Related Experiment Video
Updated: Oct 8, 2025
A Coupled Experiment-finite Element Modeling Methodology for Assessing High Strain Rate Mechanical Response of Soft Biomaterials
Published on: May 18, 2015
An Evaluation of Firearm Injuries in the Emergency Department
Meltem Songür Kodik1, Öykü Bakalım Akdöner2, Zeyyat Cüneyt Özek3
1Emergency Department, Ege University Faculty of Medicine, İzmir, TUR.
Insights
Firearm injuries significantly impact survival, with lower blood pressure and Glasgow Coma Scale (GCS) scores indicating higher mortality. Head and neck gunshot wounds are particularly fatal, unlike extremity injuries.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Public Health
Background:
- Firearm injuries represent a critical public health issue, contributing significantly to mortality and morbidity.
- Understanding injury patterns and patient outcomes is crucial for developing effective trauma care strategies.
Purpose of the Study:
- To retrospectively analyze firearm injury patterns, imaging findings, treatments, and mortality rates in emergency department patients.
- To identify independent predictors of survival following firearm-related trauma.
Main Methods:
- Retrospective descriptive study of 497 adult patients admitted with gunshot wounds between January 2017 and July 2021.
- Analysis included patient demographics, vital signs (systolic/diastolic blood pressure), Glasgow Coma Scale (GCS) scores, injury site, range of shot, and imaging results (CT scans, X-rays).
- Logistic regression was used to determine factors affecting patient survival.
Main Results:
- Deceased patients had significantly lower systolic blood pressure, diastolic blood pressure, and GCS scores compared to survivors.
- Short-range shots, need for surgical intervention, pneumocephalus on cranial CT, and referrals to neurosurgery or thoracic surgery were associated with higher mortality.
- Referral to thoracic surgery increased death risk 29-fold, while higher GCS scores approximately halved the death probability.
Conclusions:
- Extremity gunshot wounds had no associated mortality, whereas head/neck injuries exhibited the highest mortality rates.
- Lower GCS scores and vital sign instability are strong indicators of poor prognosis in firearm injury patients.
- Timely and appropriate surgical intervention, particularly for thoracic and head injuries, is critical for improving survival outcomes.
Abstract:
Introduction Firearm injuries are a significant cause of mortality and morbidity. Our study aims to evaluate the injury patterns, results of imaging studies, treatment methods, outcomes, and mortality rates of patients who were admitted to the emergency department with firearm injuries. Methods Our study was designed as a retrospective descriptive study. To this end, adult patients who were admitted to our hospital with gunshot wounds between January 1, 2017, and July 31, 2021, were screened. The files of 527 patients who were admitted with gunshot wounds were analyzed. A total of 30 patients were excluded from the study due to missing data. Statistical analyses were performed using the data of a total of 497 patients. Independent variables of the study included sex, age, systolic blood pressure (SBD), diastolic blood pressure (DBD), pulse, respiratory rate, Glasgow Coma Scale (GCS) score, range of shot, injury site, X-ray, cranial CT, thorax CT, abdominal CT, and extremity CT angiography findings, and the need for treatment and referral. Mortality was the dependent variable of the study. A logistic regression model was created to predict factors affecting the survival of the patients who were admitted to the emergency department with gunshot wounds and to identify the independent variables affecting survival. A p-value of <0.05 was considered sufficient for significance. Results The majority of patients who were admitted to the emergency department due to gunshot wounds were male and the median age of the patients was 32 years (18-70 years). The comparison of the descriptive characteristics with respect to survival revealed that the systolic and diastolic blood pressures and GCS scores of the deceased patients were significantly lower than those of the survivors. The rate of shooting at short range was significantly higher in the deceased patients when compared to that of the survivors. In addition, the rate of the need for surgical intervention and the incidence of pneumocephaly in cranial CT were higher in the deceased patients than in the survivors. Significantly higher rates of deceased patients required referral to neurosurgery and thoracic surgery clinics than survivors. The patients who were referred to the thoracic surgery clinic had an increased death rate by 29-fold and the patients who were referred to the thoracic surgery clinic had an increased death rate by about nine-fold. On the other hand, the probability of death was reduced by about half when the GCS scores of the patients were higher. Discussion We evaluated GCS in our patient group and determined a significantly lower score in the patients who did not survive, which agrees with the findings of other studies. Patients with higher SBD and DBD showed a higher probability of survival, which agrees with the results in other studies. Most patients were shot from their extremities and none had died while the death rate was significantly higher in the patients who suffered injuries to the head or neck. The patients with pneumocephalus had a very low chance of survival. Compared to wound care and dressing, patients who received surgical treatment were more likely to die as these patients had more critical injuries. Conclusion Although most injuries were to the extremities, there were no mortalities in the cohort of patients referred to orthopedics. The patients who suffered injuries to the head/neck had the highest mortality rate.
