A. McGreal1, B. Tracy2, K. Williams2, R. Smith2,3 1Mercer University School of Medicine,Department Of Surgery,Savannah, GEORGIA, USA 2Emory University School of Medicine,Department Of Surgery,Atlanta, GEORGIA, USA 3Rollins School of Public Health,Atlanta, GEORGIA, USA
Introduction: National surveillance provides data regarding the incidence and prevalence of gun-related injuries (GRIs), yet little is known about the circumstances surrounding these events. We believe an understanding of how GRIs occur will better inform patient outreach and violence prevention. This study seeks to characterize the contexts and clinical impact of GRIs.
Methods: In 2018, we performed a 4-month prospective review of patients who presented to our Level 1 trauma center because of a GRI. We analyzed patient demographics, injury details, disposition, operations performed, and length of stay. We then surveyed the patients regarding the context of the event, i.e. whether it was intentional, the immediate circumstances, or who was the owner of the gun.
Results: There were 186 patients sustaining GRIs during the study, of which 79 were included in analysis. Most patients were black males in their third decade of life. Patients presented with an average of 2.63 missile wounds with the most affected body region being the lower extremities. Men had more missile wounds than females (2.76 vs 1.92, p= 0.05) and more retained ballistics (57 vs 7, p=0.03). Sixty percent (n=47) of patients received an operation during their hospitalization with a mean of 5 procedures. Most operations were orthopedic (53%, n=25), followed by general surgery interventions (45%, n=21). Intentional injuries accounted for 76% (n=60) of GRIs, with 42% (n=25) of these events related to interpersonal altercations and 36% (n=22) related to robberies. Unintentional injuries represented 24% (n=19) of GRIs of which the majority of patients (47%, n=9) were uninvolved bystanders. Regarding gun ownership, 8 patients knew the owner, 9 owned the gun, and the remaining 62 were unknown.
Conclusion: Our patient population largely sustained GRIs from intentional, interpersonal altercations and robberies. These etiologies may shed light on the economic plight and desperation plaguing our city. Interestingly, despite the number of intentional injuries, little is known or shared about ownership of the associated gun. Furthermore, the volume of procedures per patient is high, which imparts a significant financial burden. Ultimately, we still must better understand the circumstances that surround GRIs in order to effectively treat the survivors of these injuries and create effective outreach programs aimed at violence prevention.