A Decade of Electrical Injuries: An Epidemiological Analysis of Emergency Department Data

TL;DR

This study analyzed 10 years of emergency department data to understand the patterns and risks of electrical injuries, finding that even low-voltage injuries can cause heart damage.

Contribution

The study provides new epidemiological insights and highlights the need for improved risk stratification in electrical injury cases.

Findings

Most patients were male, with a mean age of 31.8 years, and 60.6% had low-voltage injuries.

62% of tested patients showed elevated troponin T, indicating myocardial injury despite low-voltage exposure.

ECG abnormalities were found in 14.3% of patients, suggesting hidden cardiac risks.

Abstract

Objective: Electrical injuries present a diagnostic and management challenge due to their diverse clinical manifestations and potential complications. Although the current guidelines recommend cardiac monitoring in selected cases, the criteria for risk stratification remain limited. This study aimed to evaluate the epidemiological and clinical characteristics of patients with electrical injuries admitted to the emergency department over a 10-year period.

Methods: This retrospective study reviewed medical records of patients admitted to the Pamukkale University Hospital between 2014 and 2024 due to electrical injuries. Data collected included age, sex, time of injury, voltage level, current type and source, contact site, transthoracic current pathway, ECG findings, laboratory results (troponin T, CK-MB, and potassium), work-related status, and mortality. The primary outcomes were epidemiological characteristics, ECG abnormalities, and laboratory evidence of myocardial injury.

Results: A total of 112 patients were identified; 91 (81%) patients were male, with a mean age of 31.8 years. High-voltage injuries (> 1000 V) occurred in 10 patients, while low-voltage injuries (< 1000 V) were seen in 80 (60.6%) patients. Work-related injuries accounted for 14.3% of cases. One patient died due to trauma following high-voltage exposure. Troponin T was elevated in 57 of 92 tested patients (62.0%), CK-MB in 25 (22.3%), and hyperkalemia in six (5.3%). ECG abnormalities were detected in 16 patients (14.3%).

Conclusion: Biochemical evidence of myocardial injury was observed even in low-voltage exposures, raising concerns about the safety of early discharge based solely on clinical presentation and ECG findings. Prospective studies are needed to refine risk assessment strategies in electrical injury cases.

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