Marle Trevor, Mash Robert
Division of Family Medicine and Primary Care, Stellenbosch University, Box 241, Cape Town, South Africa.
Afr J Emerg Med. 2021 Jun;11(2):315-320. doi: 10.1016/j.afjem.2021.03.012. Epub 2021 Apr 27.
Trauma is a substantial component of South Africa's burden of disease. District hospitals provide primary trauma care for a large proportion of this trauma burden, although most studies are in specialised or tertiary settings. The aim was to evaluate the profile of physical trauma patients attending the emergency centre at Helderberg District Hospital, Cape Town.
An observational descriptive study was conducted between 1 January and 30 April 2019. Patients with trauma were identified from a register and systematically sampled to achieve a sample size of 377. Retrospective data from medical records was collected and analysed in the Statistical Package for Social Sciences.
Of the 14,873 patients attending the emergency centre 24.6% were trauma related and 381 folders were analysed. Of these patients 30.4% were female and 69.6% male with an average age of 27.8 years. Over 60% of patients used an ambulance to get to the hospital. Sundays were the busiest days with 23.9% of all cases. Intentional trauma accounted for 45.4% of cases and accidental injuries 49.1%. The commonest mechanisms were sharp injuries (27.6%), falls (22.0%) and blunt trauma (19.4%). Intentional trauma made up more than half of all trauma in males, was more prevalent than accidental trauma between 20 and 60 years and resulted in a higher proportion of admissions.
There were high levels of intentional trauma, especially involving young males over the weekend, mostly with sharp objects. This trauma burden resulted in high numbers of admissions and transfer to tertiary hospitals. Family physicians and other generalists need to be well trained in trauma resuscitation and stabilisation. District hospital need to be appropriately equipped and supplied to manage trauma. Further research is needed to identify underlying modifiable factors that can be addressed through community-orientated interventions.
创伤是南非疾病负担的一个重要组成部分。地区医院承担了大部分创伤负担的初级创伤护理工作，尽管大多数研究是在专科医院或三级医疗机构进行的。本研究旨在评估开普敦赫尔德伯格地区医院急诊科收治的身体创伤患者的概况。
于2019年1月1日至4月30日进行了一项观察性描述性研究。从登记册中识别出创伤患者，并进行系统抽样，以达到377例的样本量。收集医疗记录中的回顾性数据，并在社会科学统计软件包中进行分析。
在14873名就诊于急诊科的患者中，24.6%与创伤有关，共分析了381份病历。这些患者中，30.4%为女性，69.6%为男性，平均年龄为27.8岁。超过60%的患者乘坐救护车前往医院。周日是最繁忙的日子，占所有病例的23.9%。故意伤害占病例的45.4%，意外伤害占49.1%。最常见的致伤机制是锐器伤（27.6%）、跌倒（22.0%）和钝器伤（19.4%）。故意伤害在男性所有创伤中占比超过一半，在20至60岁人群中比意外伤害更为普遍，且导致更高的住院率。
故意伤害发生率较高，尤其是在周末涉及年轻男性，主要是锐器伤。这种创伤负担导致大量患者住院并转至三级医院。家庭医生和其他全科医生需要接受良好的创伤复苏和稳定治疗培训。地区医院需要配备适当的设备和物资来处理创伤。需要进一步研究以确定可通过社区导向干预措施解决的潜在可改变因素。
