Literature DB >> 28697020

Good news, bad news: An analysis of 11,294 gunshot wounds (GSWs) over two decades in a single center.

Nathan R Manley1, Timothy C Fabian, John P Sharpe, Louis J Magnotti, Martin A Croce.   

Abstract

INTRODUCTION: Gun violence is a substantial public health problem accounting for significant physical, psychological, and financial costs. Although aggregate data sources demonstrate decreasing rates of firearm violence, analyses from individual trauma centers have shown that mortality and injury severity from gunshot wounds (GSWs) are increasing. To evaluate the evolving characteristics of gun violence in our region, we studied all GSWs admitted to our trauma center over a 20-year period.
METHODS: A retrospective analysis of all newly admitted patients with GSWs was performed from 1996 to 2016. Our trauma registry was used to collect data on demographics, mortality, injury severity, body regions injured, and geographic location of injury. Homicide data were obtained from local law enforcement.
RESULTS: A total of 11,294 patients with GSWs were reviewed. The number of GSWs treated per biennium increased from 1,349 in 1996-1997 to 1,484 in 2014-2015, with a 59% increase occurring from 2010-2011 to 2014-2015. Overall mortality was 14.6% and decreased from 15.8% in 1996-1997 to 10.2% in 2014-2015 (p < 0.0001). Mean Injury Severity Score was 12.6 and the percentage of patients who suffered GSWs to ≥3 Abbreviated Injury Scale body regions increased from 2.5% in 1996-1997 to 7.7% in 2014-2015 (p < 0.0001). Local firearm homicide data show a 118% increase from 2010 to 2016.
CONCLUSIONS: In contrast to other recent studies, we found that mortality decreased whereas the number of patients treated for GSWs and those with multicompartmental injuries increased. The decrease in mortality suggests improved trauma systems as well as an increase in nonfatal GSWs that dilutes overall mortality. Wounding in multiple body regions suggests more effective weaponry, including increased magazine size. The recent increase in local homicides parallels trends in registry data and illustrates worsening gun violence in our region. Further research is needed to understand local and regional determinants of increased gun violence to better guide prevention strategies. LEVEL OF EVIDENCE: Epidemiological study, level III.

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Year:  2018        PMID: 28697020     DOI: 10.1097/TA.0000000000001635

Source DB:  PubMed          Journal:  J Trauma Acute Care Surg        ISSN: 2163-0755            Impact factor:   3.313


  7 in total

1.  Gunshot and blast injuries of the extremities: a review of 45 cases.

Authors:  Ioannis A Ignatiadis; Andreas F Mavrogenis; Vasilios G Igoumenou; Vasilios D Polyzois; Vasiliki A Tsiampa; Dimitrios K Arapoglou; Sarantis Spyridonos
Journal:  Eur J Orthop Surg Traumatol       Date:  2018-11-29

2.  The Effect of Large-Capacity Magazine Bans on High-Fatality Mass Shootings, 1990-2017.

Authors:  Louis Klarevas; Andrew Conner; David Hemenway
Journal:  Am J Public Health       Date:  2019-10-17       Impact factor: 9.308

3.  INJURIES OF BOKO HARAM INSURGENCY IN SOUTH-EAST NIGER REPUBLIC.

Authors:  R Sani; H Adamou; H Daddy; Magagi I Amodou; M B Adoulaye; L Didier James; I Garba; K Idé; Y Hama; S Sanoussi
Journal:  J West Afr Coll Surg       Date:  2018 Jul-Sep

Review 4.  Advanced interventions in the pre-hospital resuscitation of patients with non-compressible haemorrhage after penetrating injuries.

Authors:  E Ter Avest; L Carenzo; R A Lendrum; M D Christian; R M Lyon; C Coniglio; M Rehn; D J Lockey; Z B Perkins
Journal:  Crit Care       Date:  2022-06-20       Impact factor: 19.334

5.  Intracranial gunshot wounds in utero: case report and review.

Authors:  William M Mangham; William E Gordon; Stephanie L Einhaus
Journal:  Childs Nerv Syst       Date:  2021-03-24       Impact factor: 1.475

6.  Demographics and Incident Location of Gunshot Wounds at a Single Level I Trauma Center.

Authors:  Blair Benton; David Watson; Elizabeth Ablah; Kelly Lightwine; Ronda Lusk; Hayrettin Okut; Thuy Bui; James M Haan
Journal:  Kans J Med       Date:  2021-02-12

7.  Derivation and Validation of a Score Using Prehospital Data to Identify Adults With Trauma Requiring Early Laparotomy.

Authors:  Adam Gutierrez; Kazuhide Matsushima; Areg Grigorian; Morgan Schellenberg; Kenji Inaba
Journal:  JAMA Netw Open       Date:  2022-01-04
  7 in total

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