Are times getting tougher? A six year survey of urban violence related injuries in a Swiss university hospital.

QUESTIONS UNDER STUDY Injuries due to interpersonal violence are a worldwide public health problem. In Switzerland, interpersonal violence seems to be an increasing problem in emergency departments (EDs) and is a topic of keen public debate. The primary objective of the current study is to describe our experience of interpersonal violence-related ED visits over a six-year period. METHODS Retrospective analysis of medical records using the ED electronic patient database (Qualicare, Qualidoc Bern). Demographics, diagnosis, length of stay, ED and hospital charges were compared for each year. RESULTS From 1.1.2001 to 31.12.2006 we treated a total of 1190 patients injured in interpersonal violence. 1064 (89%) were males and 126 (11%) females. The mean age was 27 years (SD 10). 752 patients (63%) were Swiss citizens and 438 (37%) non-Swiss. 853 patients (71%) were employed and only 73 (6%) were unemployed in 2006. There was an increase from 155 patients in 2001 to 275 in 2006. Compared to 2001 there was an increase in cases over weekends. 796 patients (78%) were discharged within 24 hours of injury and 110 (12%) were kept for more than 24 hours. Injuries to the head and extremities were the most frequent. The leading cause of injury was blunt instruments (96%). The median cost of initial treatment per patient admitted increased from CHF 1100 (IQR 5, 4900) in 2002 to CHF 5000 (IQR 3100, 7300) in 2006. DISCUSSION There has been no significant change in patients' age nor a shift in the nationality of patients over the past 6 years There has been a notable increase in patients needing hospitalisation, principally due to a rise in serious head injuries, a factor contributing to a impressive increase in costs per patient. The data presented here are intended as a basis for further research in the field of violence and prevention throughout Switzerland.