Epidemiology of penetrating injuries in the United Kingdom: A systematic review

Whittaker, George; Norton, Joel; Densley, James A.; Bew, Duncan

doi:10.1016/j.ijsu.2017.03.051

Cited by 26 publications

(24 citation statements)

References 16 publications

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“…Our results are consistent with and extend previous research demonstrating the most pronounced increase in death by assault for men aged 15–44 years in Scotland from 1980 to 2005, and the persistently higher rates for men and in more deprived areas 11 21. This is very similar to the sociodemographic patterning of penetrating injuries found across the UK 22…”

Section: Discussionsupporting

confidence: 92%

Analysis of age–sex and deprivation stratified trends in assault deaths in Scotland (1974–2015) to identify age, period or cohort effects

2020

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ObjectivesMortality rates in Scotland are higher, and health inequalities are greater, than in the rest of Western and Central Europe. There was a marked divergence during the 1980s and 1990s in the Scottish rates partly due to rises in alcohol-related and drug-related deaths, suicide and deaths by assault. This study examines whether age, period or cohort effects account for the trends in death by assault in Scotland and any sex or deprivation inequalities in these.DesignWe calculated crude and age-standardised mortality rates for deaths by assault for Scottish men and women from 1974 to 2015 for the population overall and for populations stratified by Carstairs area of deprivation. We examined age–sex stratified trends to identify obvious age–period–cohort effects.SettingThis study was conducted in Scotland.ParticipantsMen and women whose registered death by the International Classification of Diseases was due to assault from 1974 to 2015 (n=3936) were included in this study.ResultsWhereas age-standardised mortality rates from this cause fell gradually for women since 1974, for men they increased in the early 1990s and remained higher until around 2006, before falling. Death by assault was substantially more common among men aged around 15–50 years and in the most deprived areas. There was little change in the age groups most impacted over time, which made cohort effects unlikely. A period effect for the 15 years until 2006, with a consistent age–sex–area deprivation patterning, was evident.ConclusionsMortality due to assault in Scotland is unequally felt, with young men living in the most deprived areas suffering the highest rates. There is a 15-year period effect up until 2006, impacting on young men as an age–period interaction, with no obvious cohort effects. Exploration of the demographics of criminological data may identify age, period or cohort effects among perpetrators of assault.

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Section: Discussionsupporting

confidence: 92%

Analysis of age–sex and deprivation stratified trends in assault deaths in Scotland (1974–2015) to identify age, period or cohort effects

2020

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“…From our data we clearly had an increasing trend of firearm injury admissions in recent years. The majority of patients were young males which has previously been reported [3,6,[12][13][14].…”

Section: Discussionmentioning

confidence: 94%

Epidemiology of firearm injuries in a Scandinavian trauma center

Bäckman

Riddez

Adamsson

et al. 2018

Eur J Trauma Emerg Surg

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Background There is a concern that civilian gunshot injuries in Europe are increasing but there is a lack of contemporary studies. The purpose of this study was to investigate the current epidemiology and outcome of firearm injuries. Methods Retrospective cohort study of all patients (n = 235) treated for firearm injuries admitted to a Scandinavian trauma center between 2005 and 2016. Local and national trauma registries were used for data collection. Results Mean age was 31.3 years (SD ± 12.9; range 16-88 years); 93.6% males; mean ISS was 14.3 (SD ± 15.9); 31.9% (75/235) had ISS > 15. There was a significant increase in penetrating trauma (P < 0.001) and firearm injuries (P < 0.001) over the years. The most common anatomical location of firearm injury was the lower extremity, (n = 138/235; 38%), followed by the abdomen (n = 69;19%), upper extremity (n = 53;15%), chest (n = 50; 14%), and head and neck (n = 50; 14%). Ninety patients (38.3%) had more than one anatomic injury location. There were in total 360 firearm injuries and 168 major surgical procedures were performed. 53% (n = 125) of patients underwent at least one surgical procedure. The most common procedures were fracture surgery 42% (n = 70/168), followed by laparotomy 30%% (n = 51), chest tube 17% (n = 29), and thoracotomy 11% (n = 18). Forty-one patients (17%) had at least one major vascular injury (n = 54). The most common vascular injury was lower extremity vessel injuries, 26/54 (48%), followed by vessels in chest and abdomen. There was a significant increase in vascular injuries during the study period (P < 0.006). The 30-day mortality was 12.8% (n = 30); 24 patients died within 24 h mainly due to injuries to the chest and the head and neck region. Conclusions Firearm injuries cause significant morbidity and mortality and are an important medical and public health problem. In a Scandinavian trauma center there has been an increase of firearm injuries in recent years. The lower extremities followed by the abdomen are the dominating injured regions and there has been an increase in associated vascular injuries.

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“…There is evidence that there may be demographic characteristics within different cohorts of penetrating injury patients based on aetiology. 1 , 8 , 9 , 10 This is important for our current findings, in that the proportional reduction in the number of cases attributable to IPV must be analysed to see how this translates into changes within the DSH group, for example.…”

Section: Discussionmentioning

confidence: 99%

Penetrating trauma during a global pandemic: Changing patterns in interpersonal violence, self-harm and domestic violence in the Covid-19 outbreak

et al. 2021

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Introduction The restrictions imposed on social activity in response to the Covid-19 pandemic have had a profound impact globally. In the UK, the NHS was placed on a war-footing, with elective surgery, face-to-face outpatient clinics, and community care facilities all scaled back as a temporary measure to redistribute scarce resources. There has been concern during this period over increasing levels of violence in the domestic setting, as well as self-harm. Methods Data was collected on all patients presenting with traumatic penetrating injuries during the ‘lockdown’ period of 23rd March to 29th April 2020. Demographics and injury details were compared with the same period in the two preceding years. Results Overall trauma fell by 35% compared with the previous year. Over one in four penetrating injuries seen were a result of self-harm, which was significantly higher than in previous years (11% in 2019, 2% in 2018). There were two cases of injuries due to domestic violence, while a total of 4 cases of injury arose in separate violent domestic incidents. Self-harm commonly involved penetrating injury to the neck. Discussion Our centre has seen an increase in the proportion of penetrating injuries as a result of both self-harm and violence in the domestic setting. The number of penetrating neck injury cases, which can represent suicidal intent or a major presentation of psychiatric illness, is of particular concern. We must further investigate the effect of social restrictions on violent injury, and how home confinement may influence a changing demographic picture of victims.

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Epidemiology of penetrating injuries in the United Kingdom: A systematic review

Abstract: Our ambiguous results indicate the need for further work directed towards the epidemiology of penetrating injuries within regional trauma networks.

Cited by 26 publications

References 16 publications

Analysis of age–sex and deprivation stratified trends in assault deaths in Scotland (1974–2015) to identify age, period or cohort effects

Analysis of age–sex and deprivation stratified trends in assault deaths in Scotland (1974–2015) to identify age, period or cohort effects

Epidemiology of firearm injuries in a Scandinavian trauma center

Penetrating trauma during a global pandemic: Changing patterns in interpersonal violence, self-harm and domestic violence in the Covid-19 outbreak

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