Reference des cas de traumatisme par arme à feu en Afrique.
Public Health Action 2023;
13:30-35. [PMID:
37529555 PMCID:
PMC10380415 DOI:
10.5588/pha.23.0006]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/22/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND
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.
OBJECTIVE
To determine the factors influencing the unfavourable outcome of cases referred for firearm trauma (December 2020-November 2021).
METHOD
This was a cross-sectional study using routinely collected data.
RESULTS
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 (P < 0.01), 5.9 times (P < 0.01) and 8.1 times (P < 0.01), respectively, a higher risk of an unfavourable outcome.
CONCLUSION
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.
Collapse