Unintentional Firearm Injuries Remain Prevalent Over a 12 Year Experience at a Rural Midwestern Level 1 Trauma Center.

The Iowa orthopaedic journal Pub Date : 2018-01-01
Brian Guetschow, Michele Lilienthal, Michael Willey
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Abstract

Recently, firearm injuries in the United States have taken center stage in political debates and in the media. Much of the past epidemiological research on firearm injuries has focused primarily on the urban landscape. This study was undertaken to highlight the unique spectrum of firearm injuries seen at a rural level 1 trauma center to provide insight into prevalence, mechanism of injury, and seasonal variation. An IRB-approved retrospective study was performed of the trauma registry at a rural Level 1 hospital to identify all patients with firearm injuries from January 2002 to May 2014. Data obtained for each patient included demographics, injury date, a brief injury summary, and results of drug/ alcohol screening. Chart review was performed to confirm accuracy of the database and descriptive statistics were calculated to compare subgroups. During the 12 year study period, 408 patients with firearm injuries were treated at our hospital. There were 360 males and 48 females. Ages ranged from an infant to 90 years. Handguns were the most common type of firearm (49%). Mortality in this series was 19%. The median age for fatal and non-fatal wounds was 44 and 27 years, respectively. The three main causes of injury were accidental (36%), self-inflicted (33%), and assault (26%). Alcohol and drugs were commonly present. Hunting incidents accounted for 26% of accidents and most of these occurred while deer hunting in November and December. The demographics and mechanism of firearm injuries vary across the urban-rural continuum and it is important to identify these subgroups so targeted interventions can be pursued.

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在中西部农村一级创伤中心的12年经历中,意外火器伤仍然普遍存在。
最近,美国的枪支伤害事件成为政治辩论和媒体关注的焦点。过去关于枪支伤害的流行病学研究大多主要集中在城市景观上。这项研究旨在强调在农村一级创伤中心看到的独特的枪支伤害谱,以深入了解流行率、伤害机制和季节变化。2002年1月至2014年5月,在一家农村一级医院对创伤登记处进行了IRB批准的回顾性研究,以确定所有火器伤患者。为每位患者获得的数据包括人口统计数据、受伤日期、简短的受伤总结以及药物/酒精筛查结果。进行图表审查以确认数据库的准确性,并计算描述性统计数据以比较亚组。在12年的研究期间,408名火器伤患者在我院接受了治疗。男360例,女48例。年龄从婴儿到90岁不等。手枪是最常见的枪支类型(49%)。该系列的死亡率为19%。致命伤和非致命伤的中位年龄分别为44岁和27岁。受伤的三个主要原因是意外(36%)、自我伤害(33%)和攻击(26%)。普遍存在酒精和毒品。狩猎事件占事故的26%,其中大多数发生在11月和12月的猎鹿期间。枪支伤害的人口统计和机制在城乡连续体中各不相同,重要的是要确定这些亚组,以便采取有针对性的干预措施。
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