Clinical presentations, medical complications, and functional outcomes of individuals with gunshot wound-induced spinal cord injury.

Gunshot wounds are currently the second leading cause of spinal cord injury in the United States, and coexisting injuries or complications accompanying penetrating wounds often increase patient morbidity. A review of 217 traumatic spinal cord injury rehabilitation admissions to a tertiary care hospital during a 5-yr period revealed 49 individuals (23%) with gunshot wound-induced spinal cord injury. A single bullet entry site was seen in 54%, whereas 17% had greater than 3 sites of entry. Common (>25%) sites of bullet entry included the back, abdomen, neck, and chest. Common gunshot wound-related medical complications included pain (54%), infections (40%), pneumothorax (24%), nonspinal fractures (22%), colonic perforation (17%), cerebrospinal fluid leak (10%), and retroperitoneal hematoma (10%). When compared with nonviolence-related traumatic spinal cord injury (motor vehicle accidents and falls), patients with gunshot wound-induced spinal cord injury were significantly more frequently (P < 0.01) younger, non-Caucasian, unmarried, and unemployed. Injury characteristics revealed significantly (P < 0.01) more paraplegia and complete spinal cord injury within the gunshot wound-induced spinal cord injury group. Gunshot wound-induced spinal cord injury and nonviolent traumatic spinal cord injury groups had similar lengths of stay, Functional Independence Measure scores, and discharge to home rates. This article adds to the growing body of literature examining clinical, medical, and functional outcome characteristics of individuals with spinal cord injury secondary to violence-related cause.