A five-year analysis of gun shot victims seen at the Pietermaritzburg Metropolitan Trauma Service centre showed that patients with cerebral gun shot wounds from rural areas took much longer to arrive in the city for treatment and far more died.
This study confirms what doctors have long suspected: that rural areas offer a poorer level of care and much slower time to transfer patients to large specialist hospitals.
The doctors from the University KwaZulu-Natal recently published their study in the ANZ Journal of Surgery‚ saying they were motivated to do the work as there is too little known on patients with head gunshot wounds outside of the American military.
Their study looked at 112 victims of head wounds over five years.
Most were male and 92% of injuries were as a result of interpersonal violence.
Six were attempted suicides.
The study found that 54% of the patients were based in urban areas and were transported to the Pietermaritzburg trauma centre in an average of six hours‚ but those from rural areas only arrived within 15 hours.
Patients from rural areas were initially transported by ambulance to their local rural district hospitals before being transferred to the city. The long delay meant 36% of rural patients died versus 9% of urban patients.
"Outside the few major metropolitan trauma centres‚ almost all rural hospitals are often under-staffed and ill-equipped for managing trauma‚ necessitating transfer to the urban hospitals‚" they noted.
The authors reflected that despite the generally perceived negative outlook of patients with cerebral gun shot wounds‚ approximately 70% of survivors had a reasonably good clinical outcome‚ bearing in mind that long-term neurological outcome data and functional status of survivors was lacking.
- TMG Digital/TimesLIVE
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