Norton J, Whittaker G, Kennedy D S, Jenkins J M, Bew D
Department of Trauma and Acute Surgery, King's College Hospital , London , UK.
Ann R Coll Surg Engl. 2018 Jul;100(6):464-474. doi: 10.1308/rcsann.2018.0037.
Introduction Metropolitan Police data, and those from the emergency department at a London major trauma centre show a resurgence in gun crime. The aim of this study was to collect data on all gunshot injuries over a seven-year period at South-East London's trauma hub. Materials and methods This was a retrospective observational study of all gunshot injuries between 1 January 2010 and 31 December 2016 at a London major trauma centre. Information regarding patient demographics, morbidity and mortality was collected. Data from the English indices of multiple deprivation were reviewed in relation to shooting locations and socioeconomic status in South-East London. Results A total of 182 patients from 939,331 emergency admissions presented with firearm injuries. Males comprised 178 (97.8%) victims and 124 (68.1%) were documented as being Black or Afro-Caribbean. The median age was 22 years. Some 124 (71.7%) victims were shot within a 4 km radius of the hospital. The mean indices of multiple deprivation decile ranking in shooting locations compared with non-shooting locations was 2.6 (± 0.1384) and 3.8 (± 0.1149), respectively. A total of 122 (67.0%) patients underwent specialist operative intervention and 111 (61.0%) suffered only superficial or musculoskeletal injuries. Six patients required emergency thoracotomies; three (50.0%) survived to discharge. The median length of stay was 4 days (interquartile range 2-9 days) and 35 (24.0%) were admitted to intensive care. Ten (5.5%) patients died. Discussion and conclusion Firearms injuries are increasing and place a significant burden on hospital resources. Care provided to gunshot victims has improved as a result of recent trauma management initiatives at South-East London's major trauma centre.
引言 伦敦警察厅的数据以及伦敦一家主要创伤中心急诊科的数据显示，枪支犯罪有复苏之势。本研究的目的是收集伦敦东南部创伤中心七年内所有枪伤的数据。
材料与方法 这是一项对2010年1月1日至2016年12月31日期间伦敦一家主要创伤中心所有枪伤进行的回顾性观察研究。收集了有关患者人口统计学、发病率和死亡率的信息。审查了英国多重贫困指数中与伦敦东南部枪击地点和社会经济地位相关的数据。
结果 在939331例急诊入院患者中，共有182例患者出现火器伤。男性受害者有178例（97.8%），其中124例（68.1%）被记录为黑人或非裔加勒比人。中位年龄为22岁。约124例（71.7%）受害者在医院半径4公里范围内被枪击。枪击地点与非枪击地点的多重贫困指数十分位数排名平均值分别为2.6（±0.1384）和3.8（±0.1149）。共有122例（67.0%）患者接受了专科手术干预，111例（61.0%）仅受轻伤或肌肉骨骼损伤。6例患者需要进行急诊开胸手术；3例（50.0%）存活出院。中位住院时间为4天（四分位间距2 - 9天），35例（24.0%）患者入住重症监护病房。10例（5.5%）患者死亡。
讨论与结论 火器伤不断增加，给医院资源带来了巨大负担。由于伦敦东南部主要创伤中心最近采取了创伤管理举措，为枪伤受害者提供的护理有所改善。
