Outcomes of patients with thoraco-abdominal gunshot wounds operatively managed at a district hospital in Cape Town, South Africa
| العنوان: | Outcomes of patients with thoraco-abdominal gunshot wounds operatively managed at a district hospital in Cape Town, South Africa |
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| المؤلفون: | Joshua van Zyl, Husna Moola, Samukele Luzulane, Jeremy Venter, Juan Klopper, Tinashe Muchenje, Dylan Cheddie, Jessica Chambers |
| المصدر: | African Journal of Emergency Medicine, Vol 11, Iss 1, Pp 60-64 (2021) African Journal of Emergency Medicine |
| بيانات النشر: | Elsevier, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | medicine.medical_specialty, lcsh:Medicine, 03 medical and health sciences, South Africa, 0302 clinical medicine, Primary outcome, Geochemistry and Petrology, District hospital, Medicine, 030212 general & internal medicine, Significant risk, Retrospective review, lcsh:R5-920, business.industry, General surgery, Mortality rate, High mortality, Gunshot, lcsh:R, 030208 emergency & critical care medicine, Firearm, Emergency Medicine, Original Article, Surgery, Risk of death, Thoracoabdominal, business, lcsh:Medicine (General), Gerontology, District level |
| الوصف: | Aim Trauma is a leading cause of morbidity and mortality in the first four decades of life. Thoracoabdominal gunshot wounds carry a significant risk of mortality. This risk of death is reduced if patients are managed in dedicated units. This study examines the outcome of these patients managed in a district level hospital. Method In this retrospective review, patients with thoracoabdominal gunshot wounds were identified from operating room registry for the period of January 2015 to December 2018. Data was collected retrospectively from folders and analysed for the primary outcome of mortality. Results Sixty-eight thoracoabdominal gunshot wounds were managed operatively over the period described. Only six patients were female. The median age was 29.5 years. Fourteen patients required postoperative transfer to a level 1 trauma unit. Thirteen patients died, nine at the district hospital and four at the level 1 unit. Significant differences in organ injuries were noted in the patients that died compared to the survivors. Discussion The in-hospital mortality rate of patients managed at the district hospital was 13.2% which is comparable to international rates of 12–18%. However, the subset of patients that required postoperative transfer to a level 1 trauma unit had a high mortality rate of 28.6%. The DH is committed to managing unstable and unresponsive patients once they present. Improved mortality rates will only occur with better prehospital transport policies and by equipping the DH to manage these patients postoperatively. Conclusion Management of these patients can be successful at a district hospital. However, significant obstacles exist to their optimal care, as demonstrated by the high mortality patients requiring postoperative transfer. |
| اللغة: | English |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::abcbe07323bbef99a5800b8076d8640d http://www.sciencedirect.com/science/article/pii/S2211419X20301452 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....abcbe07323bbef99a5800b8076d8640d |
| قاعدة البيانات: | OpenAIRE |
| الوصف غير متاح. |