Patterns of interpersonal violence presenting to a level one trauma centre in Johannesburg

Abstract

Trauma and intentional injury form a major burden of disease in South Africa. This study examines the patterns of injury resulting from interpersonal violence presenting at a Level One trauma centre serving an urban population. This was a cross-sectional analysis of patients attending the Johannesburg Hospital Trauma Unit, over a period of forty-one consecutive days. In keeping with the worldwide experience of trauma care, the study showed the burden of trauma rests heavily upon young males. A majority of the incidents involved a weapon, used for penetrating or blunt injury. In cases where the weapon was documented, it was more commonly a weapon carried by one of the individuals involved such as a firearm or knife, than an item obtained spontaneously during the conflict. Patients subjected to weapon-based violence were significantly more likely to require advanced or invasive radiology, admission and operation. Weapon type influenced the pattern of injury sustained and the need for specialist consultation. It did not significantly affect admission or operation rates. Although blunt assault without a weapon may cause multiple injuries, they tended to be superficial injuries either allowing for discharge from the emergency room immediately or following a period of observation. This study showed the presence of a weapon greatly increases the morbidity resulting from the event for the patient and increases the subsequent cost to the healthcare system.