Tito M G, Makelele J P K, van den Boogaard W, Ade S, Deselets A, Briskin E, Badjo C, Salviati D, Akem E T, Hejdenberg M
Médecins Sans Frontières (MSF) Centre Opérationnel Amsterdam, Amsterdam, Pays-Bas.
MSF - Centre Opérationnel Bruxelles, Kinshasa, DR Congo.
Public Health Action. 2023 Aug 1;13(2 Suppl 1):30-35. doi: 10.5588/pha.23.0006.
In a war-torn African country, Médecins Sans Frontières supports two regional referral hospitals to address emergencies, including the treatment of firearm-related traumas. It facilitates access to healthcare and referrals, which are often hindered due to non-medical reasons.
To determine the factors influencing the unfavourable outcome of cases referred for firearm trauma (December 2020-November 2021).
This was a cross-sectional study using routinely collected data.
A total of 381 patients who were victims of firearm-related trauma were admitted, with an average age of 29 years; 28.3% had severe injuries, including thoraco-abdominal injuries and fractures. The mortality rate was 4.9%, and 7.9% left against medical advice. Patients affiliated with the irregular armed forces accounted for 45.4%, and had a two-thirds higher rate of unsuccessful referral for non-medical reasons. Patients with severe injuries at triage, affiliation with the irregular forces and being in the regular army had 2 times ( < 0.01), 5.9 times ( < 0.01) and 8.1 times ( < 0.01), respectively, a higher risk of an unfavourable outcome.
Serious cases caused by firearm injuries were more likely to have an adverse outcome. The risk was higher in those with a specific affiliation, who were more often denied access to higher referral care based on socio-political rather than medical reasons.
在一个饱受战争蹂躏的非洲国家，无国界医生组织支持两家地区转诊医院应对紧急情况，包括治疗与枪支相关的创伤。该组织为获得医疗服务和转诊提供便利，而这些往往因非医疗原因受到阻碍。
确定影响转诊治疗枪支创伤病例不良结局的因素（2020年12月至2021年11月）。
这是一项使用常规收集数据的横断面研究。
共有381名枪支相关创伤受害者入院，平均年龄29岁；28.3%的患者伤势严重，包括胸腹伤和骨折。死亡率为4.9%，7.9%的患者擅自离院。隶属于非正规武装部队的患者占45.4%，因非医疗原因转诊未成功的比例高出三分之二。分诊时伤势严重、隶属于非正规部队以及在正规军中服役的患者出现不良结局的风险分别高出2倍（<0.01）、5.9倍（<0.01）和8.1倍（<0.01）。
枪支伤害导致的严重病例更有可能出现不良结局。特定隶属关系的患者风险更高，他们往往因社会政治而非医疗原因被拒绝获得更高水平的转诊治疗。
