Abstract
IntroductionThe Eastern Democratic Republic of Congo (DRC) has been the battleground for multiple armed conflicts, resulting in many fatal and nonfatal firearm injuries (F&NFFIs). Chronic insecurity has stressed the health system’s resources and created barriers to seeking, reaching, and receiving timely care further increasing the F&NFFI burden. Our institution is the largest trauma center in the region and receives the bulk of F&NFFI cases. We aimed to identify correlates of mortality in Congolese F&NFFI patients.MethodsWe included all F&NFFI patients admitted to our institution between 2017 and 2020. We extracted data from patient charts and admission logs. We identified mortality correlates using the two-sample t-test, Chi-square test, and multivariable regression analysis. A P-value of less than 0.05 was considered statistically significant.ResultsThis study included 814 adult patients, mostly male (86%) with an average age of 34.5 years and living 154.4 km away from the hospital on average. The most affected anatomical sites were the lower limbs (48.2%) and upper limbs (23.2%). The median length of stay was 34.0 days, and the in-hospital mortality rate was 3.6%. In addition, mortality was negatively correlated with diastolic blood pressure (P = 0.01), SaO2 (P < 0.001), and hemoglobin concentration (P = 0.002).ConclusionF&NFFIs cause an enormous burden in the region, and mortality is correlated with some clinical and biological variables. Thus, the study findings will inform F&NFFI referral, triage, and management in low-resource and mass casualty settings.
Highlights
The Eastern Democratic Republic of Congo (DRC) has been the battleground for multiple armed conflicts, resulting in many fatal and nonfatal firearm injuries (F&NFFIs)
Mortality was negatively correlated with diastolic blood pressure (P = 0.01), Oxygen saturation (SaO2) (P < 0.001), and hemoglobin concentration (P = 0.002)
F&NFFIs cause an enormous burden in the region, and mortality is correlated with some clinical and biological variables
Summary
The Eastern Democratic Republic of Congo (DRC) has been the battleground for multiple armed conflicts, resulting in many fatal and nonfatal firearm injuries (F&NFFIs). There are more than 60 ongoing conflicts globally, and most are in low- and middle-income countries (LMICs) [3]. Six of these conflicts (10.0%) are in the Democratic Republic of Congo, and four of the six are based in the Eastern Democratic Republic of Congo. The two Kivu regions are home to the Kivu conflict. This complex sociopolitical context can be traced back to the colonial era with the tense relations between the indigenous Kivu population and neighboring Rwandans [4]. The recurrent clashes have led to over 1.4 million internal displacements and nearly 12,000 deaths [4]
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