Emergency Department, Cayenne General Hospital, French Guiana, France.
French Guiana University, French Guiana, France.
Eur J Trauma Emerg Surg. 2024 Aug;50(4):1649-1659. doi: 10.1007/s00068-024-02499-7. Epub 2024 Mar 21.
French Guiana (FG) is a French territory located in South America with the highest rate of armed assaults. FG presents a poorly developed road system and a young and precarious population that makes the geographical and socio-demographic characteristics specific. No data concerning the firearm injury management are available in this country. Studying thesis trauma could permit to improve the management of victims. The objective of this study is to investigate the epidemiology of firearm injuries in FG, to define characteristics of the victims, and to assess factors associated with death. These identified factors could enable target primary prevention and intensification of medical management.
From January 2016 to December 2019, we conducted a retrospective study at the Cayenne General Hospital (CGH), including all patients admitted for firearm injuries in the emergency department, the medical emergency and resuscitation service, and the forensic service. A bivariate analysis was performed to assess relevant clinical data that were entered into a logistic regression model to assess factors associated with death.
A total of 871 files were analyzed concerning 340 patients included after cross-checking. Victims were mainly males (90%) and young (30 ± 11 years old). The injury occurred mainly at night (60%), in a context of assaults (83%) and with long-barreled guns (82%). Among the 290 patients managed at the CGH, 60% were hospitalized including 12% that were in the intensive care unit, 41% that required surgical treatment, and 7% that died in hospital. The overall average length of stay was 10 ± 18 days. Overall mortality (n = 71, 21%) is statistically associated with male gender (p = 0.007) and suicide context (p < 0.001). In multivariate analysis, the sites of wounds (head and neck, thorax; p < 0.001) as well as induced organ injuries (neurological, respiratory, and vascular; p < 0.005) were independent factors associated to mortality.
This work underlines the high incidence of ballistic trauma in FG. This mainly involves a young and male population linked to the use of long arms and assaults. Despite the geographical difficulties of the territory and the technical platform deficits (no neurosurgery, no cardiothoracic surgery, no interventional radiology), the mortality is comparable to other studies, but remains more than twice as high as in mainland France. Finally, despite a change in legislation restricting access to firearms, our results show that gunshot firearm injuries remain a major public health concern requiring greater political actions.
法属圭亚那（FG）是位于南美洲的法国领土，其武装袭击率最高。FG 呈现出欠发达的道路系统和年轻且不稳定的人口结构，这使得其地理和社会人口特征具有独特性。该国没有关于枪支伤害管理的数据。研究创伤学论文可以改善对受害者的管理。本研究的目的是调查 FG 地区枪支伤害的流行病学情况，确定受害者的特征，并评估与死亡相关的因素。这些确定的因素可以使初级预防和医疗管理得到加强。
自 2016 年 1 月至 2019 年 12 月，我们在卡宴综合医院（CGH）进行了一项回顾性研究，包括所有因枪伤在急诊科、医疗急救和复苏服务以及法医服务中住院的患者。我们进行了一项双变量分析，以评估相关的临床数据，并将这些数据输入逻辑回归模型，以评估与死亡相关的因素。
共分析了 871 份文件，经交叉核对后共纳入 340 名患者。受害者主要为男性（90%）和年轻人（30±11 岁）。伤害主要发生在夜间（60%），在袭击（83%）和长枪（82%）的背景下发生。在 290 名在 CGH 接受治疗的患者中，60%住院治疗，包括 12%在重症监护病房，41%需要手术治疗，7%在医院死亡。总体平均住院时间为 10±18 天。总体死亡率（n=71，21%）与男性（p=0.007）和自杀背景（p<0.001）统计学相关。在多变量分析中，伤口部位（头部和颈部、胸部；p<0.001）以及诱导性器官损伤（神经、呼吸和血管；p<0.005）是与死亡率相关的独立因素。
这项工作强调了法属圭亚那地区弹道创伤的高发生率。这主要涉及到一个年轻和男性人口，与使用长枪和袭击有关。尽管该地区存在地理困难和技术平台不足（无神经外科、无心胸外科、无介入放射学），但死亡率与其他研究相当，但仍是法国本土的两倍多。最后，尽管枪支立法有所改变，限制了枪支的获取，但我们的结果表明，枪击枪支伤害仍然是一个重大的公共卫生问题，需要采取更大的政治行动。
