Outcomes related to the number and anatomic placement of gunshot wounds

Carr, B. G., Schwab, C. W., Branas, C. C., Killen, M., & Wiebe, D. J. (2008). Outcomes related to the number and anatomic placement of gunshot woundsJournal of Trauma and Acute Care Surgery64(1), 197-203.


Objectives: Firearm wounding patterns have changed, and patients more commonly present with multiple gunshot wounds (GSWs). We hypothesized that multiple GSW are associated with increased mortality risk and increased hospital length of stay (LOS).

Methods: Medical charts were abstracted for patients with GSW during a 4-month period. GSW to each of six anatomic regions were quantified. Proportions, medians, and trends were compared, and relative risks of death were computed.

Results: Among 111 patients, GSW per patient ranged from 1 to 12. Most (62%) patients sustained GSW to a single region. The median number of regions involved increased with the number of GSW (p < 0.01). Patients with multiple regions injured were more likely to die in the emergency department (16% vs. 12%, p < 0.05) or be admitted (72% vs. 52%, p < 0.01). Intensive care unit and hospital LOS increased (p < 0.05) with the number of regions involved.

Conclusions: Multiple GSW are associated with higher mortality, more intensive care unit days, and longer LOS. Changing wounding patterns seem to have increased morbidity and mortality associated with firearm injuries. These data have associated health policy implications.