Emergency Anesthesiology Encounters, Care Practices, and Outcomes for Patients with Firearm Injuries: A 9-Year...

Area of Science:

• Trauma Surgery
• Anesthesiology
• Public Health

Background:

• Firearm injuries contribute significantly to trauma-related morbidity and mortality.
• Optimal anesthesia care and outcomes for firearm injury patients remain incompletely described.
• This study compares anesthesia practices and outcomes between firearm and non-firearm trauma injuries.

Purpose of the Study:

• To examine anesthesia care, resource utilization, and outcomes for patients with acute firearm injuries.
• To compare these factors with those of patients sustaining non-firearm injuries.

Main Methods:

• Retrospective cross-sectional study of adult trauma patients requiring operative management within 2 hours of arrival.
• Data collected between 2014-2022 at a Level 1 trauma center.
• Analysis of clinical characteristics, anesthesiology practices, and intra/postoperative outcomes.

Main Results:

• Firearm injuries showed the largest yearly increase in trauma admissions.
• Patients with firearm injuries were younger, more often male, and received earlier anesthesia care.
• Firearm injury patients had higher rates of invasive monitoring, blood product transfusion, tranexamic acid use, and ICU transfer.
• Intraoperative mortality was similar, but postoperative mortality was lower for firearm injury patients.

Conclusions:

• Anesthesiologists are increasingly managing firearm injury patients, often presenting urgently outside of daytime hours.
• Operating room readiness and robust resuscitation capabilities are crucial for survival.
• Effective hemostatic control measures are vital for favorable outcomes in firearm injury patients.