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Crossbow Injuries: Predictors of Mortality
Joshua W Julian1, Maxwell L Todd1, Benjamin J Marcheschi1
1Department of Surgery, Division of Emergency Medicine, Saint Louis University School of Medicine, St. Louis, MO.
Wilderness & Environmental Medicine
|March 8, 2024
Summary
Crossbow injuries are rare but dangerous. Broadhead arrows and assaults lead to higher fatality rates, while injury location does not significantly impact survival. Many injuries result from suicide attempts.
Area of Science:
- Traumatology
- Forensic Medicine
- Public Health
Background:
- Crossbow injuries present a significant, yet under-documented, cause of morbidity and mortality.
- Limited medical literature exists to guide the management of these injuries.
Purpose of the Study:
- To review case reports and series of crossbow injuries.
- To identify trends in morbidity and mortality based on arrow type, injury location, and intent.
Main Methods:
- A comprehensive search of multiple databases was conducted for crossbow injury case reports.
- Data from 71 articles describing 90 incidents were abstracted and statistically analyzed.
Main Results:
- Broadhead arrows resulted in a 71% fatality rate compared to 36% for field tip arrows (p=0.024).
- Assaults had an 84% fatality rate, significantly higher than suicides (29%) or accidental injuries (17%) (p<.001).
- Mortality rates were similar across different anatomic locations (head/neck, chest, abdomen, extremities).
Conclusions:
- Crossbows are lethal weapons; broadhead arrows and assaults increase fatality risk.
- Injury location does not correlate with mortality.
- Over half of crossbow injuries are from suicide attempts, with a high case-fatality rate, highlighting a significant public health concern.
