Penetrating stab injuries in Iceland: a whole-nation study on incidence and outcome in patients hospitalized for penetrating stab injuries

• Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
• Main Authors: Una Johannesdottir, Gudrun Maria Jonsdottir, Bergros K. Johannesdottir, Alexandra Aldis Heimisdottir, Elias Eythorsson, Tomas Gudbjartsson, Brynjolfur Mogensen
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2019
• Subjects: Stabbing injury; Trauma; Penetrating; Treatment; Mortality; Outcome; Medical emergencies. Critical care. Intensive care. First aid; RC86-88.9; Iceland
• Online Access: https://doi.org/10.1186/s13049-018-0582-2; https://doaj.org/article/31cb7b7d16274e60b7698a10da98b421

Abstract Background Studies on penetrating injuries in Europe are scarce and often represent data from single institutions. The aim of this study was to describe the incidence and demographic features of patients hospitalized for stab injury in a whole nation. Materials and methods This was a retrospective nationwide population-based study on all consecutive adult patients who were hospitalized in Iceland following knife and machete-related injuries, 2000–2015. Age-standardized incidence was calculated and Injury Severity Score (ISS) was used to assess severity of injury. Results Altogether, 73 patients (mean age 32.6 years, 90.4% males) were admitted during the 16-year study period, giving an age-standardized incidence of 1.54/100,000 inhabitants. The incidence did not vary significantly during the study period (P = 0.826). Most cases were assaults (95.9%) occurring at home or in public streets, and involved the chest (n = 32), abdomen (n = 26), upper limbs (n = 26), head/neck/face (n = 21), lower limbs (n = 10), and the back (n = 6). Median ISS was 9, with 14 patients (19.2%) having severe injuries (defined as ISS > 15). The median length of hospital stay was 2 days (range 0–53). Forty-seven patients (64.4%) underwent surgery and 26 of them (35.6%) required admission to an intensive care unit (ICU), all with ISS scores above 15. Three patients did not survive for 30 days (4.1%); all of them had severe injuries (ISS 17, 25, and 75). Conclusion Stab injuries that require hospital admission are rare in Iceland, and their incidence has remained relatively stable. One in every five patients sustained severe injuries, two-thirds of whom were treated with surgical interventions, and roughly one-third required ICU care. Although some patients were severely injured with high injury scores, their 30-day mortality was still low in comparison to other studies.