A retrospective analysis of data obtained from the Qatar National Trauma Registry at Hamad Trauma Center (HTC) was conducted. The study received ethical approval from Institutional Review Board (IRB) of Hamad Medical Corporation (#MRC-01-18-189). The HTC is the one and only level 1 trauma center in Qatar which sees and treats moderate to severely injured patients all over the country including referrals from other hospitals. Each year, Trauma Code (Level I, II or III Trauma Criteria) is activated for nearly 2500 patients and almost 1800 are admitted in the HTC. This study included all patients presented to the level 1 HTC following violence-related (IPV and self-inflicted) injuries in the duration between June 2010 and June 2017.
Data extracted included age, gender, nationality, mechanism of injury, injured regions, injury severity score (ISS), major procedures and outcome. The patients were grouped by nationality as following; South Asians (India, Nepal, Pakistan, Bangladesh and Sri Lanka); Southeast Asians (Indonesia and Philippines) and Northeast Asians (China, Japan, North Korea, and South Korea). The Gulf Cooperation Council (GCC) and Middle East countries include; Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates, Iran, Iraq, Jordan, Palestine, Lebanon, Syria & Yemen. African, European and American countries were also included. The population data were obtained from website of the Ministry of Development, Planning and Statistics .
The patients in this study were identified using the Classification of External Cause of Injury and Poisoning (E-Codes) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The E-codes for suicide and self-inflicted injury (E950-E959) included: injuries in suicide and attempted suicide, self-inflicted injuries specified as intentional. The codes for homicide and injury purposely inflicted by other persons (E960-E969) included: injuries inflicted by another person with intent to injure or kill, by any means. The codes for legal intervention (E970-E978) included: injuries inflicted by police or other law enforcing agents. Each patient record was given a unique study number, and patient anonymity was maintained throughout the study.
Case fatality rate (CFR) was calculated by dividing the number of deaths from violence-related injuries in the study duration by the number of patients presented with violence-related trauma during that time. The resulting ratio was then multiplied by 100 to yield a percentage. This manuscript adheres to the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines (Suppl table) .
Statistical data analysis was performed using Statistical Package for the Social Sciences (IBM® SPSS version 18 (IBM Inc., Armonk, USA). Data were summarized in form of proportions and frequent tables for categorical variables. Continuous variables were summarized using means, median, mode and standard deviation. P-values were computed for categorical variables using Chi-square test and Fisher exact test depending on the size of the data set. Independent student t-test was used for continuous variables. A two-tailed p-value of less than 0.05 was considered to constitute a statistically significant difference.