Violence–related injuries in a rapidly developing Middle Eastern country: A Retrospective Study from a Level 1Trauma Center

Abstract

Background: Violence is a global public health problem leading to injuries, long-term physical, sexual or mental health problems and mortality. The burden of violence-related injuries remains understudied in the Arabian Gulf region. The present study aimed to describe the epidemiology of hospitalized violence-related injuries in Qatar.Methods: A retrospective analysis of trauma registry data from a level 1 trauma center was conducted by including all patients admitted to the hospital for violence-related injuries between June 2010 and June 2017. We analyzed and compared the hospitalized interpersonal and self-inflicted violence groups.Results: The hospitalization rate of violence-related injuries was 4.6 per 100,000 population per year; it was significantly higher in males (5.5/100,000 males/year vs. 1.8/100,000 females/year) and in younger populations, specifically in the 25-34 years age-group (41%). South Asians constituted 55% of the affected study population. Interpersonal violence (76.7%) was the most common mechanism of injury. Significant differences between interpersonal and self-inflicted violence were evident, especially for the type of trauma (i.e. blunt or penetrating), injured body regions, alcohol use, injury severity, need for intubation and psychiatric referral (p<0.05). Overall, in-hospital mortality was 6.4%; with a significantly higher rate in females (16% vs.5%, p=0.001). Outcomes, including length of hospital stay and mortality, were comparable in the two types of violence. Multivariate analysis showed that male gender and alcohol use were predictors for interpersonal violence whereas a high Injury Severity Score and a low Glasgow Coma Scale were predictors of hospital mortality.Conclusions: The rate of hospitalization for violence-related injuries in Qatar is low; however, its burden on the trauma system is of concern. Although it comprised only 9.6% of the study population, females are more likely to get hospitalized following self-inflicted injuries when compared to interpersonal violence. Disproportionate burden of violence in the South Asians and young population warrants an evidence-based public health approach in violence prevention to well address the risk factors.