Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Outcomes of patients with thoraco-abdominal gunshot wounds operatively managed at a district hospital in Cape Town, South Africa
Dublin Core
Title
Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Outcomes of patients with thoraco-abdominal gunshot wounds operatively managed at a district hospital in Cape Town, South Africa
African Journal of Emergency Medicine
Outcomes of patients with thoraco-abdominal gunshot wounds operatively managed at a district hospital in Cape Town, South Africa
Subject
Thoracoabdominal
Gunshot
Firearm
Surgery
South Africa
District hospital
Gunshot
Firearm
Surgery
South Africa
District hospital
Description
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
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
Creator
Juan Klopper a,b, Husna Moola , Jeremy Venter , Dylan Cheddie , Samukele Luzulane , Tinashe Muchenje , Joshua van Zyl , Jessica Chambers
Source
www.elsevier.com/locate/afjem
Publisher
elsevier
Date
30 November 2020
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Citation
Juan Klopper a,b, Husna Moola , Jeremy Venter , Dylan Cheddie , Samukele Luzulane , Tinashe Muchenje , Joshua van Zyl , Jessica Chambers, “Jurnal Internasional Afrika vol. 11 issue 1 2021
African Journal of Emergency Medicine
Outcomes of patients with thoraco-abdominal gunshot wounds operatively managed at a district hospital in Cape Town, South Africa,” Repository Horizon University Indonesia, accessed April 19, 2025, https://repository.horizon.ac.id/items/show/2489.
African Journal of Emergency Medicine
Outcomes of patients with thoraco-abdominal gunshot wounds operatively managed at a district hospital in Cape Town, South Africa,” Repository Horizon University Indonesia, accessed April 19, 2025, https://repository.horizon.ac.id/items/show/2489.