Epidemiology of firearm injuries in a Scandinavian trauma center

Abstract

Background There is a concern that civilian gunshot injuries in Europe are increasing but there is a lack of contemporary studies. The purpose of this study was to investigate the current epidemiology and outcome of firearm injuries. Methods Retrospective cohort study of all patients (n = 235) treated for firearm injuries admitted to a Scandinavian trauma center between 2005 and 2016. Local and national trauma registries were used for data collection. Results Mean age was 31.3 years (SD ± 12.9; range 16-88 years); 93.6% males; mean ISS was 14.3 (SD ± 15.9); 31.9% (75/235) had ISS > 15. There was a significant increase in penetrating trauma (P < 0.001) and firearm injuries (P < 0.001) over the years. The most common anatomical location of firearm injury was the lower extremity, (n = 138/235; 38%), followed by the abdomen (n = 69;19%), upper extremity (n = 53;15%), chest (n = 50; 14%), and head and neck (n = 50; 14%). Ninety patients (38.3%) had more than one anatomic injury location. There were in total 360 firearm injuries and 168 major surgical procedures were performed. 53% (n = 125) of patients underwent at least one surgical procedure. The most common procedures were fracture surgery 42% (n = 70/168), followed by laparotomy 30%% (n = 51), chest tube 17% (n = 29), and thoracotomy 11% (n = 18). Forty-one patients (17%) had at least one major vascular injury (n = 54). The most common vascular injury was lower extremity vessel injuries, 26/54 (48%), followed by vessels in chest and abdomen. There was a significant increase in vascular injuries during the study period (P < 0.006). The 30-day mortality was 12.8% (n = 30); 24 patients died within 24 h mainly due to injuries to the chest and the head and neck region. Conclusions Firearm injuries cause significant morbidity and mortality and are an important medical and public health problem. In a Scandinavian trauma center there has been an increase of firearm injuries in recent years. The lower extremities followed by the abdomen are the dominating injured regions and there has been an increase in associated vascular injuries.

Gunshot injuries: patterns, presentations, and outcomes of civilian hospital experiences in a developing country setting

“…Conversely, the perineum was found to be the least affected site (2%). These ndings are like those reported in previous literature [6,8,13].…”

“…In this study, we reviewed the data (clinical presentation, treatments and management outcome) of 157 patients presented to the hospital with gunshot wounds due to various causes in the period of January 2014 to January 2019 to assess the pattern, causes, management and the outcome. The total number of patients reviewed in this study is same or slightly higher than some an available national and international [6,11,12] data but still less than reported number from USA and South Africa [8,13,14].…”

“…The most common anatomical site of the body affected by nonfatal rearm injuries are the upper or lower limbs extremities including soft tissue as well as bone tissue [6]. In this study the lower limb followed by the upper limb are the most common sites injured (65%).…”

“…In USA approximately 30,000 patients are hospitalized for gunshot injuries yearly, and 2500 of them die in the hospital. Firearm homicides are 19 times more prevalent in the USA than other higher income countries [6]. In Africa, rearm injuries represent a major health problem.…”

Atypical gunshot injury to the neck with an unexpected nonlinear bullet trajectory: a case report and review of the literature

“…Because the head and neck region is densely occupied with vital structures in a relatively small volume, even the minimum motions of a penetrating bullet can simultaneously inflict severe damage to a major artery, vein, and nerve, leading to serious lifethreatening conditions. This anatomical property is reflected in the high mortality rates associated with head and neck-related firearm injuries that reach up to 35-36% [5,6]. Furthermore, in terms of the proportion, while the head and neck region accounts for 13.8-20% of all gunshot injuries [5][6][7], deaths from head and neck-related firearm injuries account for as high as 54-58% of all firearmrelated deaths [5,6].…”