Firearm Injuries Presenting to a Tertiary Care Hospital of Karachi, Pakistan

BACKGROUND: Violence is a public health problem in low and middle income countries. Our study attempted to define the circumstances, risk groups, extent and severity of firearm-related injuries in patients coming to the Aga Khan University Hospital (AKUH) Karachi, Pakistan. METHODS: This was a retrospective study conducted in the department of Emergency Medicine (EM) at AKUH Karachi, Pakistan. Past medical records of all patients who were injured by firearms and were presented to the AKUH Emergency Department (ED) from June 2002 till May 2007 were reviewed. Data were recorded on the basic demographics of injured, length of hospital stay, body parts injured and the outcome (alive vs. dead). RESULTS: Total of 286 patients with firearm injuries were identified. Majority of them were males (92%; n=264). More than half of the patients (63%) were in the age group of 21-40 years. Upon arrival to the hospital 85% (n=243) of patients had Glasgow Coma Scale (GCS)>= 13. The mean injury severity score (ISS) was found to be 6 (SD ±4). The length of hospital stay of patients ranged from 0 to 54 days with a mean of 7 days. Lower limb were the most affected body parts (30%, n=86) followed by abdomen pelvis (27%, n=77). Seven percent (n=21) of the patient who were brought to the hospital were labeled as "deceased on arrival". Most of the injuries were caused during the act of robbery (40%, n=103) in the city. CONCLUSIONS: Robbery was the most common cause of firearm injuries. Lower limb, abdomen and pelvis were the most affected body regions. Educational efforts, and individual, community and societal approaches are needed to alleviate firearm-related injuries.