Civilian perspective of firearm injuries in Bahawalpur

To study the firearm injury patterns, weaponry detail, etiological factors and offered management in civilian population.

The retrospective descriptive cross-sectional study was conducted at the Bahawal Victoria Hospital comprising 297 cases of civilian firearms fulfilling the inclusion criteria from January 2008 to December 2010. Medicolegal record of the hospital's Statistical Department was collected and recorded on a pre-designed proforma.

Of the 297 cases 248 (84%) related to men, and 49 (16%) to women. The age of patients ranged between 10 and 50 years, with a 5: 1 male-female ratio. There was an yearly increase in the number of patients, with 84 patients in 2008; 99 in 2009; and 114 in 2010. Weaponry detail was not available in 89 cases; hand-guns were used in 104 cases; hunting guns in 62 cases; and assault rifles in 42 cases. There were 178 (60%) injuries in civilian clashes; 59 (20%) in homicidal cases; and 30 (10%) in robbery encounters. Limbs were involved in 148 (50%) patients; abdomen injuries in 92 (31%) patients; thorax in 35 (12%) patients; head and neck in 18 (6%) patients; and multiple injuries in 6 (2%). Overall mortality was 36 (12%).

Hand-guns were the commonest weapons in civilian firearm injuries. Civilian clashes were the leading cause followed by homicidal and robbery events. Firearm injuries to the extremities were associated with severe morbidity. Laparotomy was used in the majority of abdominal firearms, while chest intubation was the mainstay in thoracic injuries.