Pattern of civilian gunshot wounds in Durban, South Africa

To evaluate the pattern, demographics, circumstances behind events and patient outcome of civilian gunshot wounds (GSWs), we conducted a prospective review in a surgical department in Durban, South Africa over a period of 9 months.

All patients admitted with GSWs to Prince Mshyeni Memorial Hospital were included in this study from June 2006 to February 2007. Patients’ characteristics, events during assault, time of admission, mode of transport to hospital, pattern of injury and patient outcome were noted.

A total of 154 patients with GSWs were included in this study (85.1% males; 14.9% females) with average age of 21 years. Mode of transport to hospital was as follows: private (57.1%), ambulance (31.8%) and unknown (11.1%). The common sites of GSW injury were abdomen (26.6%), upper/lower limbs (25.3%) and chest (8.8%). Circumstances during injury were as follows: armed robbery (59.7%), car-hijacking (10.4%), interpersonal violence (9.1%) and 6.5% were shot by police. Injury to arrival time ranged from 20 min to 24 h (average 200 min). The common complications of GSW injury were superficial wound sepsis (27.4%), prolonged morbidity (7.1%) and empyema (3.2%). The mortality rate was 4.5%, all males.

This study provides evidence that the burden of GSW-related mortality and morbidity poses a substantial threat to the local public health. A national database for reporting all GSWs is recommended for proper assessment of the magnitude of the problem and to facilitate funding for research into injury prevention.