TY - JOUR
T1 - The impact of retained bullet fragments on outcomes in patients with gunshot wounds
AU - Andrade, Erin G.
AU - Uberoi, Megha
AU - Hayes, Jane M.
AU - Thornton, Melissa
AU - Kramer, Jessica
AU - Punch, Laurie
N1 - Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2022/4
Y1 - 2022/4
N2 - Background: Nationally, 115,000 non-fatal firearm injuries occurred in 2017, with many such victims possessing retained bullet fragments (RBFs); however, the impact of RBFs has not been well studied. Methods: An institutional trauma database from an urban, level one trauma center was queried for patients presenting with gunshot wounds (GSWs) to the ED in 2017. GSWs were stratified by the presence or absence of RBFs. Groups were compared using t-tests, chi-squared, and logistic regression. Results: Of 674 patients with GSWs who met inclusion criteria, 394 had RBFs versus 280 with no RBFs. Patients with RBFs were more likely admitted from the ED (57.4% vs. 41.8%, p < 0.001), had significantly higher rates of return to the ED within six months (30.7% vs. 18.6%, p < 0.001), and higher rates of subsequent GSW in the next year (5.1% vs. 1.8%, p = 0.03). On return to ED, 17.6% of those with a RBF had symptoms associated with their RBF. Conclusion: RBFs may represent an unrecognized risk factor for both repeat ED visits and subsequent bullet injury.
AB - Background: Nationally, 115,000 non-fatal firearm injuries occurred in 2017, with many such victims possessing retained bullet fragments (RBFs); however, the impact of RBFs has not been well studied. Methods: An institutional trauma database from an urban, level one trauma center was queried for patients presenting with gunshot wounds (GSWs) to the ED in 2017. GSWs were stratified by the presence or absence of RBFs. Groups were compared using t-tests, chi-squared, and logistic regression. Results: Of 674 patients with GSWs who met inclusion criteria, 394 had RBFs versus 280 with no RBFs. Patients with RBFs were more likely admitted from the ED (57.4% vs. 41.8%, p < 0.001), had significantly higher rates of return to the ED within six months (30.7% vs. 18.6%, p < 0.001), and higher rates of subsequent GSW in the next year (5.1% vs. 1.8%, p = 0.03). On return to ED, 17.6% of those with a RBF had symptoms associated with their RBF. Conclusion: RBFs may represent an unrecognized risk factor for both repeat ED visits and subsequent bullet injury.
KW - Gunshot wound
KW - Recidivism
KW - Retained bullet fragment
UR - http://www.scopus.com/inward/record.url?scp=85108079466&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2021.05.022
DO - 10.1016/j.amjsurg.2021.05.022
M3 - Article
C2 - 34144806
AN - SCOPUS:85108079466
SN - 0002-9610
VL - 223
SP - 787
EP - 791
JO - American journal of surgery
JF - American journal of surgery
IS - 4
ER -