The burden and outcomes of firearm injuries at two district-level emergency centres in Cape Town, South Africa: A descriptive analysis
Background. In South Africa (SA), injuries are the second leading cause of years of healthy life lost, and interpersonal violence dominates the SA injury profile. Half of all injury-related deaths in SA are intentional, and firearms contribute to a quarter of these deaths. Injury surveillance s...
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South African Medical Association
2024-02-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/1176 |
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| author | L Bush C Hendrikse C Van Koningsbruggen K Evans |
| author_facet | L Bush C Hendrikse C Van Koningsbruggen K Evans |
| author_sort | L Bush |
| collection | DOAJ |
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Background. In South Africa (SA), injuries are the second leading cause of years of healthy life lost, and interpersonal violence dominates the SA injury profile. Half of all injury-related deaths in SA are intentional, and firearms contribute to a quarter of these deaths. Injury surveillance systems are essential to develop, implement and monitor strategies that reduce preventable trauma.
Objectives. To describe the burden of patients with firearm injuries and their outcomes at district-level emergency centres in the Western Cape.
Methods. This study was a retrospective analysis of a prospectively collected database. All patients who presented to two district-level emergency centres with a firearm injury over a 12-month period (1 January 2019 - 31 December 2019) were eligible for inclusion.
Results. Firearm injuries represented 5.7% of the trauma burden at the two district emergency centres. Of the 776 patients with firearm injuries who were included, the median age was 27 years, and 91% were male. A total of 520 (67%) patients self-presented, and there were 18 (2.3%) deaths in the emergency centre and a further 23 (3%) as inpatients. Of the total where wound location was determined (n=595), 30.4% sustained more than one firearm injury, and 112 out of the 167 admitted to Mitchells Plain Hospital required at least one visit to theatre. This accounted for 413 theatre hours and 1 376 inpatient bed days at Mitchells Plain Hospital. A significant proportion of patients (n=219, 29%) were transferred from the emergency centres to a tertiary service for further care.
Conclusion. Firearm injuries represent a substantial proportion of the trauma burden at district emergency centres in the Western Cape Province. Managing patients with firearm injuries is resource intensive, as evident by their high acuity, the need for operative care, the long length of stay, the high burden on emergency medical services with interfacility transfers and the high demand for tertiary care. Data from this study aid our understanding of the prevalence and burden of firearm injuries at district level emergency centres, and multisectoral action, supported by evidence-based primary and secondary preventive strategies, is required to reduce the burden of firearm injuries, and mitigate their effects.
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| format | Article |
| id | doaj-art-91ff7ec321494d95a8ebd3a5d468d29e |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-91ff7ec321494d95a8ebd3a5d468d29e2025-02-10T12:26:28ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-02-01114210.7196/SAMJ.2024.v114i2.1176The burden and outcomes of firearm injuries at two district-level emergency centres in Cape Town, South Africa: A descriptive analysisL Bush0C Hendrikse1https://orcid.org/0000-0001-9963-5775C Van Koningsbruggen2K Evans3Division of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South AfricaDivision of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Emergency Centres, Mitchells Plain and Heideveld Hospitals, Cape Town, South AfricaDivision of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Emergency Centres, Mitchells Plain and Heideveld Hospitals, Cape Town, South AfricaDivision of Emergency Medicine, Faculty of Health Sciences, University of Cape Town, South Africa; Emergency Centres, Mitchells Plain and Heideveld Hospitals, Cape Town, South Africa Background. In South Africa (SA), injuries are the second leading cause of years of healthy life lost, and interpersonal violence dominates the SA injury profile. Half of all injury-related deaths in SA are intentional, and firearms contribute to a quarter of these deaths. Injury surveillance systems are essential to develop, implement and monitor strategies that reduce preventable trauma. Objectives. To describe the burden of patients with firearm injuries and their outcomes at district-level emergency centres in the Western Cape. Methods. This study was a retrospective analysis of a prospectively collected database. All patients who presented to two district-level emergency centres with a firearm injury over a 12-month period (1 January 2019 - 31 December 2019) were eligible for inclusion. Results. Firearm injuries represented 5.7% of the trauma burden at the two district emergency centres. Of the 776 patients with firearm injuries who were included, the median age was 27 years, and 91% were male. A total of 520 (67%) patients self-presented, and there were 18 (2.3%) deaths in the emergency centre and a further 23 (3%) as inpatients. Of the total where wound location was determined (n=595), 30.4% sustained more than one firearm injury, and 112 out of the 167 admitted to Mitchells Plain Hospital required at least one visit to theatre. This accounted for 413 theatre hours and 1 376 inpatient bed days at Mitchells Plain Hospital. A significant proportion of patients (n=219, 29%) were transferred from the emergency centres to a tertiary service for further care. Conclusion. Firearm injuries represent a substantial proportion of the trauma burden at district emergency centres in the Western Cape Province. Managing patients with firearm injuries is resource intensive, as evident by their high acuity, the need for operative care, the long length of stay, the high burden on emergency medical services with interfacility transfers and the high demand for tertiary care. Data from this study aid our understanding of the prevalence and burden of firearm injuries at district level emergency centres, and multisectoral action, supported by evidence-based primary and secondary preventive strategies, is required to reduce the burden of firearm injuries, and mitigate their effects. https://samajournals.co.za/index.php/samj/article/view/1176Emergency MedicineEmergency Medical Servicesfirearm violenceTraumainterpersonal violenceLow- and middle-income countries |
| spellingShingle | L Bush C Hendrikse C Van Koningsbruggen K Evans The burden and outcomes of firearm injuries at two district-level emergency centres in Cape Town, South Africa: A descriptive analysis South African Medical Journal Emergency Medicine Emergency Medical Services firearm violence Trauma interpersonal violence Low- and middle-income countries |
| title | The burden and outcomes of firearm injuries at two district-level emergency centres in Cape Town, South Africa: A descriptive analysis |
| title_full | The burden and outcomes of firearm injuries at two district-level emergency centres in Cape Town, South Africa: A descriptive analysis |
| title_fullStr | The burden and outcomes of firearm injuries at two district-level emergency centres in Cape Town, South Africa: A descriptive analysis |
| title_full_unstemmed | The burden and outcomes of firearm injuries at two district-level emergency centres in Cape Town, South Africa: A descriptive analysis |
| title_short | The burden and outcomes of firearm injuries at two district-level emergency centres in Cape Town, South Africa: A descriptive analysis |
| title_sort | burden and outcomes of firearm injuries at two district level emergency centres in cape town south africa a descriptive analysis |
| topic | Emergency Medicine Emergency Medical Services firearm violence Trauma interpersonal violence Low- and middle-income countries |
| url | https://samajournals.co.za/index.php/samj/article/view/1176 |
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