Assault injury presentation and lifetime psychological trauma in emergency centre patients in South Africa: A cross-sectional study

There is a paucity of data from emergency centers regarding (a) the prevalence of recurrent assault injury and prior psychological trauma, and (b) psychosocial predictors of assault-injury presentation. Objective: To address the above gaps to identify psychosocial needs and injury-prevention opportunities. Method: Patients presenting with assault or unintentional injuries were recruited from 2 emergency centers (ECs; n = 200) and assessed for injury history, traumatic events, and mental disorders. Descriptive statistics were computed and predictors for assault-injury presentation and recurrent assault injury were identified using logistic regression. Univariate regression models were employed to identify significant variables before entering these into multivariate models. Results: The majority of the participants were male (67%), of whom 43% were between the ages of 25 and 40 years. The median number of lifetime traumatic events was 7. Recurrent assault injury was found in 31%. These injuries were predicted by lifetime traumatic events other than injury (OR = 1.035, 95% CI [1, 1.07]). Assault-injury presentation was significantly less likely in female participants (OR = 0.221, 95% CI [0.1, 0.5]) and was associated with high levels of witnessing community violence (OR = 1.157, 95% CI [1.01, 1.32]). Conclusion: Patients presenting with assault injuries are at risk for injury recurrence, have high levels of past psychological trauma, and should be screened for psychosocial risk. Further research is needed to assess the role of past psychological trauma in risk for assault injury, and clarify treatment needs. The role of EC-based interventions in injury prevention and mental health requires increased recognition in South African policy and practice.