BMC Emergency Medicine (Oct 2021)

Fatal and nonfatal firearm injuries in the eastern Democratic Republic of Congo: a hospital-based retrospective descriptive cohort study assessing correlates of adult mortality

  • Paul Munguakonkwa Budema,
  • Roméo Bujiriri Murhega,
  • Tshibambe Nathanael Tshimbombu,
  • Georges Kuyigwa Toha,
  • Fabrice Gulimwentuga Cikomola,
  • Paterne Safari Mudekereza,
  • Léon-Emmanuel Mubenga,
  • Ghislain Maheshe-Balemba,
  • Darck Cubaka Badesire,
  • Ulrick Sidney Kanmounye

DOI
https://doi.org/10.1186/s12873-021-00506-3
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 9

Abstract

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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), SaO2 (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.

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