Gunshot Injuries in American Trauma Centers: Analysis of the Lethality of Multiple Gunshot Wounds

Ahmad Zeineddin, Mallory Williams, Harry Nonez, Wasay Nizam, Olubode A. Olufajo, Gezzer Ortega, Adil Haider, Edward E. Cornwell

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Introduction: Trauma center care and survival have been improving over the past several years. However, yearly firearm-related deaths have remained near constant at 33 000. One challenge to decreasing gunshot mortality is patients presenting with complex injury patterns from multiple gunshot wounds (GSWs) made possible by high-caliber automated weapons. Our study analyzes outcomes of trauma patients of firearms using the National Trauma Databank (NTDB). Methods: We conducted a retrospective review of the NTDB from the years 2003-2015 for patients with penetrating injuries. We separated patients into groups based on stab wounds, single GSW, and multiple GSW. We performed multivariate logistic regression analyses in which we adjusted for demographics and injury severity. Results: Overall, 382 376 patients presenting with penetrating injuries were analyzed. Of those 167 671 had stab, 106 538 single GSW, and 57 819 multiple GSW injuries. Crude mortality was 1.97% for stab wounds, 13.26% for single GSW, and 18.84% for multiple GSW. Adjusted odds ratio (OR) compared with 2003 demonstrates a trend toward decreased mortality for stab wounds (OR range of 0.48-0.69, P <.05 for years 2010-2015). A similar trend was demonstrated in single GSW injuries (OR 0.31-0.83, P <.01 for years 2005-2015). Conversely, multiple GSW injuries did not follow this trend (OR 0.91-1.36 with P > 0.05 for each year). Conclusion: In contrast to significant improvement in survival in patients with a single GSW injury since 2003, multiple GSW injuries still pose a challenge to trauma care. This warrants further investigation into the efficacy of legislature, and the lack thereof, as well as future preventative measures to this type of injury.

Original languageEnglish
Pages (from-to)39-44
Number of pages6
JournalAmerican Surgeon
Volume87
Issue number1
DOIs
Publication statusPublished - Jan 2021
Externally publishedYes

Keywords

  • firearm injury
  • gunshot injury
  • mortality
  • trauma centers

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