• Rym Karray, Olfa Chakroun-Walha, Folla Mechri, Imen Salem, Hanen Drira, Abdennour Nasri, Ayman Damak, and Noureddine Rekik.
• Emergency Department, Habib bourguiba university hospital, Faculty of Medicine, Sfax University, Majida Boulila Avenue, Sfax, Tunisia.
• Eur J Trauma Emerg Surg. 2025 Jan 27; 51 (1): 8585.

IntroductionElectrical injuries (EIs) represent a significant clinical challenge due to their complex pathophysiology and variable presentation, ranging from minor burns to severe internal organ damage. Despite their prevalence in both; domestic and occupational settings, there remains a rareness of systematic guidelines and comprehensive literature to aid clinicians in effectively managing these injuries. Understanding these factors is crucial for developing protocols that can mitigate the risk of delayed complications, such as cardiac arrhythmias, in patients who initially appear stable.ObjectivesThis study aims to elucidate the epidemiology, clinical outcomes, and predictors of severe presentation in EIs, providing insights to improve patient assessment and management strategies.MethodsA retrospective study was conducted over 4 years. Data were collected from standardized medical records. The group of patients with severe complications included those who presented a life-threatening cardiac, respiratory, neurological, or biological impairment or died within the first 48 h of the EI.ResultsWe enrolled 118 cases of electrical injury (EI). Ages ranged from 4 to 82 years, with 31.3% under 15. EI incidence peaked in summer, with 63.5% being home accidents. High-voltage injuries occurred in 13.6%. The most common ED complaints were burns in children (59.5%) and trauma in adults (48.1%). ECG abnormalities correlated with tetany (p = 0.016), and palpitations (p = 0.014). Complications included cardiac arrest (n = 8), rhabdomyolysis (n = 23), and acute renal injury (n = 9). Severe EI was linked to respiratory distress and creatine kinase levels higher than ≥ 253 UI/l. A normal ECG within 1 h post-injury was correlated to a low risk of severe EI. At 2-year follow-up, 43.9% of survivors reported aesthetic sequelae, 25.3% had psychological disorders, and 7% of adults could not return to their previous occupations.ConclusionEIs are frequent, with diverse clinical presentations requiring multidisciplinary care. Awareness of potential delayed complications is essential, and prevention is crucial.© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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