Nationwide Analysis of Firearm Injury Versus Other Penetrating Trauma: It's Not all the Same Caliber

• Published in: The Journal of surgical research 2024-02, Vol.294, p.106-111
• Main Authors: Ramsey, Walter A., O'Neil, Christopher F., Shatz, Connor D., Lyons, Nicole B., Cohen, Brianna L., Saberi, Rebecca A., Gilna, Gareth P., Meizoso, Jonathan P., Pizano, Louis R., Schulman, Carl I., Proctor, Kenneth G., Namias, Nicholas
• Format: Article
• Language: English
• Subjects: Female; Firearm violence; Firearms; GSW; Humans; Injury scoring; Injury Severity Score; Male; Penetrating trauma; Retrospective Studies; Trauma Centers; Trauma quality improvement; Wounds, Gunshot; Wounds, Penetrating - epidemiology; Wounds, Stab
• ISSN: 0022-4804; 1095-8673; 1095-8673
• DOI: 10.1016/j.jss.2023.09.067

Ballistic injuries cause both a temporary and permanent cavitation event, making them far more destructive and complex than other penetrating trauma. We hypothesized that global injury scoring and physiologic parameters would fail to capture the lethality of gunshot wounds (GSW) compared to other penetrating mechanisms. The 2019 American College of Surgeons Trauma Quality Programs participant use file was queried for the mortality rate for GSW and other penetrating mechanisms. A binomial logistic regression model ascertained the effects of sex, age, hypotension, tachycardia, mechanism, Glasgow Coma Scale, ISS, and volume of blood transfusion on the likelihood of mortality. Subgroup analyses examined isolated injuries by body regions. Among 95,458 cases (82% male), GSW comprised 46.4% of penetrating traumas. GSW was associated with longer hospital length of stay (4 [2-9] versus 3 [2-5] days), longer intensive care unit length of stay (3 [2-6] versus 2 [2-4] days), and more ventilator days (2 [1-4] versus 2 [1-3]) compared to stab wounds, all P