Analysis of emergency centre recidivism for interpersonal violence in a district-level hospital in Cape Town, South Africa
Background. Interpersonal violence is a major cause of morbidity and mortality in low- and upper-middle-income countries. It is postulated that a significant portion of these patients have repeated presentations to an already overburdened healthcare system. Data describing the burden of interpe...
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South African Medical Association
2024-11-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/2373 |
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| author | J J Horn L Bush D J van Hoving |
| author_facet | J J Horn L Bush D J van Hoving |
| author_sort | J J Horn |
| collection | DOAJ |
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Background. Interpersonal violence is a major cause of morbidity and mortality in low- and upper-middle-income countries. It is postulated that a significant portion of these patients have repeated presentations to an already overburdened healthcare system. Data describing the burden of interpersonal violence recidivism are poor.
Objective. To determine and describe the burden of emergency centre recidivism for interpersonal violent injury presenting to Khayelitsha Hospital, Cape Town, over a 2-year period.
Methods. An analysis of a prospectively collected observational database combined with a retrospective chart review was conducted of all trauma patients who presented to Khayelitsha Hospital from 1 October 2020 to 30 September 2022. All patients (aged ≥14 years) with ≥2 presentations for interpersonal violence-related injuries were included. Cases were limited to the inclusion of mechanisms of injury attributable to stab wounds, blunt assault, firearm injury and gender-based violence. Recidivist cases were identified by repeat hospital number on the electronic hospital patient system. Repeat cases were manually reviewed for inclusion. Summary statistics are used to describe all variables.
Results. In total, 10 218 interpersonal violence presentations were identified over the study period, and 1 125 (11.0%) were attributed to recidivists (522 patients). The mean (standard deviation) age was 30 (7.7) years, and most were male (n=463, 88.7%). Stab wounds (n=583, 51.8%) and blunt assault injuries (n=456, 40.5%) were the main mechanisms of injury. Repeat presentation occurred within a median of 198 (25th - 75th percentile, 81.5 - 373.9) days. A total of 337 (64.6%) patients presented with higher acuity at one of their subsequent visits.
Conclusion. Recidivist presentations represent a significant proportion of interpersonally violently injured patients, and are likely to be under-documented. Recidivism poses a measurable burden, and further research is needed to facilitate the identification of at-risk individuals, and specific secondary prevention strategies should be developed to prevent or reduce escalating patterns of injury associated with interpersonal violence.
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| format | Article |
| id | doaj-art-37857f5169f44289803dcf2f1d390976 |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-37857f5169f44289803dcf2f1d3909762025-02-10T12:25:33ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-11-011141110.7196/SAMJ.2024.v114i11.2373Analysis of emergency centre recidivism for interpersonal violence in a district-level hospital in Cape Town, South AfricaJ J Horn0L Bush1D J van Hoving2 Division of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South AfricaDivision of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Khayelitsha Hospital, Cape Town, South AfricaDivision of Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa Background. Interpersonal violence is a major cause of morbidity and mortality in low- and upper-middle-income countries. It is postulated that a significant portion of these patients have repeated presentations to an already overburdened healthcare system. Data describing the burden of interpersonal violence recidivism are poor. Objective. To determine and describe the burden of emergency centre recidivism for interpersonal violent injury presenting to Khayelitsha Hospital, Cape Town, over a 2-year period. Methods. An analysis of a prospectively collected observational database combined with a retrospective chart review was conducted of all trauma patients who presented to Khayelitsha Hospital from 1 October 2020 to 30 September 2022. All patients (aged ≥14 years) with ≥2 presentations for interpersonal violence-related injuries were included. Cases were limited to the inclusion of mechanisms of injury attributable to stab wounds, blunt assault, firearm injury and gender-based violence. Recidivist cases were identified by repeat hospital number on the electronic hospital patient system. Repeat cases were manually reviewed for inclusion. Summary statistics are used to describe all variables. Results. In total, 10 218 interpersonal violence presentations were identified over the study period, and 1 125 (11.0%) were attributed to recidivists (522 patients). The mean (standard deviation) age was 30 (7.7) years, and most were male (n=463, 88.7%). Stab wounds (n=583, 51.8%) and blunt assault injuries (n=456, 40.5%) were the main mechanisms of injury. Repeat presentation occurred within a median of 198 (25th - 75th percentile, 81.5 - 373.9) days. A total of 337 (64.6%) patients presented with higher acuity at one of their subsequent visits. Conclusion. Recidivist presentations represent a significant proportion of interpersonally violently injured patients, and are likely to be under-documented. Recidivism poses a measurable burden, and further research is needed to facilitate the identification of at-risk individuals, and specific secondary prevention strategies should be developed to prevent or reduce escalating patterns of injury associated with interpersonal violence. https://samajournals.co.za/index.php/samj/article/view/2373Interpersonal violenceRecidivismEmergency MedicineInjurygender-based violence |
| spellingShingle | J J Horn L Bush D J van Hoving Analysis of emergency centre recidivism for interpersonal violence in a district-level hospital in Cape Town, South Africa South African Medical Journal Interpersonal violence Recidivism Emergency Medicine Injury gender-based violence |
| title | Analysis of emergency centre recidivism for interpersonal violence in a district-level hospital in Cape Town, South Africa |
| title_full | Analysis of emergency centre recidivism for interpersonal violence in a district-level hospital in Cape Town, South Africa |
| title_fullStr | Analysis of emergency centre recidivism for interpersonal violence in a district-level hospital in Cape Town, South Africa |
| title_full_unstemmed | Analysis of emergency centre recidivism for interpersonal violence in a district-level hospital in Cape Town, South Africa |
| title_short | Analysis of emergency centre recidivism for interpersonal violence in a district-level hospital in Cape Town, South Africa |
| title_sort | analysis of emergency centre recidivism for interpersonal violence in a district level hospital in cape town south africa |
| topic | Interpersonal violence Recidivism Emergency Medicine Injury gender-based violence |
| url | https://samajournals.co.za/index.php/samj/article/view/2373 |
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