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Overview of stab injuries in Far North Queensland: A new insight into the demographics, injury patterns and management

Published:December 31, 2022DOI:https://doi.org/10.1016/j.injury.2022.12.031

      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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      1. Australian Government - Australian Institute of Criminology. 'Knife Crime’ in Australia: incidence, aetiology and responses. [Internet]. 2011 [cited 2021 Sep 12]. Available from: https://www.aic.gov.au/sites/default/files/2020-05/tbp045.pdf.

      2. Cairns and Hinterland Hospital and Health Service. State of Queensland (Cairns and Hinterland Hospital and Health Service), Cairns and Hinterland Hospital and Health Service - Health Service Plan 2018-2022 [Internet]. Queensland Government; 2018 [cited 2021 Sep 12]. Available from: https://cairns-hinterland.health.qld.gov.au/_media/about-us/clinical-service-plan/clinical-services-plan-2018-2022.pdf.

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