Injury patients presenting to the emergency department: a retrospective state-based comparative analysis of Illinois, USA, and Victoria, Australia.

Introduction: The aim of this study was to describe and compare all injuries that present to emergency departments (EDs) in Illinois, USA, and Victoria, Australia, and determine if there are differences in patterns and severity of injuries to inform future public health policy. Methods: Acute traumatic injuries that presented to the ED in hospitals in Illinois, USA, and Victoria, Australia, from 1 July 2018 through 30 June 2023 were analysed. Descriptive statistics, age-standardised rates and Poisson regression models compared the incidence rate of injuries in Illinois and Victoria. Results: In the 5-year period, there were 3 886 151 injury-related ED presentations in Illinois (a rate of 6146 per 100 000 population annually) and 1 858 092 in Victoria (a rate of 6027 per 100 000 population). Illinois injury rates were highest in children (0-4 years) while in Victoria, injury rates were highest in the oldest age group (85+ years). Among those who were admitted in Illinois, 30% were classified as severe versus 5% in Victoria. Transport and assault/homicide injury rates were substantially higher in Illinois with incidence rate ratios (Victoria vs Illinois) of 0.5 and 0.4, respectively. Injury-related ED presentations in Victoria were much more likely to be admitted while in Illinois subsequently admitted injuries were much more severe. We discuss social, economic, healthcare system and policy differences between the two countries that contribute to differences in patient demographics and injury mechanisms. Conclusion: This comparison can help both countries identify opportunities for improvement in acute injury management and injury prevention.