Pattern of Traumatic Injury Sustained by Civilian Victims of Armed Conflicts Presenting to Federal Teaching Hospital Katsina (2022–2024)

Abstract Background Armed conflict in Northwestern Nigeria has caused a sharp rise in civilian casualties, yet local epidemiological data to guide trauma systems remain scarce. Methodology: We conducted a retrospective case series analysis of medical records for all civilian victims of armed conflict admitted to Federal Teaching Hospital Katsina (FTHK) from January 2022 to December 2024. Demographic profiles, injury mechanisms, anatomical distributions, Injury Severity Scores (ISS), and clinical outcomes were evaluated. Results Among 321 civilian casualties, 90.3% were male (mean age: 33.43 ± 13.71 years), with agricultural workers representing the largest occupational group (43.6%). Gunshot ballistics accounted for 100% of injuries. Extremities were the most frequent anatomical site (57.4%), followed by abdomen/pelvis (24.1%), head/neck (11.6%), and chest (9.6%). Overall, in-hospital mortality was 14.3%, while 17.2% did not complete care (12.5% left against medical advice, 4.7% absconded). In multivariate regression, ISS was the sole independent predictor of mortality (aOR = 1.052, 95% CI: 1.023–1.083, p = 0.0005). Discussion The total predominance of ballistic trauma contrasts with modern global conflict trends dominated by blast ordnance. The lower proportions of central thoracic and cranial injuries suggest a severe pre-hospital survival gap due to delayed transit and absent formal emergency medical services. High rates of premature discharge highlight critical financial barriers in emergency care. Conclusion Conflict-related civilian trauma in this setting disproportionately affects productive-age males and carries substantial mortality driven by injury severity. Mitigating this burden requires decentralized pre-hospital stabilization, subsidized trauma care funds, and coordinated regional registry surveillance.