Citation

Budema PM, Murhega RB, Tshimbombu TN, Toha GK, Cikomola FG, Mudekereza PS, Mubenga LE, Maheshe-Balemba G, Badesire DC, Kanmounye US. BMC Emerg. Med. 2021; 21(1): e116.

Copyright

(Copyright © 2021, Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s12873-021-00506-3

PMID

34641813

Abstract

INTRODUCTION: The Eastern Democratic Republic of Congo (DRC) has been the battleground for multiple armed conflicts, resulting in many fatal and nonfatal firearm injuries (F&NFFIs). Chronic insecurity has stressed the health system's resources and created barriers to seeking, reaching, and receiving timely care further increasing the F&NFFI burden. Our institution is the largest trauma center in the region and receives the bulk of F&NFFI cases. We aimed to identify correlates of mortality in Congolese F&NFFI patients.

METHODS: We included all F&NFFI patients admitted to our institution between 2017 and 2020. We extracted data from patient charts and admission logs. We identified mortality correlates using the two-sample t-test, Chi-square test, and multivariable regression analysis. A P-value of less than 0.05 was considered statistically significant.

RESULTS: This study included 814 adult patients, mostly male (86%) with an average age of 34.5 years and living 154.4 km away from the hospital on average. The most affected anatomical sites were the lower limbs (48.2%) and upper limbs (23.2%). The median length of stay was 34.0 days, and the in-hospital mortality rate was 3.6%. In addition, mortality was negatively correlated with diastolic blood pressure (P = 0.01), SaO(2) (P < 0.001), and hemoglobin concentration (P = 0.002).

CONCLUSION: F&NFFIs cause an enormous burden in the region, and mortality is correlated with some clinical and biological variables. Thus, the study findings will inform F&NFFI referral, triage, and management in low-resource and mass casualty settings.

Language: en

Keywords

Survival; Barriers to care; Conflict; Democratic Republic of Congo; Firearm injury