Chloé Descamps1, Sophie Hamada2,3, Jean-Luc Hanouz4, Fanny Vardon-Bounes5, Arthur James6, Delphine Garrigue7, Paer Abback8, Mickaël Cardinale9, Guillaume Dubreuil10, Jeanne Chatelon11, Fabrice Cook12, Arthur Neuschwander2, Nathalie de Garambé1, Sylvain Ausset13, Mathieu Boutonnet14,15. 1. Anesthesiology and Intensive Care Unit, Percy Military Teaching Hospital, Clamart, France. 2. Department of Anaesthesiology and Critical Care, Université de Paris, AP-HP, Hôpital Européen Georges Pompidou, 25, rue Leblanc, 75015, Paris, France. 3. CESP, INSERM, Univ. Paris-Sud, UVSQ, Université Paris-Saclay, Maison de Solenn, 97, boulevard de Port-Royal, 75014, Paris, France. 4. Department of Anesthesiology and Intensive Care Medicine, Caen University Hospital, and Normandie Univ, UNICAEN, Caen, France. 5. Department of Anesthesiology and Critical Care, Toulouse University Hospital, Toulouse, France. 6. Groupe Hospitalier Universitaire APHP-Sorbonne Université, Site Pitié-Salpêtrière, Département d'Anesthésie Réanimation, 75013, Paris, France. 7. Department of Anesthesiology and Critical Care, Centre Hospitalier Universitaire de Lille, 59000, Lille, France. 8. Department of Anaesthesiology and Intensive Care, DMU PARABOL, AP-HP.Nord, Beaujon Hospital, University of Paris, Clichy, France. 9. Anesthesiology and Intensive Care Unit, Sainte Anne Military Teaching Hospital, Toulon, France. 10. Department of Anesthesia and Critical Care, AP-HP, Bicêtre Hospital, Paris, France. 11. Anesthesiology and Intensive Care Unit. Hôpital Nord, Assistance Publique Hôpitaux de Marseille, Aix Marseille Université, Marseille, France. 12. Department of Anesthesia and Surgical Intensive Care, Henri Mondor University Hospital of Paris, Paris-Est Créteil University, 51, Avenue du Maréchal de Lattre de Tassigny, 94000, Créteil, France. 13. French Military Health Service Schools, Lyon-Bron, France. 14. Anesthesiology and Intensive Care Unit, Percy Military Teaching Hospital, Clamart, France. mathieuboutonnet@hotmail.com. 15. Val-de-Grâce Military Health Academy, Paris, France. mathieuboutonnet@hotmail.com.
Abstract
PURPOSE: Severe trauma is a major problem worldwide. In France, blunt trauma (BT) is predominant and few studies are available on penetrating trauma (PT). The purpose of this study was to perform a descriptive analysis of severe gunshot (GSW) and stab wounds (SW) in patients who were treated in French trauma centers. METHODS: Retrospective study on prospectively collected data in a national trauma registry. All adult (> 15 years) trauma patients primarily admitted in 1 of the 17 trauma centers members of the Traumabase between January 2015 to December 2018 were included. Data from patients who had a PT were compared with those who had suffered a BT over the same period. Due to the known differences between GSW and SW, sub-group analyses on data from GSW, SW and BT were also performed. RESULTS: 8128 patients were included. Twelve percent of the study group had a PT. The main mechanism of PT was SW (68.1%). Five hundred and eighty patients with PT (59.4%) required surgery within the first 24 h. Severe hemorrhage was more frequent in penetrating traumas (11.2% vs. 7.8% p < 0.001). Hospital mortality following PT was 8.9% vs 11% for blunt trauma (p = 0.047). Among PT the mortality after GSW was ten times higher than after SW (23.8% vs 2%). CONCLUSION: This work is the largest study to date that has specifically focused on GSW and SW in France, and will help improving knowledge in managing such patients in our country.
PURPOSE: Severe trauma is a major problem worldwide. In France, blunt trauma (BT) is predominant and few studies are available on penetrating trauma (PT). The purpose of this study was to perform a descriptive analysis of severe gunshot (GSW) and stab wounds (SW) in patients who were treated in French trauma centers. METHODS: Retrospective study on prospectively collected data in a national trauma registry. All adult (> 15 years) trauma patients primarily admitted in 1 of the 17 trauma centers members of the Traumabase between January 2015 to December 2018 were included. Data from patients who had a PT were compared with those who had suffered a BT over the same period. Due to the known differences between GSW and SW, sub-group analyses on data from GSW, SW and BT were also performed. RESULTS: 8128 patients were included. Twelve percent of the study group had a PT. The main mechanism of PT was SW (68.1%). Five hundred and eighty patients with PT (59.4%) required surgery within the first 24 h. Severe hemorrhage was more frequent in penetrating traumas (11.2% vs. 7.8% p < 0.001). Hospital mortality following PT was 8.9% vs 11% for blunt trauma (p = 0.047). Among PT the mortality after GSW was ten times higher than after SW (23.8% vs 2%). CONCLUSION: This work is the largest study to date that has specifically focused on GSW and SW in France, and will help improving knowledge in managing such patients in our country.
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