Health Services Planning, Delivery, Monitoring and Evaluation Component, KZN Department of Health, Durban, South Africa.
School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
World J Surg. 2023 Aug;47(8):1940-1945. doi: 10.1007/s00268-023-07032-2. Epub 2023 May 9.
Trauma remains an important cause of morbidity and mortality in South Africa, but attempts to track the epidemic are often based on mortality data, or derived from individual health facilities. This project is based on the routine collection of trauma data from all public health facilities in the province of KwaZulu-Natal (KZN), between 2012 and 2022.
Hospital level data on trauma over the past ten years was drawn from the district health information system (DHIS). Data relating to assaults, gunshots and motor vehicle collisions (MVCs) were recorded in the emergency rooms, whilst data on admissions are recorded in the wards and intensive care units.
There were 1,263,847 emergency room visits for assaults, gunshots and MVCs over the ten-year period and trauma admissions ranged between four and five percent of the total number of hospital admissions annually. There was a dramatic decrease in trauma presentations and admissions over 2020/2021 as a result of the COVID lockdowns. Over the entire period, intentional injury was roughly twice as frequent as non-intentional injury. Intentional trauma had an almost equal ratio of blunt assault to penetrating assault. Gunshot-related assault increased dramatically over the 2021/2022 collecting period.
The burden of trauma in KZN remains high. The unique feature of this burden is the excessively high rate of intentional trauma in the form of both blunt and penetrating mechanisms. Developing injury-prevention strategies to reduce the burden of interpersonal violence is more difficult than for unintentional trauma.
在南非，创伤仍然是发病率和死亡率的一个重要原因，但追踪这一流行情况的尝试往往基于死亡率数据，或者源自个别卫生机构。本项目基于在过去十年中从夸祖鲁-纳塔尔省（KZN）所有公立卫生机构常规收集的创伤数据。
从地区卫生信息系统（DHIS）中提取过去十年间医院层面的创伤数据。在急诊室记录与袭击、枪击和机动车碰撞（MVC）相关的数据，而入院数据则记录在病房和重症监护室。
在过去十年中，有 1263847 人次因袭击、枪击和 MVC 到急诊室就诊，创伤入院率每年占医院总入院人数的 4%至 5%。由于 COVID 封锁，2020/2021 年创伤就诊和入院人数急剧下降。在整个时期，故意伤害的发生率几乎是意外伤害的两倍。故意伤害中钝器性攻击和锐器性攻击的比例大致相等。与枪击相关的攻击在 2021/2022 收集期间急剧增加。
夸祖鲁-纳塔尔省的创伤负担仍然很高。这种负担的独特之处在于，故意创伤的发生率过高，包括钝器性和锐器性创伤。制定伤害预防策略来减轻人际暴力的负担比意外伤害更具挑战性。
