Trauma beyond the limbs: Epidemiology and outcomes of non-extremity penetrating trauma in a tertiary hospital Emergency Department, Eastern Cape, South Africa

Laetitia Lüttich; Sian Geraty; Roshen Maharaj

doi:10.1016/j.afjem.2025.100916

Trauma beyond the limbs: Epidemiology and outcomes of non-extremity penetrating trauma in a tertiary hospital Emergency Department, Eastern Cape, South Africa

Afr J Emerg Med. 2025 Dec;15(4):100916. doi: 10.1016/j.afjem.2025.100916. Epub 2025 Oct 30.

Authors

Laetitia Lüttich¹, Sian Geraty¹, Roshen Maharaj¹

Affiliation

¹ Emergency Department, Livingstone Tertiary Hospital, Korsten, Gqeberha, 6001, South Africa.

Abstract

Introduction: Trauma is a major health burden in low- to middle-income countries, with penetrating injuries being a leading cause of death. South Africa's trauma rates are estimated to be 5-9 times higher than the global average. Penetrating injuries, compared to blunt trauma, carry higher morbidity and mortality. This study describes the epidemiology and resource burden of penetrating non-extremity injuries presenting to a teriary hospital Emergency Department (ED) in Gqeberha, South Africa.

Methods: This descriptive retrospective study was conducted at Livingstone Tertiary Hospital (LTH) ED in Gqeberha, Eastern Cape, and included all patients with non-extremity penetrating trauma from 1 June 2020 to 31 January 2021.

Results: During the study period, there were 6020 consecutive trauma presentations to the ED, of which 1107 cases met inclusion criteria and were included in the study. The study revealed a male predominance, with a male-to-female ratio of 5.6:1 (p < 0.001). The median age was 29 years (range: 1-80 years). Most patients presented over the weekend (Saturday and Sunday) [N = 488, 44%, p < 0.001] and after hours on weekdays (N = 444, 40%). Resource utilisation in the ED increased during these periods, including increased diagnostic imaging, procedural interventions, and blood product requests. Of the study participants, 828 (75%) were brought to the ED using private transport. There were a total of 30 deaths (3%), of which 17 (57%) were deceased on arrival in the ED; the remaining 13 deaths (43%) occurred while in the ED or after disposition to a specialist.

Conclusion: This study offers insight into the epidemiology and outcomes of non-extremity penetrating trauma, including prolonged hospital stays and ICU admissions. It underscores the need for multidisciplinary prevention strategies, structured trauma systems, and comparative research to guide best practices, improve resource allocation, and reduce the broader economic impact of trauma on individuals and communities.

Keywords: Emergency department; Epidemiology; Non-extremity injuries; Penetrating trauma; South Africa.