injuries among adults, with existing studies predominantly focusing on a single injury mechanism within a single health facility setting. Objective This study aimed to describe the distrubution of hospital based reported injuries among adults in Ghana and to identify associations of injury-related mortality. Methods A cross-sectional study was conducted using data from four regional teaching hospitals in Ghana between January 2017 and December 2020. Descriptive statistics were used to summarize demographic characteristics, injury mechanisms and outcomes. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for variable selection, followed by survey-weighted logistic regression to estimate factors associated with mortality, accounting for facility-level effects and population structure using R statistical software. Results A total of 6,662 adult injury cases were included (mean age 41 ± 18 years), of which 4,702/6,662 (70.6%) were males. Road traffic injuries (4,371/6,662; 66%) and falls (1,909/6,662; 29%) were the leading injury mechanisms. The overall in-hospital mortality rate was 113/6,662 (1.7%). In multivariable analysis, educational attainment was a significant protective factor: junior high school (adjusted OR: 0.24; 95% CI: 0.13–0.45), senior high school (adjusted OR: 0.45; 95% CI: 0.23–0.85), and tertiary education (adjusted OR: 0.23; 95% CI: 0.12–0.45), compared to no formal education. Urban residence (3,814/6,662; 57.3%) was associated with lower odds of mortality (adjusted OR: 0.57; 95% CI: 0.33–0.98) relative to peri-urban areas (970/6,662; 14.6%). Age, sex, injury mechanism, and weekend occurrence were not significantly associated with mortality after adjustment. Conclusion Injuries among adults in Ghana are predominantly due to road traffic incidents and falls, with relatively low in-hospital mortality. Mortality is more strongly associated with socioeconomic and geographic factors than with injury mechanism or demographic characteristics. Strengthening trauma health systems, addressing social determinants such as education, and improving road safety measures in high-risk environments is recommended.