Epidemiology and injury severity of 294 extremity gunshot wounds in ten months: a report from the Cape Town trauma registry Evaluation of 294 patients at a level I trauma centre, South Africa

Epidemiology and injury severity of 294 extremity gunshot wounds in ten months: a report from the Cape Town trauma registry Evaluation of 294 patients at a level I trauma centre, South Africa

Aims: To describe the epidemiology and injury severity of patients with extremity gunshot injuries in an area with a high rate of interpersonal violence. Patients and methods: This is a prospective cohort study of patients who presented with an extremity gunshot injury and were recorded as part of a...

Full description

Saved in:
Bibliographic Details
Published in:SA orthopaedic journal Vol. 18; no. 2; p. 31
Main Authors: Engelmann, Esmee WM, Maqungo, Sithombo, Maritz Laubscher, Hoppe, Sven, Roche, Stephen, Nicol, Andrew, Navsaria, Pradeep, Held, Michael
Format: Journal Article
Language:English
Published: Johannesburg Medpharm Publications 01-05-2019
Subjects:
Epidemiology
Injuries
Trauma
South Africa
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aims: To describe the epidemiology and injury severity of patients with extremity gunshot injuries in an area with a high rate of interpersonal violence. Patients and methods: This is a prospective cohort study of patients who presented with an extremity gunshot injury and were recorded as part of a trauma registry at a large tertiary care hospital in Cape Town, South Africa, between June 2015 and April 2016. Patient demographics, injury severity scores, injury patterns and referral pathways were evaluated. Results: Of 1 123 gunshot trauma admissions in ten months, 290 (25.8%) patients (91.5% males, n=269) with a median age of 26 years (IQR 13.0) presented with extremity injuries. Median injury severity score (ISS) was 4.0 (IQR 8.0). Only one-fifth of patients had an ISS of 15 or more (n=50, 17%). Upper extremity injuries were associated with a higher risk of fractures (RR 2.15, p=0.05), higher number of nerve injuries (p=0.01), and a two times higher mean ISS (p=0.01). Admissions between 7pm and 7am with limited staffing at the emergency department were twice as high as the day admissions (n=169, 57.5% versus n=79, 26.9%). Conclusion: There is a high trauma load on the emergency department and orthopaedic service due to extremity gunshot injuries. Although upper extremity gunshot wounds constituted a red flag for higher injury severity, the overall injury severity was low. Inadequate timing and selection of emergency referrals of patients with low ISS are avoidable aggravators of this burden and should be targeted to increase efficiencies in the care of these patients. Level of evidence: Level 4
ISSN:1681-150X
2309-8309