Aggressions in urgency and emergency care in Brazilian capitals: perspectives of 2011, 2014 and 2017 VIVA Survey

Pinto, Isabella Vitral; Bevilacqua, Paula Dias; Ribeiro, Adalgisa Peixoto; Santos, Ana Pereira dos; Bernal, Regina Tomie Ivata; Malta, Deborah Carvalho

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Revista Brasileira de Epidemiologia

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ORIGINAL ARTICLES • Rev. bras. epidemiol. 23 (Suppl 01) • 2020 • https://doi.org/10.1590/1980-549720200009.supl.1 copy

Aggressions in urgency and emergency care in Brazilian capitals: perspectives of 2011, 2014 and 2017 VIVA Survey

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT:

Objectives:

To describe the profile of care provided by aggressions in emergency units from the VIVA Survey 2011, 2014 and 2017 data, and to compare the evolution of six indicators over four (2011 to 2014) and seven years (2011 to 2017).

Methods:

Cross-sectional study, using data from the last three editions of the VIVA Survey carried out in the Federal District and in 19 Brazilian capitals. The types of occurrence were selected: aggression/mistreatment and intervention by a public agent. The weighted frequencies of the characteristics of the people assisted, of the aggressions, injuries and evolution of the cases were calculated, according to sex. Differences between proportions were compared using the χ² Test. Six indicators were also selected and their evolution over the years was evaluated by means of the percentage variation and the 95% confidence interval.

Results:

In most cases of aggression, the individuals were black, young and adult, of both sexes. The main nature of the assaults was physical, reaching over 85% in all investigations, followed by negligence. In the comparison between 2011 and 2017, “neglect” aggressions had a significant increase in both sexes and in children and the elderly; aggressions of a “sexual” nature had a significant increase only in children.

Conclusions:

The VIVA Survey is an important tool for Brazil’s Violence and Accident Surveillance System, providing evidence for public health decision-making and for coping with and preventing violence.

Keywords:
Violence; Health surveys; Emergency care; Wounds and injuries

Variables	2011					2014					2017
	Male		Female		p	Male		Female		p	Male		Female		p
	n	%*	n	%*	p	n	%*	n	%*	p	n	%*	n	%*	p
Ethnicity/color
White	442	19.37	212	26.41	< 0.01	460	21.31	232	29.25	< 0.01	356	20.38	156	24.89	0.01
Black	449	17.19	144	16.81		527	21.47	159	16.60		426	22.78	124	16.37
Brown	1,534	61.35	504	54.58		1,513	55.11	528	51.70		1,205	54.70	450	56.25
Yellow/Indigenous	58	2.09	23	2.20		64	2.10	30	2.45		55	2.14	19	2.49
Age
0 to 14	193	7.61	110	12.71	< 0.01	285	11.58	175	17.79	< 0.01	194	9.11	140	18.70	< 0.01
15 to 29	1,210	49.88	388	42.00		1,180	45.11	389	40.79		913	43.42	284	35.26
30 to 59	997	39.92	352	41.89		1,031	40.58	352	37.86		936	44.01	320	41.61
60+	61	2.59	30	3.41		64	2.73	35	3.56		67	3.46	38	4.43
Nature of the aggression
Physical	2,460	98.99	836	96.34	< 0.01	2,402	95.18	801	85.61	< 0.01	2,016	96.19	690	88.39	< 0.01
Negligence	12	0.23	12	1.09		100	4.16	66	7.02		59	2.64	52	6.58
Other**	18	0.78	35	2.57		19	0.66	57	7.37		32	1.17	37	5.03
Mean of aggression
Physical/beating	981	39.61	501	59.28	< 0.01	906	38.98	518	57.87	< 0.01	832	43.42	436	60.53	< 0.01
Firearm	433	19.29	55	7.69	< 0.01	572	21.27	63	6.81	< 0.01	414	17.66	40	3.85	< 0.01
Sharp object	699	26.65	174	17.58		636	21.81	146	11.88		492	21.01	120	13.13
Blunt object	313	12.74	97	10.61		293	11.58	98	10.56		233	12.30	69	9.87
Other***	55	1.71	53	4.84		158	6.36	114	12.88		124	5.61	105	12.62
Aggressor
Relative	245	9.56	162	18.17	< 0.01	302	12.51	198	20.80	< 0.01	230	11.05	159	19.62	< 0.01
Current/ex partner	112	3.96	271	30.58		125	5.55	277	28.83		133	6.98	234	32.28
Friend	772	32.75	212	23.67		663	27.35	196	19.44		524	26.40	184	26.29
Unknown person	1,117	48.32	194	24.55		1,200	48.31	223	25.84		916	47.85	151	19.52
Other****	123	5.41	22	3.04		154	6.27	40	5.09		152	7.71	19	2.28
Evolution
Discharge	1,469	59.50	619	70.35	<0.01	1,467	57.73	659	73.22	< 0.01	1.179	60.95	557	76.07	< 0.01
Hospitalization	598	25.91	96	12.86		630	26.18	124	13.14		591	26.15	88	10.41
Referral to another service	301	11.23	124	13.48		323	12.35	126	12.11		197	8.51	81	8.27
Evasion or Death	80	3.35	29	3.31		83	3.73	16	1.53		79	4.40	29	5.25

Indicator	Variable	Year			2011-2014		2011-2017
		2011	2014	2017	2011-2014		2011-2017
		%	%	%	Variation (%)	95%CI	Variation (%)	95%CI
Sexual violence	Sex
	Male	0.23	0.33	0.45	0.10	(-0.24; 0.44)	0.22	(-0.11; 0.55)
	Female	1.36	4.47	2.81	3.11	(1.13; 5.08)	1.45	(-0.57; 3.47)
	Age group
	0 to 14	2.37	5.38	8.02	3.01	(-0.08; 6.10)	5.65	(0.95; 10.35)
Physical violence	Sex
	Male	98.99	95.18	96.19	-3.81	(-5.10; -2.52)	-2.80	(-3.90; -1.70)
	Female	96.34	85.61	88.39	-10.73	(-13.86; 7.60)	-7.95	(-12.04; -3.87)
	Age group
	0 to 14	91.90	58.63	62.73	-33.27	(-40.63; -25.91)	-29.17	(-37.82; -20.53)
	15 to 29	98.55	98.13	98.89	-0.41	(-2.33; -0.29)	0.34	(-0.57; 1.26)
	30 to 59	99.31	98.05	98.67	-1.26	(-2.23; -0.29)	-0.64	(-1.43; 0.07)
	60+	97.17	85.08	83.95	-12.09	(-20.76; -3.42)	-13.22	(-20.94; -5.52)
Negligence	Sex
	Male	0.23	4.16	2.64	3.93	(2.81; 5.06)	2.41	(1.52; 3.30)
	Female	1.09	7.02	6.58	5.93	(3.69; 8.17)	5.49	(2.46; 8.52)
	Age group
	0 to 14	4.71	34.30	28.46	29.60	(22.52; 36.67)	23.75	(15.98; 31.52)
	60+	1.33	13.45	8.84	12.12	(3.93; 20.30)	7.51	(0.94; 14.08)

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[1] Corresponding author: Isabella Vitral Pinto. Avenida Augusto de Lima, 1715, CEP: 30190-009, Barro Preto, Belo Horizonte, MG, Brazil. E-mail: isabella.pinto@fiocruz.br