Abdool Karim S S, Andelman R
Department of Community Health, University of Natal, Durban.
S Afr Med J. 1991 Aug 3;80(3):134-8.
In order to investigate the impact of the political violence in Natal on a tertiary hospital's emergency surgical services, 5 days in February 1990 (based on newspaper reports of political violence) were identified and matched for the day of week and time of month to obtain comparable control days in February 1989. Data for each of the 10 days were obtained from casualty department attendance registers and a 40% random sample of emergency outpatients' charts. Comparing violence to control days, the total number of patients treated in casualty increased by 9.6% (1,915 v. 1,747), first visits to casualty by black patients increased by 34.4% (1,741 v. 1,295) and emergency patients treated in the casualty department increased by 29.6% (206 v. 159). Gunshot injuries accounted for 21.4% and 3.1% of surgical emergencies on violence and control days, respectively (relative risk 6.79; 95% confidence interval 2.76-16,73; P less than 0.001). Men comprised 76.2% and 65.4% of surgical emergencies on violence and control days, respectively (P less than 0.05). The mean age of surgical emergency patients with gunshot injuries was 26.4 years on violence days and 31.4 years on control days. Among surgical emergencies, gunshot injuries accounted for 19.2% of ward admissions on violence days compared with 5% on control days. Political violence in Natal increased the utilisation of tertiary hospital emergency surgical services, particularly for young black men with gunshot injuries requiring inpatient care. Until there is peace in this region, tertiary hospital emergency surgical services need to be strengthened and prepared to cope with the trauma resulting from the political violence.
为了调查纳塔尔地区的政治暴力对一家三级医院急诊外科服务的影响，我们根据报纸对政治暴力的报道，确定了1990年2月的5天，并将其与一周中的日期和月份时间进行匹配，以获取1989年2月可作比较的对照日。这10天中每一天的数据均来自急诊科出勤登记册以及40%的急诊门诊病历随机样本。将暴力日与对照日进行比较，急诊科治疗的患者总数增加了9.6%（1915例对1747例），黑人患者首次到急诊科就诊的人数增加了34.4%（1741例对1295例），在急诊科接受治疗的急诊患者增加了29.6%（206例对159例）。在暴力日和对照日，枪伤分别占外科急诊的21.4%和3.1%（相对风险6.79；95%置信区间2.76 - 16.73；P小于0.001）。在暴力日和对照日，外科急诊患者中男性分别占76.2%和65.4%（P小于0.05）。暴力日有枪伤的外科急诊患者的平均年龄为26.4岁，对照日为31.4岁。在外科急诊中，暴力日枪伤患者占病房收治人数的19.2%，而对照日为5%。纳塔尔地区的政治暴力增加了三级医院急诊外科服务的使用率，尤其是对于需要住院治疗的年轻黑人枪伤患者。在该地区实现和平之前，三级医院的急诊外科服务需要得到加强，并做好应对政治暴力造成的创伤的准备。
