Highlights
- •Stabbing injuries in far North Queensland disproportionately affect high-risk groups, particularly indigenous and mental health patients.
- •Conservative management of abdominal stab injuries in select patients can have good outcomes in regional hospitals with lower trauma volume.
- •Imaging is protective against negative laparotomy rate.
- •Implementation and adherence to management algorithms for penetrating abdominal injuries may further reduce unnecessary laparotomies.
Abstract
Background
Cairns Hospital is the northernmost tertiary referral hospital in Far North Queensland
(FNQ) and manages trauma from a large catchment area. A large burden of stab injuries
occurs in at-risk patient groups, such as Indigenous and mental health patients, in
this region. This research aims to present an overview of the demographics, injury
patterns, management and outcomes for stabbings injuries in FNQ.
Methods
A five-year retrospective single-centre study of all patients treated for neck, torso
or junctional stab wounds in Far North Queensland was performed searching for all
patients with a coded diagnosis of stabbing or knife injury from 1 March 2016 to 31
March 2021.
Results
214 knife injuries were identified and 50.5% of those injured identified as Aboriginal
and/or Torres Strait Islander. Stabbing injury locations were most commonly the abdomen/flank/pelvis
(n = 81) and the chest/thorax (n = 77). Two-thirds of injuries that breached abdominal fascia had concurrent intra-abdominal
injury. Hollow viscus injury commonly involved the small bowel (n = 8), colon (n = 5) and stomach (n = 2), whilst the liver was the most frequently injured solid organ (n = 6). There were 19 vascular injuries, excluding the extremities. 89.2% received
diagnostic imaging in the emergency department. FAST scan had 76% sensitivity and
100% specificity for intra-abdominal injury at operation. Overall, 35% of patients
required an operation. There were only two in-hospital deaths.
Conclusion
Stab injuries annually in FNQ are comparable to other centres in Australia. Overall
injury severity was low, with excellent survival rates and outcomes for patients who
reached hospital. Operative intervention rates for abdominal stab wounds were low
in FNQ compared to available data and imaging again appears protective against negative
laparotomy rate.
Keywords
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Article info
Publication history
Published online: December 31, 2022
Accepted:
December 30,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
Crown Copyright © 2022 Published by Elsevier Ltd. All rights reserved.
