TY  - JOUR
PY  - 2020//
TI  - National trends and cost burden of surgically treated gunshot wounds in the US
JO  - Journal of the American Academy of Surgeons
A1  - Dobaria, Vishal
A1  - Aguayo, Esteban
A1  - Sanaiha, Yas
A1  - Tran, Zachary
A1  - Hadaya, Joseph
A1  - Sareh, Sohail
A1  - Cho, Nam Yong
A1  - Benharash, Peyman
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - Introduction  Gun violence remains a major burden on the US healthcare system with annual costs exceeding $170 billion. Literature regarding the national trends in costs and survival of gun violence victims requiring operative interventions is lacking.     Study Design  All adults admitted with a diagnosis of gunshot wound (GSW) requiring operative intervention(s) were identified using the 2005-16 National Inpatient Sample (NIS). The International Classification of Diseases Injury Severity score (ICISS), a validated prediction tool, was used to quantify the extent of traumatic injuries. Survey-weighted methodology was employed to provide national estimates. Hospitalizations exceeding the 66 th percentile of annual costs were considered as high cost tertile (HCT). Multivariable logistic regressions with stepwise forward selection were used to identify factors associated with mortality and HCT.     Results  Over the study period, 262,098 admissions met inclusion criteria with a significant increase in annual frequency and decrease in ICISS scores. A decline in mortality (8.6% to 7.6%, P-trend=0.03) was accompanied by increasing mean costs ($25,900 to $33,000, NP- trend<0.001). After adjusting for patient and hospital characteristics, head and neck (adjusted odds ratio (AOR): 31.2; 95% CI: 11.0-88.4, P<0.001), vascular operations (AOR: 24.5; 95% CI:19.2-31.1, P<0.001), and gastrointestinal (AOR: 27.8; 95% CI:17.2-44.8, P<0.001), were independently associated with HCT designation compared to patients who did not undergo these operations.     Conclusion  Over the past decade, the increase in gun violence and severity has resulted in higher costs. Operations involving selected surgical treatments incurred higher in-hospital costs. Given the profound economic and social impact of surgically treated GSWs, policy and public health efforts to reduce gun violence are imperative.<p />  <p>Language: en</p>
LA  - en
SN  - 1072-7515
UR  - http://dx.doi.org/10.1016/j.jamcollsurg.2020.06.022
ID  - ref1
ER  -