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Self-Inflicted Gun Shot Wounds: A Retrospective, Observational Study of U.S. Trauma Centers

INTRODUCTION: Intentional self-harm (suicide) by firearms is a growing problem in the United States. Currently, there are no large studies that have identified risk factors for patients who die from self-inflicted gunshot wounds. Our objectives are to 1) identify risk factors for patients with the h...

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Autores principales: Quenzer, Faith, Givner, Andrew, Dirks, Rachel, Coyne, Christopher J., Ercoli, Frank, Townsend, Ricard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203010/
https://www.ncbi.nlm.nih.gov/pubmed/34125021
http://dx.doi.org/10.5811/westjem.2021.4.49315
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author Quenzer, Faith
Givner, Andrew
Dirks, Rachel
Coyne, Christopher J.
Ercoli, Frank
Townsend, Ricard
author_facet Quenzer, Faith
Givner, Andrew
Dirks, Rachel
Coyne, Christopher J.
Ercoli, Frank
Townsend, Ricard
author_sort Quenzer, Faith
collection PubMed
description INTRODUCTION: Intentional self-harm (suicide) by firearms is a growing problem in the United States. Currently, there are no large studies that have identified risk factors for patients who die from self-inflicted gunshot wounds. Our objectives are to 1) identify risk factors for patients with the highest morbidity and mortality from self-inflicted gunshot wounds (SIGSWs) at trauma centers 2) present the outcomes of victims of SIGSW by handguns (HG) versus all other specified guns (AOG) and 3) compare the presentations and outcomes of victims with head or face (HF) injuries to other regions of the body. METHODS: We performed a retrospective analysis from the National Trauma Database (NTDB) data between 2012 and 2013 of all SIGSW patients who presented to trauma centers. Categorical data included patient characteristics upon presentation and outcomes which were compared between patients with HG injury versus AOG injury using the Chi-Squared test, where AOG includes shotguns, hunting rifles, and military firearms. Additionally, analysis of head and face (HF) injuries versus other bodily injuries (OBI) were compared between the HG group versus AOG group using Chi-squared test. RESULTS: There were 7,828 SIGSWs, of those, 78% (6,115) were white and 84.3% (6,600) were male. There were 5,139 HG injuries, 1,130 AOG injuries, and 1,405 unidentified gun injuries. The HG group was likely to be older (>55 years old), hypotensive (systolic blood pressure < 90), have a lower Glasgow Coma Score (GCS < 9), use illegal, or use prescription drugs. In comparing HF injuries (4,799) versus other bodily injuries (OBI) (3,028), HF group was more likely to use handguns, expire in ED, require ICU, and have a higher percent of overall mortality. Of the total OBI, the thorax, upper extremities, and abdomen were the most commonly injured. CONCLUSION: In our retrospective study of SIGSWs, we were able to demonstrate that SIGSW by handguns are associated with higher rates of mortality versus all other types of firearms. SIGSWs in older white males with handguns are the most at-risk for severe complications. Future efforts should improve screening methods for handguns in suicidal patients and at developing prevention programs.
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spelling pubmed-82030102021-06-21 Self-Inflicted Gun Shot Wounds: A Retrospective, Observational Study of U.S. Trauma Centers Quenzer, Faith Givner, Andrew Dirks, Rachel Coyne, Christopher J. Ercoli, Frank Townsend, Ricard West J Emerg Med Violence Assessment and Prevention INTRODUCTION: Intentional self-harm (suicide) by firearms is a growing problem in the United States. Currently, there are no large studies that have identified risk factors for patients who die from self-inflicted gunshot wounds. Our objectives are to 1) identify risk factors for patients with the highest morbidity and mortality from self-inflicted gunshot wounds (SIGSWs) at trauma centers 2) present the outcomes of victims of SIGSW by handguns (HG) versus all other specified guns (AOG) and 3) compare the presentations and outcomes of victims with head or face (HF) injuries to other regions of the body. METHODS: We performed a retrospective analysis from the National Trauma Database (NTDB) data between 2012 and 2013 of all SIGSW patients who presented to trauma centers. Categorical data included patient characteristics upon presentation and outcomes which were compared between patients with HG injury versus AOG injury using the Chi-Squared test, where AOG includes shotguns, hunting rifles, and military firearms. Additionally, analysis of head and face (HF) injuries versus other bodily injuries (OBI) were compared between the HG group versus AOG group using Chi-squared test. RESULTS: There were 7,828 SIGSWs, of those, 78% (6,115) were white and 84.3% (6,600) were male. There were 5,139 HG injuries, 1,130 AOG injuries, and 1,405 unidentified gun injuries. The HG group was likely to be older (>55 years old), hypotensive (systolic blood pressure < 90), have a lower Glasgow Coma Score (GCS < 9), use illegal, or use prescription drugs. In comparing HF injuries (4,799) versus other bodily injuries (OBI) (3,028), HF group was more likely to use handguns, expire in ED, require ICU, and have a higher percent of overall mortality. Of the total OBI, the thorax, upper extremities, and abdomen were the most commonly injured. CONCLUSION: In our retrospective study of SIGSWs, we were able to demonstrate that SIGSW by handguns are associated with higher rates of mortality versus all other types of firearms. SIGSWs in older white males with handguns are the most at-risk for severe complications. Future efforts should improve screening methods for handguns in suicidal patients and at developing prevention programs. Department of Emergency Medicine, University of California, Irvine School of Medicine 2021-05 2021-05-19 /pmc/articles/PMC8203010/ /pubmed/34125021 http://dx.doi.org/10.5811/westjem.2021.4.49315 Text en Copyright: © 2021 Quenzer et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Violence Assessment and Prevention
Quenzer, Faith
Givner, Andrew
Dirks, Rachel
Coyne, Christopher J.
Ercoli, Frank
Townsend, Ricard
Self-Inflicted Gun Shot Wounds: A Retrospective, Observational Study of U.S. Trauma Centers
title Self-Inflicted Gun Shot Wounds: A Retrospective, Observational Study of U.S. Trauma Centers
title_full Self-Inflicted Gun Shot Wounds: A Retrospective, Observational Study of U.S. Trauma Centers
title_fullStr Self-Inflicted Gun Shot Wounds: A Retrospective, Observational Study of U.S. Trauma Centers
title_full_unstemmed Self-Inflicted Gun Shot Wounds: A Retrospective, Observational Study of U.S. Trauma Centers
title_short Self-Inflicted Gun Shot Wounds: A Retrospective, Observational Study of U.S. Trauma Centers
title_sort self-inflicted gun shot wounds: a retrospective, observational study of u.s. trauma centers
topic Violence Assessment and Prevention
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8203010/
https://www.ncbi.nlm.nih.gov/pubmed/34125021
http://dx.doi.org/10.5811/westjem.2021.4.49315
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