Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar.
Department of Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.
BMC Public Health. 2020 Nov 3;20(1):1640. doi: 10.1186/s12889-020-09754-7.
Violence is a global public health concern leading to injuries, long-term physical, sexual or mental health problems and even mortality. The burden of violence-related injuries on hospital systems remains understudied in the Arabian Gulf region. The present study aimed to describe the epidemiology of hospitalized violence-related injuries in a rapidly developing Middle Eastern country.
A retrospective analysis from a level 1 trauma center, in the state of Qatar, was conducted. Data were retrieved from the Qatar national trauma registry for all patients who were admitted with violence-related injuries between June 2010 and June 2017. Analyzed data were used to compare hospitalized interpersonal and self-inflicted violence groups.
The hospitalization rate of violence-related injuries was 4.6 per 100,000 population per year; it was significantly higher in males (5.5/100,000 males/year vs. 1.8/100,000 females/year) and younger persons, particularly in the 25-34 years old population (41%). South Asians constituted 55% of the affected study population. Interpersonal violence (76.7%) was the most common mechanism of injury. Significant differences between interpersonal and self-inflicted violence groups were evident, especially for the type of trauma (i.e. blunt or penetrating), injured body regions, alcohol use, injury severity, need for intubation and psychiatric referral (p < 0.05). Overall, in-hospital mortality was 6.4%; with a significantly higher rate in females (16% vs.5%, p = 0.001). Outcomes, including length of hospital stay and mortality, were comparable between the two study groups. Multivariate analysis showed that male gender and alcohol use were predictors for interpersonal violence whereas high Injury Severity Score (ISS) and low Glasgow Coma Scale (GCS) were predictors of hospital mortality.
The rate of hospitalization for violence-related injuries in Qatar is low; however, its burden on the trauma system is of concern. Although it comprised only 9.6% of the study population, females are more likely to get hospitalized following self-inflicted injuries when compared to interpersonal violence. The disproportionate burden of violence among South Asian and young populations warrants an evidence-based public health approach to appropriately address the risk factors and set prevention programs.
暴力是一个全球性的公共卫生问题，会导致受伤、长期的身体、性或心理健康问题，甚至死亡。在阿拉伯海湾地区，医院系统中与暴力相关的伤害负担仍然研究不足。本研究旨在描述一个快速发展的中东国家中与住院治疗相关的暴力伤害的流行病学情况。
对卡塔尔一家 1 级创伤中心进行回顾性分析。从卡塔尔国家创伤登记处检索 2010 年 6 月至 2017 年 6 月期间因与暴力相关的伤害而住院的所有患者的数据。分析数据用于比较住院期间的人际间暴力和自我伤害暴力群体。
与暴力相关的伤害住院率为每 10 万人每年 4.6 人；男性（每 100000 男性/年 5.5/100000 与每 100000 女性/年 1.8/100000）和年轻人的发生率明显更高，尤其是 25-34 岁人群（41%）。南亚人占受影响研究人群的 55%。人际间暴力（76.7%）是最常见的损伤机制。人际间暴力组和自我伤害暴力组之间存在显著差异，尤其是在创伤类型（即钝性或穿透性）、受伤身体部位、酒精使用、损伤严重程度、需要插管和转介精神科治疗（p<0.05）方面。总体而言，院内死亡率为 6.4%；女性的死亡率明显更高（16%比 5%，p=0.001）。两组的住院时间和死亡率等结果相当。多变量分析表明，男性性别和酒精使用是人际间暴力的预测因素，而较高的损伤严重程度评分（ISS）和较低的格拉斯哥昏迷量表（GCS）是住院死亡率的预测因素。
卡塔尔因与暴力相关的伤害而住院的比率较低，但对创伤系统的负担令人担忧。尽管女性仅占研究人群的 9.6%，但与人际间暴力相比，女性更有可能因自我伤害而住院治疗。南亚和年轻人中暴力的不成比例负担需要采取循证公共卫生方法来适当解决风险因素，并制定预防计划。
