Urban Trauma, Chronic Recurrent Disease

Sims, Deborah; Bivins, Brack A.; Obeid, Farouck N.; Horst, Harriette; Sorensen, Victor; Fath, John J.

doi:10.1097/00005373-198807000-00092

Cited by 166 publications

(186 citation statements)

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“…7 Studies of assault-related injuries have clearly established a relationship between unemployment, alcohol, young age, male sex and illiteracy. 1,2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] This study has established almost the same pattern. The researcher believes that, to be successful, prevention programmes have to include these factors in education protocols, given the prevalence of assault.…”

Section: Introductionmentioning

confidence: 85%

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Pattern of injuries suffered by patients treated for alleged assault at Witbank General Hospital, Mpumalanga

Nkombua

2007

South African Family Practice

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BackgroundViolence has been with us since time immemorial. In South Africa, violence plays a detrimental role in our daily lives, affecting almost everybody, directly or indirectly. The country experiences high levels of violence, with incidents of violence being reported in the newspapers and on radio and television on a daily basis. In the author's personal experience as a casualty officer at Witbank General Hospital, a considerable number of patients with assault-related injuries were seen every day. The objectives of this study were to assess the demographic and social factors associated with assault incidents, as well as to establish the type of injuries suffered by the victims of assault. MethodsThe method used was a descriptive, cross-sectional survey, undertaken at the casualty department of the Witbank General Hospital in Mpumalanga Province from 29 October 1999 to 1 May 2000. All patients who attended for injuries due to alleged assault (interpersonal violence) and met the inclusion criteria were included in the study. A total of 547 patients were selected as subjects of the study. ResultsThe majority of the victims were male (71.8%; N = 389), 69% (N = 377) were single and 91% (N = 498) were of African descent. The age group of the majority (86.9%; N = 475) ranged between 17 and 45 years. All the respondents had injuries to more than one part of the body. Among the assaulted patients, 86.6% (N = 474) had more than one type of injury. The majority of the victims of assault (81.4%; N = 445) were not admitted for in-hospital treatment. ConclusionsThe study revealed that a typical victim of assault treated at Witbank Hospital was an African male between the ages of 17 and 45 years. He had been attacked during the night or over the weekend. He had also probably been drinking. He would have suffered minor injuries, mainly to the head and neck.

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Section: Introductionmentioning

confidence: 85%

“…These findings correlate with those of other studies. 11,12,15,22 Hocking reported that only 12% of the victims of assault in his study were admitted. 13 Wladis et al found that about 15% of assault victims required admission.…”

Section: Admission To Hospitalmentioning

confidence: 95%

Pattern of injuries suffered by patients treated for alleged assault at Witbank General Hospital, Mpumalanga

Nkombua

2007

South African Family Practice

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“…Among individuals of all ages, Sims et al 18 found that criminality was common among admissions for intentional injuries in Detroit. Of the patients admitted during a 2-year period for treatment of a stab wound, an assault, or a gunshot wound, 54% had criminal records over the following 5-year period.…”

Section: Discussionmentioning

confidence: 99%

Juvenile Delinquency and Adolescent Trauma: How Strong Is the Connection?

Conseur¹,

Rivara²,

Emanuel³

1997

Pediatrics

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ABSTRACT. Objectives. To determine whether youth convicted of juvenile offenses have a greater risk of injury resulting in hospitalization compared with nonoffending adolescents.Design. A statewide hospital discharge database was linked to juvenile justice records to identify all hospitalizations occurring at ages 13 to 17 years for juvenile offenders and nonoffenders.Subjects. Juvenile offenders and nonoffenders in Washington State during 1989 through 1992.Main Outcome Measures. Incidence of hospitalizations attributable to injury, analyzed by cause of injury and intent.Results. The prevalence of delinquency was 19.1% of male and 9.5% of female adolescents. Hospitalization for injury was 2.7-fold greater for male and 1.6-fold greater for female offenders compared with nonoffenders. The greatest risk of hospitalization was for intentional injury, especially that attributable to firearms, and for drug overdoses.Conclusions. Juvenile offenders are much more likely to be hospitalized for an injury than nonoffenders. Admission to the hospital for trauma may serve as an opportunity for health providers to intervene with youth exhibiting high-risk behavior. Pediatrics 1997;99(3). URL: http://www.pediatrics.org/cgi/content/ full/99/3/e5;

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“…17 For patients that survive, the estimated rate of trauma re-currence (sometimes termed "recidivism") ranges from a minimum of 13% 18 to approximately 25% [19][20][21] to above 40%, 22 with a 5-year mortality rate of 20%. 23 Relevant to health care economics, this cohort is known for prolonged hospital stays and greater utilization of expensive health care resources. [24][25][26][27] Our investigation asks whether integrating a psychiatrist into the trauma surgery service (surgical/emergency medicine staff and residents) improves staff recognition of preexisting psychopathology in trauma patients.…”

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confidence: 99%

The Role of Psychiatry in the Management of Acute Trauma Surgery Patients

Findley

Sanders²,

Groves³

2003

Prim. Care Companion CNS Disord.

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Background: Trauma is a leading cause of death and disability in the United States, with high prevalence and recidivism in individuals with psychiatric and substance abuse disorders. Half of these disorders go undiagnosed by the trauma team, resulting in adverse public health and economic consequences.Method: In a 16-week pilot study in the emergency department of an inner-city tertiary care hospital, a psychiatrist was integrated into the trauma surgery team by responding to all traumas and rounding with the staff 1 shift per week (March 1, 2000, through June 31, 2000. During this 16-week period, 375 patients passed through the trauma surgery service. Data on the frequency of psychiatric consultations were compared with those for a retrospectively selected control group consisting of all 360 patients passing through the trauma surgery service during the corresponding 16 weeks of the previous year (March 1, 19991, , through June 31, 1999. To determine the prevalence of psychopathology, eligible patients seen during the psychiatrist's shift (N = 28) were assessed with a semistructured interview, and charts for eligible patients seen in the corresponding shift during the previous year (N = 18) were assessed according to the same criteria. Before the study, a 10-item, self-report questionnaire was completed by 16 (73%) of the 22 emergency medicine physicians who serve as front-line staff members. The survey assessed physicians' attitudes toward psychiatric consultation for psychopathology and addictions in trauma patients.Results: Based on DSM-IV screening criteria, the prevalence of preexisting psychopathology was 68% (19/28), but before the psychiatrist's involvement, only 12% (2/16) of physicians surveyed had considered consulting psychiatry, even for patients with gross psychopathology. Before the psychiatrist's integration into the 16-week study period, 75% (9/12) of trauma patients were discharged without psychiatric consultation despite the fact that more than half had documented substance abuse. After the psychiatrist joined the team, staff awareness of psychopathology sharpened. The number of patients treated for a psychiatric disorder that was often the proximal cause of the traumatic event nearly doubled, even on shifts not covered in the study.Conclusions: The ability to identify and treat coexisting psychopathology requires trauma surgeons to routinely incorporate a psychiatrist into their evaluation and treatment algorithm. Such a change in physician awareness and motivation hinges on a psychiatrist's visible presence (even if brief) and regular, active participation in the emergency department.

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Urban Trauma, Chronic Recurrent Disease

Cited by 166 publications

References 0 publications

Pattern of injuries suffered by patients treated for alleged assault at Witbank General Hospital, Mpumalanga

Pattern of injuries suffered by patients treated for alleged assault at Witbank General Hospital, Mpumalanga

Juvenile Delinquency and Adolescent Trauma: How Strong Is the Connection?

The Role of Psychiatry in the Management of Acute Trauma Surgery Patients

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