Citation

Foran CP, Clark DH, Henry R, Lalchandani P, Kim DY, Putnam BA, Schellenberg M, Lane CJ, Inaba K, Demetriades DG. J. Am. Coll. Surg. 2019; 229(2): 141–149.

Affiliation

Division of Acute Care Surgery and Surgical Critical Care, Los Angeles County + University of Southern California Medical Center (LAC+USC), Los Angeles, CA.

Copyright

(Copyright © 2019, American College of Surgeons, Publisher Elsevier Publishing)

DOI

10.1016/j.jamcollsurg.2019.02.048

PMID

30878583

Abstract

BACKGROUND: Gunshot wound (GSW) injuries present a unique surgical challenge. This study explored the financial and clinical burdens of GSW victims across two Los Angeles County Level I trauma centers over the last 12 years and compared them to other forms of interpersonal injury (OIPI). STUDY DESIGN: This was a retrospective study of patients presenting as the victim GSW and OIPI (defined as combined stab wound or blunt assault) between 1/1/2006 until 3/30/2018 at LAC+USC Medical Center (LAC+USC) and Harbor UCLA Medical Center (HUCLA). Demographic and clinical variables were assessed for GSW victims and compared to victims of OIPI.

RESULTS: 17,871 patients met inclusion criteria. There was a significant difference in mortality for victims of GSW versus OIPI (11% versus 2%, p<0.001). The odds ratio for GSW patients requiring operation was twice as high as OIPI (OR = 2.0, 95% CI 1.8-2.2). The odds ratio for GSW patients requiring ICU admission was 20% higher than OIPI (OR = 1.23, 95% CI 1.11-1.36). GSW victims experienced a longer median length of stay versus OIPI victims (3 days versus 2 days, p < 0.001). The median hospital charge per admission for GSW was twice that of OIPI (GSW $12,612 versus OIPI $6,195; p < 0.001).

CONCLUSION: When compared to OIPI, GSW victims arrived more severely injured, required more operations, more ICU admissions, and longer hospital stays. GSW victims incurred significantly higher hospital charges and had a significantly higher mortality rate. GSW injury is a unique public health concern requiring comprehensive, nation-wide, contemporary study.

Copyright © 2019. Published by Elsevier Inc.

Language: en

Keywords

Gunshot wound; Interpersonal Violence; Youth Violence